Ursa Health has introduced new capabilities to Ursa Studio, its ground-breaking 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. A redesign and rebrand of the Global Professional Direct Contracting (GPDC) Model, the ACO REACH Model seeks to further the goals of value-based healthcare transformation based on feedback from earlier Direct Contracting initiatives, with a specific focus on health equity.
Explained Robin Clarke, M.D., Ursa Health’s chief executive officer, “As CMS works to help shift the healthcare delivery system toward provider-defined initiatives, it’s encouraging to see that the lessons learned along the way are incorporated into new payment models. The challenge facing innovators participating in these models, however, is that traditional analytics tools can’t keep up with the pace of change. Ursa Studio’s combination of no-code technology and prebuilt content ensures that organizations can not only adapt quickly to meet these and other emerging requirements but also fully customize their analytics to their particular 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 an array 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 business.
Key capabilities for ACO REACH participants include Ursa Health Data Integration Modules designed specifically to accelerate the process of mapping new data sources into fully enriched, analytics-ready data model tables. Participants in the ACO REACH Model will need 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 analytics.
In addition, participants can access Ursa Health Analytics Modules, which blend domain knowledge, data assets, and analytics best practices to help organizations generate critical insights from their data within 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 tweak, clone, or extend transformations in seconds using the no-code interface, generating powerful, trustworthy, 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 immediate access to the Ursa Health Population Health Foundations Module, which includes performance measures covering essential concepts related to utilization and financial performance, as well as data marts with key patient features and risk factors, such as socioeconomic deprivation, chronic disease burden, primary care provider attribution, 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 has made this a foundational concept throughout Ursa Studio. The first step in addressing health equity is to measure where important disparities occur. 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 swiftly analyze the relationship between equity and performance, allowing risk adjustment refinement and the implementation of interventions that drive outcomes. Ursa Studio also includes SVI’s individual component measures, so users can probe 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 physicians and other healthcare providers continue to play a primary role in accountable care, participating providers or their designated representatives must retain at least 75 percent control of each ACO’s governing body, versus 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 hold voting rights.
- To ensure participants’ interests align with CMS’s vision, CMS will require additional information on applicants’ ownership, leadership, and governing board. CMS plans to increase both the screening of applicants and the monitoring of program progress, sharing more information on 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 January 1, 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.
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