Zimmet Healthcare Services Group on Thursday launched an analytics platform specifically targeting financial and reimbursement professionals in the skilled nursing space.
Providers’ data needs are only likely to grow with the implementation of the Patient-Driven Payment Model (PDPM) on October 1, 2019.
“There’s going to be tremendous variation in nursing home Medicare expenditures [with PDPM], whereas now, there’s not as much because of the way Medicare reimbursement works,” Vincent Fedele, partner and director of analytics at the New Jersey-based Zimmet Healthcare, told Skilled Nursing News. “It’s going to be important to measure your episodic spend by PDPM category.”
The CORE UB-04 platform was launched as a distinct company by the consulting firm this month, and it draws upon Medicare claims data to generate insights into the value provided by a given SNF. It uses the public Medicare claims file, analyzed through various methods, to track referrals from hospitals; current Medicare claims data that a facility submits every month to provide insights based on PDPM category; and clinical information from the Medicare claims to compare the score that sets the payment rate from PDPM to diagnosis coding.
The cost to facilities will vary based on how many beds they have and how many facilities are in a given portfolio, Fedele told SNN. The average price is around $300 a month, but he noted that a large metropolitan facility will be paying more than a small rural one.
The database also embeds hospital metrics that are formatted to highlight post-acute referral patterns, as well as the efficiency and quality of local competitors.
“Today’s SNF performance analytics either rely on dated [Minimum Data Set]-driven elements that offer limited financial insight, or historic public claims that lack important variable-sensitivity,” Zimmet Healthcare and CORE president and CEO Marc Zimmet said in a press release announcing the launch of the tool. “We got tired of explaining to our clients that the reporting they purchased had little practical relevance. SNF stakeholders need one standard tool that measures outcomes, episodic spend and variable care-cost related to current activity.”
Written by Maggie Flynn