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October 16, 2020 . Ursa Health

A new solution for participants in CMS's Primary Cares Initiative

Blog 2020

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NASHVILLE, Tenn., October 16, 2020—In response to the Centers for Medicare & Medicaid Services announcement of its new Primary Cares Initiative, Ursa Health has released a version of Ursa Studio, its ground-breaking analytics development platform, that will make it easier for organizations to meet the initiative’s goals. The Primary Cares Initiative is designed to spur value-based transformation in primary care by reducing administrative burdens, which will in turn accelerate innovations that improve both outcomes and the healthcare experience for Medicare beneficiaries.

Explained Robin Clarke, M.D., Ursa Health’s chief executive officer, “CMS is looking to broaden providers’ participation in value-based care by opening up its programs, shifting from pre-defined structures to more provider-designed initiatives. Correspondingly, the measures of success are based less on the reporting of formulaic processes of care and more on improving meaningful population health outcomes. These shifts are designed to help providers deliver innovations customized to the needs of their particular patient populations, healthcare ecosystem, and regions. Ursa Studio creates the precise analytics that inform decision-making and enable these successful transformation stories.”

With Ursa Studio, organizations have a complete set of healthcare data management, analysis, visualization, and communication tools, all in one HITRUST® CSF Certified platform. As a unified solution, the application streamlines the necessary IT infrastructure, answers clinical, operational, and financial questions, and eliminates the need for complicated, time-consuming coding. Key capabilities include:

  • A healthcare content reference library, synthesizing international code sets, best-in-class third-party resources, and Ursa Health’s proprietary intelligence, that can be used to enrich an organization’s existing claims and electronic medical record (EMR) data
  • No-code data modeling that allows organizations to quickly and accurately integrate and transform raw data to create the building blocks for healthcare analytics, including integration connectors to EMR and claims sources; a unified, longitudinal patient record; and accurate provider attribution logic
  • Out-of-the-box population health content in the form of clinical, operational, and financial measure sets that deliver foundational insights in month one, as well as fully flexible claims and EMR data models for efficiently building innovation-specific analytics
  • Data integrity tools that seamlessly capture all the micro-decisions made as raw data transforms into useable insights, avoiding definitional conflicts and other maintenance challenges while ensuring that any upstream change in a definition automatically finds its way into all downstream uses
  • No-code analytics authoring that accelerates the development of new answers by reducing report-writing cycles and freeing up technical and business/clinical teams to collaborate more effectively
  • Visualization and communication tools that allow organizations to distinguish true signal from noise and share key findings efficiently, fostering greater collaboration

Administered by the CMS Innovation Center, the CMS Primary Cares is a set of five voluntary payment model options that focus on supporting advanced care for patients who have chronic conditions and serious illnesses:

  • The two Primary Care First (PCF) models (standard and high need populations) will compensate primary care practitioners and other clinicians according to easily understood outcome-based performance measures, with the goal of reducing total Medicare expenditures while maintaining or enhancing care. Providers will receive a simplified total monthly payment that allows them to focus on patient care rather than revenue cycle management. Higher payments will be made to practices that specialize in care for high-need patients, including those with complex chronic conditions and seriously ill populations.
  • The three Direct Contracting (DC) models (professional, global, and geographical) are similar to the PCF models in their goal of transforming primary care. However, while the PCF models focus on individual primary care practices, the DC payment model options hope to spur engagement from organizations with experience taking on financial risk and serving larger populations, such as accountable care organizations (ACOs), Medicare Advantage plans, and Medicaid managed care organizations. Depending on the model, participants will receive a fixed monthly payment that can range from a portion of anticipated primary care costs to the total cost of care.

(Photo by Clay Banks on Unsplash)

 

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