ServData

ServData has developed a software program to assist in the utilization and quality measurement of beneficiaries enrolled in Accountable Care Organizations. This program utilizes claims data from CMS to produce graphs and reports that allows the user to manipulate the claims data to see all of the costs generated (down to the individual claims level) by the beneficiaries of the ACO. The program not only generates cost reports by beneficiary, but also by provider so that data is easily manipulated by the user to produce a wide range of utilization reports. In addition, by utilizing the claims data, specific information can be obtained to aid in determining which beneficiaries have met many of the Quality Performance Measures. If the ACO supplies the NPI numbers for its provider network, then the program can differentiate between claims generated by the ACO providers and those generated by the “out of network” providers. If the ACO can assign beneficiaries to specific primary care physicians, accountability at the primary care physician level can be determined.