Predictive Analytics And
Predictive Analytics andSimulation to MaximizeIncentive Payments andEliminate PenaltiesVicky Mahn-DiNicola RN, MSVice President ClinicalAnalytics & ResearchMedisolv, Inc.MEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Today’sDiscussionPoints1. How predictive and prescriptive analyticsare useful to maximize value-basedpayments2. How simulation can be used to create thebest plan of action3. Impact of distribution of national measureperformance on your regulatory penaltiesand incentive payments4. Things to consider when choosing avendor for assistanceMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Analytics: Improving Insight and Business ValuePrescriptive AnalyticsWhat should happen?ValuePredictive AnalyticsWhat will happen?DescriptiveAnalyticsWhat happened?Statistics, planningDiagnostic AnalyticsWhy did it happen?Ad hoc query, data miningReporting, ion, tConcurrent“Big Data”AdvancedAnalyticsDifficultyOriginal Source: Gartner Business Intelligence & Analytics Summit 2013MEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Predictive and Prescriptive Analytics DefinitionPredictive analytics is a data miningpractice of extracting information fromexisting data sets in order to determinepatterns and statistical models topredict future outcomes and trends.Prescriptive analytics is dedicated tofinding the best course of action for agiven situation and the impact ofconsidering a solution on a futureoutcome or trend.Both may involve “machine learning” and “statistical learning” techniquesto “learn” which variables correlate to trends or outcomes.MEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
How is Machine Learning Used Today? National security and law enforcementPolitical campaigningMeteorology and weather forecastingNetflix and Amazon product recommendation systemsTargeted marketing by major retailersEmail spam and junk filtersSelf driving carsMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Healthcare Industry’s Big Question Where can advanced analyticmethodologies be applied to accelerateprogress in transforming healthcaredelivery?“If we could know X then we could DO Y”Medisolv’s Big Question How can advanced analytics be used toreduce regulatory penalties and increaseincentive payments?Medisolv’s Answer Predictive and prescriptive analytics to forecastperformance so hospitals can be more focusedand proactive in their performance improvementMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Timeline for Influencing Penalties andIncentive Payments for CMS FY 2022(Aggregate Timelines Across CMS Hospital Value-based Purchasing,HAC Reduction and Readmission Reduction Programs)Estimated PaymentAdjustments AvailableJuly – August 2021Baseline ReportsAvailableBaseline PeriodApril 1, 2012 to December 31, 201820122013201420152016July 20192017201820192020Performance PeriodApril 1, 2017 to December 31, 202020212022Payment PeriodOctober 1, 2021There are only three weeks left to influencefinancial impact for FY 2022 penalties andincentive paymentsMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Timeline for Influencing Penalties andIncentive Payments for CMS FY 2023(Aggregate Timelines Across CMS Hospital Value-based Purchasing,HAC Reduction and Readmission Reduction Programs)Estimated PaymentAdjustments AvailableJuly – August 2022Baseline ReportsAvailableBaseline PeriodApril 1, 2013 to December 31, 2019July e PeriodApril 1, 2018 to December 31, 202120222023Payment PeriodOctober 1, 2022There are only about 12 months left toinfluence financial impact for FY 2023depending on the measureMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Timeline for Influencing Penalties andIncentive Payments for CMS FY 2024(Aggregate Timelines Across CMS Hospital Value-based Purchasing,HAC Reduction and Readmission Reduction Programs)Estimated PaymentAdjustments AvailableJuly – August 2023Baseline ReportsAvailableBaseline PeriodApril 1, 2014 to December 31, 2020July 202120142015201620172018201920202021Performance PeriodApril 1, 2019 to December 31, 2022202220232024Payment PeriodOctober 1, 2023Medisolv advanced analytics will provide ourclients with insights to help them improve theirperformance up to 20 months before the end ofthe FY 2024 performance period!MEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Medisolv Analytics Methodology toMaximize Payments Data for computations and estimates for 64 measures isaccessed from CMS Hospital Compare Website(data.medicare.gov) for all US Hospitals that participate inone or more of the three hospital regulatory reportingprograms during FY 2015-2018ü CMS Hospital Value Based Purchasing Programü CMS Hospital Acquired Conditions Reduction Programü CMS Hospital Readmission Reduction ProgramHistorical data is extracted from zipped hospital flat tablesThe financial data used to compute the base operating rateand base operating payment are extracted from the IPPS finalrule and correction notice data files and tablesData is updated and refreshed quarterlyFuture performance scores, performance percentiles andfinancial gains/losses calculated using machine learning andstatistical learning techniquesMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
MortalityMortalityMortalityMost Machine Learning Models are Evaluated Using Regression AnalysisCardiogenic ShockEjection FractionEducational LevelImportant to coach clinical stakeholders so they don’t confuse correlation with causation!MEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Hospital Cost in ThousandsRegression Draws the Best Line of Fit Through the Cloud252015My best guess is thatpatients with a LOSof 5 days have costs ofabout 15K .but thereis also variability1015LOS as Predictor10MEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Evaluating Linear Regression ModelsHospital Costs in ThousandsContinuous Variables like LOS, ChargesMeanAbsoluteError 1.5252015Mean Absolute Error explains the variationaround your best guess1015LOS as Predictor10MEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Evaluating Logistic Regression ModelsMortality following Colon ResectionBinomial variables like mortality or readmissionsC- StatisticThe area under the curveexplains the probability of yourbest guess isn’t random .5 to .6 random.6 to .7 adequate.7 to .8 good.8 to .9 very good.9 excellentSleep apnea as PredictorMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Machine Learning Using Time Series Analysis Statisticaltechniques areused by datascientists to take alarge set ofhistorical “trainingdata” to forecastfuture trends with ahigh degree ofaccuracyMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Strong CorrelationBetween MedisolvPredictive Scoresand Actual Scoresfor FY 2018Initial predictive models trained on CMS FY 2015-2017 data.Medisolv ran a FY 2018 Forecast through the model and compared toactual results published for FY 2018. High correlation demonstratedbetween actual and predicted total performance scores.MEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Two Types of Simulation“What If” SimulationWhat will be the financial impact if Iimprove my performance in selectedmeasures?What if I improvenurse communicationfrom the 38thpercentile to the 50thpercentile?üCheck ideas you have about areas inwhich you are currently focused on forimprovement or considering as a futureimprovement priorityüUnderstand the potential financial impactof moving the needle on your performanceüDynamic data display lets you seefinancial impact for changing performanceMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Two Types of SimulationüProprietary algorithms provide a “shortlist” of recommended measures andperformance targets (scores andpercentiles) that are mathematically themost efficient way to achieve yourfinancial goalWhat is the mostefficient way toincrease ourincentive paymentsfrom 12K to 350K?“How To” Simulation What performance do I need toachieve a desired financialtarget? Which measures will give me themost “lift” towards my desiredfinancial goals?MEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Medisolv How To Simulation toMaximize PerformanceEach measure (for each hospital and for each quarter) is evaluated for: Net gain financial gain achieved with each measure score “leap” (0-10) Effort Change in performance/range in performance across US Efficiency Net gain/effortIn other words .we do a comparison of the effort it takes to leapfrogpast other US Hospitals to the level of financial gain you will receivefor that leap relative to your performance with other measures andthe performance of all other hospitalsNet gainEffortEfficiencyMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Which of these measures should you focus on? USA General Hospital is a 275-bed hospital with 40M of annual Medicare revenue.In the Hospital VBP Program they had a maximum potential incentive payment of 495K.Medisolv estimated that they would net 12,960k incentive payment for FY 2022.They want to aim for 495K in payments.Which measurement improvement strategy is the most efficient?- ( 33,326)- ( 345,511) 12,376MEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
More Insight if You Know the Percentile LeapMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Best Insight if You Understand the DistributionFinancial gains depend on distribution of performance for all US Hospitalsand where your hospital is in the distributionA little improvement when yourperformance is slightly less thanthe central tendency yieldsbigger pay offsSmaller pay offs for a lot ofimprovement can be seen indistributions with large tailsAlmost no added payments formeasures that are approachingstatistical top offVendors must evaluate the distribution on both known and forecasted results!MEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Communication with DoctorsSmall financial gain for big improvementEfficiency Score 3.79I have to surpass the performanceof about 1600 other US hospitalsto make a net gain of 92,966- ( 33,327)29.66 Percentile 59,63987.98 PercentileMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Impact of getting to zero CLABSIModerate financial gain for big improvementEfficiency score 5.74I have to surpass the performanceof about 950 other hospitals tomake a net gain of 104,942 117,3186.85 Percentile 12,37656.22 PercentileMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Medicare Spending per BeneficiaryLarge financial gain for small improvementEfficiency score 54.41I have to surpass the performanceof about 450 other hospitals tomake a net gain of 209,885- ( 135,627)39.37 Percentile- ( 345,512)54.06 PercentileMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Medisolv Value MaximizerDashboardMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Medisolv Summary ReportMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Medisolv Value MaximizerDomain DetailMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Medisolv Value MaximizerDomain Time Trend AnalysisMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Medisolv Follows the Mathto Find the Most Efficient PathMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Medisolv Follows the Mathto Find the Most Efficient PathMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
Analytics Vendor Evaluation Check Listfor Value Payment Forecasting and SimulationqqqqqqqqqqqqqqqqIncludes all measures in all three CMS programsTrends evaluated for all US Hospitals (not just vendor’s clients)Forecasts available through CMS FY 2023 (2024 available in April)Distributions of both actual results and forecasts evaluatedPerformance can be displayed as scores, percentiles, rates (including excessreadmissions)Data refreshed quarterlySimulation available for client selected measuresOptimization targets and recommendations providedRecommended targets can by adjusted by userTargets and recommendations can be saved for later reviewSupports multi-facility analysisNo software installation or complex implementation to view forecastsAccessed via the Web on PC or mobile technologyDrill down on value payment measures to encounter and provider detailTransparent vendor methodologyHigh correlations demonstratedMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
For More Information Please contact us for a full tour of the MedisolvValue MaximizerContact Information– vdinicola@medisolv.com– 520-990-0876– For more information about Medisolv Solutions seehttps://medisolv.com/solutions/– Or call us at 1-800-MEDISOLV or email us at– info@medisolv.comMEDISOLV.COM 2020 Medisolv, Inc. All Rights Reserved
WHEN YOU RETURNOur next presentation will be in the main workshop room.Click the link found in your calendar invitation toreturn to the main session.
YOU ARE HERE§ 1:00-1:10: Break§ 1:10-2:00: The 2021 “Voluntary” Electronic MeasuresJoin this session by clicking the mainworkshop link found in your calendarinvitation or confirmation email.§ A review of the specifications and steps for implementingBREAKthe Hybrid Hospital-Wide 30-Day Readmission measure andthe Safe Use of Opioids - Concurrent Prescribing eCQM.
Analytics: Improving Insight and Business Value n Difficulty e Descriptive Analytics What happened? Reporting, dashboards Diagnostic Analytics Why did it happen? Ad hoc query, data mining Predictive Analytics What will happen? Statistics, planning Prescriptive Analytics What
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predictive analytics and predictive models. Predictive analytics encompasses a variety of statistical techniques from predictive modelling, machine learning, and data mining that analyze current and historical facts to make predictions about future or otherwise unknown events. When most lay people discuss predictive analytics, they are usually .
The Predictive Analytics Modeler career path prepares students to learn the essential analytics models to collect and analyze data efficiently. This will require skills in predictive analytics models, such as data mining, data collection and integration, nodes, and statistical analysis. The Predictive Analytics Modeler will use tools for market
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In-Database Analytics: Predictive Analytics, Oracle Exadata and Oracle Business Intelligence Charlie Berger Sr. Director Product Management, Data Mining and Advanced Analytics . 12 years ―stem celling analytics‖ into Oracle Designed advanced analytics into database kernel to leverage relational
Totally 25 articles based on the predictive analytics were surveyed, and the primary sources, the strategies followed and the challenges in the adoption and the accuracy in prediction was reviewed. The remaining paper is organized with the predictive analytics in section 2, the uses of big data predictive analytics in
organization. Upon reading this paper, you should be able to get started crafting a predictive analytics program and choosing partners who can ensure your success. PREDICTIVE ANALYTICS PRESENTS IMPORTANT USE CASES DRIVING COSTS DOWN AND QUALITY UP Healthcare presents the perfect storm for predictive analytics. The digitalization of the clinical
