NASHVILLE, Tenn.–(BUSINESS THREAD)–Ursa Health has introduced new capabilities to Ursa Studio, its groundbreaking healthcare analytics development platform, to help organizations meet the requirements of the Centers for Medicare & Medicaid Services (CMS) ACO REACH (Accountable Care Organization Realizing Equity, Access, and Community Health) Model. The ACO REACH model, a redesign and renaming of the Global Professional Direct Contracting (GPDC) Model, seeks to advance the goals of value-based healthcare transformation, based on feedback from earlier Direct Contracting initiatives, with a specific focus on health equity.
Explains Robin Clarke, MD, Ursa Health’s CEO, “As CMS works to help shift the healthcare delivery system toward provider-defined initiatives, it’s encouraging to see the lessons learned along the way translated into new payment models are being incorporated. However, the challenge faced by innovators participating in these models is that traditional analytics tools cannot keep up with the pace of change. Ursa Studio’s combination of no-code technology and pre-built content ensures that organizations not only can quickly adapt to meet these and other emerging requirements, but also fully adapt their analytics to their specific patient populations, healthcare ecosystem and clinical model.”
Ursa Studio spans the full breadth of healthcare data work in one no-code platform, including raw data ingestion and integration, data modeling, analytics development and business intelligence. Organizations can use Ursa Studio in its entirety, avoiding the need to manage a variety of point solutions, or use the components of the platform that fill gaps in their existing infrastructure to optimize existing investments. Either way, the platform helps teams replace non-strategic modeling, management and validation activities with high-value analytics development work that can guide clinical, operational and financial areas of the enterprise.
Key capabilities for ACO REACH participants include Ursa Health data integration modules specifically designed to accelerate the process of mapping new data sources into fully enriched, analytics-ready data model tables. Participants in the ACO REACH Model will be required to work with Claim and Claim Line Feed (CCLF) data files as well as program specific file layouts such as Weekly Reduction, Assignment List reports, provider alignment files and performance reports. The Ursa Health Data Integration Module for CCLF/ACO REACH essentially automates the wrangling of these various files to unlock any and all downstream analysis.
In addition, participants have access to Ursa Health Analytics modules, which blends domain knowledge, data assets and analytics best practices to help organizations generate critical insights from their data in just weeks. All out-of-the-box logic is built with Ursa Studio, with ‘white box’ visibility down to the SQL code level. Organizations can adapt, clone or extend transformations in seconds using the no-code interface, generating powerful, reliable, localized opportunities that analytics consumers actually believe.
For example, the Ursa Health ACO REACH module generates program performance measures and uncovers their underlying drivers to better understand opportunities for improvement, including CMS-specified ACR, UAMCC, and TFU measures. In addition, all Ursa Studio users get instant access to the Ursa Health Population Health Foundations module, which includes performance metrics covering essential concepts related to utilization and financial performance, as well as data marts with key patient characteristics and risk factors, such as socioeconomic deprivation. , chronic disease burden, attribution of primary care providers and plan membership status. Organizations can add additional issue-specific modules as their needs evolve and change, such as modules for pharmacy optimization, chronic kidney disease management and preventable hospital utilization management.
All analytics modules are “health equity enabled,” meaning that Ursa Health has recognized the need to view data through this important lens and made it a fundamental concept throughout Ursa Studio. The first step in addressing health equity is to measure where important inequalities exist. Ursa Studio’s core measures include the University of Wisconsin’s Area Deprivation Index (ADI) and the CDC’s Social Vulnerability Index (SVI), composite scores that reflect regional variation in socioeconomic deprivation. Ursa Studio users can quickly analyze the relationship between equity and performance, enabling risk adjustment refinement and the implementation of interventions that drive outcomes. Ursa Studio also includes SVI’s individual component measures, so users can examine the specific effects of household composition, transportation access, minority status, and language barriers, among others.
The ACO REACH model incorporates changes to the GPDC model in three important areas:
To better support care delivery and coordination for patients in underserved communities, each model participant must design and implement a comprehensive health equity plan that identifies its underserved communities and establishes initiatives to measurably reduce health disparities within their beneficiary populations.
To ensure that physicians and other health care providers continue to play a primary role in accountable care, participating providers or their designated representatives must maintain at least 75 percent control of each ACO’s governing body, up from 25 percent during the first two performance years of the GPDC model . In addition, at least two beneficiary advocates (one Medicare beneficiary and one consumer advocate) must be on the governing board and have voting rights.
To ensure that participants’ interests are aligned with CMS’s vision, CMS will require additional information about applicants’ ownership, leadership and governing board. CMS plans to increase both the screening of applicants and the monitoring of program progress, by sharing more information about the participants and their work to improve care. The agency will also explore stronger protections against inappropriate coding and risk score growth.
The GPDC model will transition to the ACO REACH model on 1 January 2023, with the model performance period running through 2026. Provider-led organizations interested in joining the ACO REACH model must agree to meet all of the model’s requirements by January 1 to participate.
About Ursa Health
Ursa Health transforms analytics so innovators can transform healthcare. Our analytics development platform, Ursa Studio, combines no-code technology with healthcare-specific content, enabling health plans, providers, digital health companies and others to take a Buy Your Build™ approach to their analytics infrastructure. With the structured adaptability of Ursa Studio, organizations can fully utilize their rich data sources to accelerate growth. To learn more, visit www.ursahealth.com.