Healthcare Strategic Growth Blog

Tracking the Impact of COVID-19 Using All-Payer Claims Data

By Dave Sellers and Morgan Atkins

In a recent blog post, we took a data-based look at virtual care. We considered the importance of data for growth planning and how All-Payer Claims Data (APCD) provides unique insights that can inform hospitals and health systems as they prepare to respond to the growth of telemedicine.

In this post, we’re once again analyzing APCD, this time looking for COVID-19 trends. We’ve reviewed data trends from January - June of 2020, compared year-over-year numbers to see shifts from 2019 to 2020, and considered pre- vs post-COVID diagnosis code fluctuations. It’s important to note that while we reviewed diagnosis codes related to COVID, there are several which are for negative for inconclusive results. See below for our findings related to gender, age, and care setting shifts.

Early Data Shows the Rapid Shift in How Patients are Receiving Care

By Dave Sellers, Beth Duke, and Lee Ann Lambdin

In a recent blog post on planning for the future of telehealth, we shared tips for how to shift to a more aggressive virtual care strategy. We discussed ways growth planners can embrace telehealth and be better prepared for the future. We also talked about the importance of data while growth planning and how All-Payer Claims Data (APCD) provides unique insights that can inform hospitals and health systems as they prepare to respond to the growth of telemedicine.

We won’t have complete data insights until July as to the full impact of COVID-19 and the resulting rapid adoption of virtual care. The data we do have shows the drastic impact of the virus and the resulting stay-at-home mandates. By tracking the “Telehealth” care setting, we see a momentous spike in virtual care in March of 2020. While the transition to virtual care began to take effect in 2018, it clearly jumped in March of 2020 due to virus concerns. Take a look at claims and encounter data below to see the spike in virtual visits.

How Patients are Utilizing this Convenient Form of On-demand Care

By Daniel Dreaden

Urgent care centers continue to be a popular alternative for patients in need of care that fits their busy schedules. The convenience of these clinics—with longer hours and broader availability—is appealing to patients seeking fast, reliable relief to minor injuries and illnesses. 

As providers look to meet these needs by opening new urgent care clinics, it helps to know the top diseases being treated at these facilities. The list of diseases shown in the infographic below provides a helpful starting point for urgent care placement discussions. 

Track Your Patient’s Journey for More Informed Growth Planning

By Jennifer Beck

As we countdown the days to the 2020 election, political debate over how to improve the US healthcare system continues. A push for lower cost, higher quality care is a top focus for many candidates. Meanwhile, mergers and acquisitions between hospitals and health-care focused companies continue to transpire. These unions often tout similar goals of better care and reduced expenses, though there is debate, of course, over the likelihood of those results. 

No one truly knows what the future of healthcare in the US will look like. But for the immediate future, the shift by insurers and health systems to a value-based reimbursement methodology is already underway.  

In a value-based reimbursement model, providers are compensated for the quality of the care they provide which is measured by patient health outcomes. They are rewarded for effectively managing the health of individuals and populations. 

As value-based reimbursement models become more common, the need for a more team-oriented approach to patient care is also a must. Care must be coordinated across the continuum to deliver the best health outcomes possible.

Uncover the Fundamental Truths Your APCD Should Deliver

By Morgan Atkins and Daniel Dreaden

Not all APCD (all-payer claims data) is created equally. Depending on the data aggregator and clearinghouse used, the APCD offered by any given analytics company can vary significantly.

When choosing a partner to provide your APCD, it can be difficult to discern what’s most important. Many incentives offered may sound nice to have, but could also be distractions to keep you from noticing more critical features that are lacking. As you consider your options, keep these three questions in mind:

• Does this APCD provide patient cohort tracking?
• Will you be able to access submit and remit data?
• Is there transparency into what is being modeled and how?

Let's discuss in more detail each of these questions and why it’s critical to have these clearly answered before signing on with an APCD provider.

A More Efficient Way to Boost Revenue and Attract Patients

By Tony Camarata

Historically, market performance has been measured through market share, a single snapshot of patients treated. While market share can be used to measure market position, it fails to deliver the complex intricacies of patient choice, which are vital to improving care delivery. Hospitals planners need better visibility into the full continuum of patient choice in order to deliver the right services for their patients.

Share of wallet provides this added visibility by not only showing the patient treatment snapshot, but also showing everywhere else your patients are utilizing care. These insights will lead your team down the path of determining if you can provide that same care to your patients and potentially attract them to choose your hospital over your competition.

Effectively Leverage Your Data for Maximum Growth Insights

By Lee Ann Lambdin, Kola Omotade, Tony Camarata

Are you asking the wrong questions of the right data; or the right questions of the wrong data? Most healthcare strategic planners understand the value of using data for informed decision making, but many don’t know how to effectively use data—or when to acquire new data—to find the answers they need.

When looking to assess market share or performance, you may feel the datasets you already have access to will provide the answers you need. But what if you don’t have the right data to answer these particular questions? Using the wrong data, you may miss important segments of your population in your analysis and risk using out-of-date or inconsistent data. A new data set all together may be needed to properly address the issues at hand.

Why You Need Both for Growth Planning and Physician Relations

By Haley Attridge, Tony Camarata, Rebecca Groner, Lee Ann Lambdin, and Dave Sellers

Every hospital and healthcare system looking to grow could benefit from reliable, clean, and standardized healthcare patient data. It’s critical for strategic planners and physician liaisons, in particular, to have access to data they can trust when looking to expand offerings, build physician relationships, and improve accessibility to care for their service area.

We recently compared state and CMS datasets and discussed how to sort through the complexities of both to extract valuable insights. If you missed that post, we encourage you to check it out, here.

In this post, we’re analyzing state and all-payer claims data. We’ll explore how these datasets differ, why they differ, and how, when armed with insights from both datasets, planners and liaisons can gain a more complete picture of the opportunities within their market.