Care Accelerator

Care Accelerator offers leading financial and clinical signals delivered within hours of data availability to maximize care coordination and financial performance. CareJourney has identified that numerous partners face challenges with short clinical timeframes, delayed financial outcomes, and incomplete ADT insights. To best help VBC leaders maximize their impact, Care Accelerator takes advantage of the claims recency offered for both adjudicated and pre-adjudicated claims through the Beneficiary Claims Data API (BCDA) and curates only the metrics that matter for clinically relevant insights. It offers organizations the benefits of reducing operational costs and risk, speeding up insights, streamlining integration, and providing easily adaptable metrics. It also seamlessly integrates into workflows, helping prioritize patient care, identify gaps, prevent duplication, detect rising risks early, address coding gaps, and integrate patient data into clinical tools through multiple methods. Data sources: The primary data source for CMS Claims data is BCDA, although it can also be obtained from other sources such as payer APIs or payer-provided claim files. Each view is organized by: - Curated Beneficiary and Claim Information - Operational Events and Measures Curated Beneficiary and Claim Information: - Claim Service Line - Pharmacy Claim Service Line - Claim Beneficiary Operational Events and Measures: - New Diagnoses - Chronic Conditions - Last Screening Date - Most Seen Primary Care Physician - Frailty Score and Patient Segmentation - Patient Events (Admissions, Discharges, Professional, Visits, Diagnostics) - Preventive screenings - Annual Wellness Visit - Colorectal Cancer Screening - Breast Cancer Screening - Fall Risk - Depression

搜集汇总

背景与挑战

背景概述

Care Accelerator数据集通过整合BCDA等渠道的索赔数据，提供临床相关指标和财务信号，帮助医疗机构降低运营风险并优化患者护理流程。其核心内容包括受益人索赔明细、慢性病管理、预防性筛查等操作事件指标，支持早期风险识别和临床决策。