Data Analytics
2018 AHCA/NCAL Annual Convention
Vincent Fedele, MBA
Partner & Director of Analytics
Zimmet Healthcare Services Group, LLC
Sheryl Rosenfield, RN, BC
Partner, Director of Clinical Operations
Zimmet Healthcare Services Group
Fee-for-service (FFS) performance has historically been defined by an SNF’s Medicare per diem rate and average length of stay. As unbridled FFS disappears from the post-acute care reimbursement landscape, value-based incentive payment systems necessitate more sophisticated measures of SNF performance. Health systems and insurance companies demand quantifiable, measurable, and comparable outcomes data, unbiased by the qualitative nature of concurrent patient conditions. Accordingly, SNF episodic revenue (or cost to the payer), rehospitalization rates, and functional improvement cannot be taken at face value. Dynamic variables must be case-mixed and demographically adjusted to calculate accurate measures of quality. If they don’t identify and neutralize bias, SNFs risk unbalancing the care/payment equation associated with risk-based payment models that continue to gain traction with insurance companies and care management concerns. The Minimum Data Set (MDS) has been the go-to source for comparative quality and predictive analytics intelligence. However, the MDS was not designed to serve in this capacity; it lacks the important cost elements that are readily available on the UB-04. This program will include case studies that demonstrate how to aggregate, interpret, and report intelligence beyond the MDS. The presenters (a registered nurse with 30-plus years of SNF experience and a risk management expert) will introduce the next-generation analytics required to reconcile care delivery to new payment models. They will explain how to distill key dependent qualitative variables that drive cost. In short, the session is designed to connect the human condition to business intelligence, and in doing so empower providers to balance the care/payment equation for years to come.
Partner & Director of Analytics
Zimmet Healthcare Services Group, LLC
Email Address: vincent@zhealthcare.com
Telephone Number: (732) 970-0733
DA-5 - Next-Generation Analytics: Positioning for Success in 2020
Tuesday, October 9
2:30 PM – 4:00 PM
Partner, Director of Clinical Operations
Zimmet Healthcare Services Group
Email Address: Sheryl@zhealthcare.com
Telephone Number: (732) 970-0733
DA-5 - Next-Generation Analytics: Positioning for Success in 2020
Tuesday, October 9
2:30 PM – 4:00 PM
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