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Midas+ Xerox

Midas+ Xerox. Hospital Readmission Penalty Forecaster. Hospital Readmission Reduction Program Penalties Forecasted to Impact More Hospitals in Future. Acute Myocardia Infarction Pneumonia Heart Failure Total Hip and Knee COPD CABG.

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Midas+ Xerox

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  1. Midas+ Xerox Hospital Readmission Penalty Forecaster

  2. Hospital Readmission Reduction ProgramPenalties Forecasted to Impact More Hospitals in Future • Acute Myocardia Infarction • Pneumonia • Heart Failure • Total Hip and Knee • COPD • CABG 64% US hospitals had penalties and 18 had a full 2% reduction of their base operating DRG FY 2014 CMS estimates only 39 hospitals will be subject to maximum 3% reduction in FY 2015 Midas+ Xerox estimates 80% of all hospitals will be penalized in FY 2017 FY 2015 FY 2016 FY 2017

  3. Excessive Readmission RatiosValues > 1.0 = Financial Penalties ERR Your Hospital OtherHospitals

  4. Hospital Readmission Reduction ProgramPenalties Forecasted to Impact More Hospitals in Future • Acute Myocardia Infarction • Pneumonia • Heart Failure • Total Hip and Knee • COPD • CABG Excess Readmission Ratio’s > 1 in ANY one of the clinical cohorts results in financial penalties Excess Readmission Ratio = Predicted /Expected

  5. A Primer on Predicted and Expected Excess Readmission Ratio = Predicted /Expected Your hospital provider Intercept (July 1, 2011 - June 30, 2014) Risk Coefficients (July 1, 2011 – June 30, 2014) Your patient’s risk factors for FY 2016 Part A & B Claims (July 1, 2010 – June 30, 2014) Predicted FY 2016 + = x Average hospital provider intercept for all Section(d) Hospitals in US (July 1, 2011 – June 30, 2014) Risk Coefficients (July 1, 2011-June 30, 2014) Your patient’s risk factors for FY 2016 Part A & B Claims (July 1, 2010 – June 30, 2014) Expected FY 2016 + = x

  6. FY 2017 Financial Penalties Will Be Determined by June 30, 2015 We have less than a year to impact these values! July 2011 to June 2015 August 2016 July 2012 to June 2015 October 1, 2016 • Risk Factors • Risk Coefficients • Hospital Specific Reports • Adjusted Payments Begin

  7. Midas+ Advanced Analytics • Five years of Medicare data linked with your patients in Midas+ to replicate CMS risk models proactively • Adjusted readmission rates to account for non-same hospital readmissions • See predicted and expected readmission rates for your hospital nearly two years before CMS provides you with your hospital specific reports • Prioritize which clinical cohorts have the greatest risk for financial penalty and the greatest opportunity for improvement • Patient level risk coefficients to drive quality improvement across your organization

  8. Midas+ Predictive Analytics Creates a Proactive Response Strategy…… July 2012 to June 2015 July 2011 to June 2015 October 2016 August 2016 TODAY! Risk Factors and Risk Coefficients calculated from Medicare Part A & B Claims July 1, 2011 – Dec 31, 2013 + Midas+ Data Jan 1, 2014 to date + Midas+ Predictive Analytics Midas+ Hospitals can prioritize and intervene high risk populations to impact financial penalties two years before they apply!

  9. Understanding Your Tipping Point • Which populations are at greatest risk? • How many readmissions are too many?

  10. Identify Hospitals and Populations at Highest Risk for Readmission Penalties 2 Years Earlier!

  11. Call Us Today to ScheduleYour Hospital Readmission Reduction Engagement 800.737.8835 orwww.midasplus.com

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