Surgical Episodes of Care
With the evolution of Bundled Payment programs and increased value-based performance payor agreements, utilizing apples to apples comparisons of cases across the full episode of surgical care can drive up to 10X greater value in reducing unwarranted clinical variation
Where it matters:
- Provider-owned Health Plans
- CMS Bundled Payment Programs
- Commercial At-Risk Performance Contracts
- Shoppable Procedures
Example of Opportunities Identified:
- Reducing cost by performing a surgery at an ambulatory surgery center versus the hospital operating room
- Reducing operating room time, improving outcomes and reducing cost by not performing a common secondary procedure
- Reducing cost and improving outcomes by sending a patient to in-home rehab versus inpatient rehab
- Utilizing an alternate medication that impacts inpatient length of stay and medication cost with the same, if not better, outcomes
As an example of Empiric’s evaluation of Surgical Episodes of Care, Empiric uses Data Science and Machine Learning to identify unwarranted clinical variation in Claims Data through a process of cohorting, variation targeting, K-Means clustering and articulation of opportunity
Laparoscopic Cholecystectomy
Cohort Family
Laparoscopic Cholecystectomy Outpatient Adult Payor Medical Claims
K-Means Clustering
Identify Opportunities
