Archway Health Offers First Patient Case Mix Analytics Tool for BPCI Advanced Participants
Summary
Believed to be the first of its kind, Archway’s PCMA function complements the existing patient-specific target pricing features of Archway Analytics to further aid providers in achieving savings in the program. With the introduction of BPCI Advanced in 2018, CMS began adjusting providers’ target prices to account for patient population factors out of their control such as age, comorbidities, and dual eligibility. “Providers applauded the patient case mix adjustment in BPCI Advanced, but the variation has also made it difficult for providers to know how they will perform until the moment of truth – known as reconciliation – six months later,” said Keely Macmillan, SVP of Policy & Solutions Management. As the healthcare landscape continues to shift towards value-based payment models, these insights are critical for understanding the mechanics of reimbursement and ultimately, achieving savings in programs like BPCI Advanced. Archway is currently working with leading healthcare providers participating in risk-based contracts including CMMI bundled payment programs such as BPCI Advanced, OCM, and CJR.