As part of the BPCI program, CMS drops claims data monthly on their secure FTP site for you or your conveners to access. It's up to you to log in to this site and retrieve those files within 30 days, as files are deleted past that timeframe. Finding a more permanent (and still HIPAA compliant) storage solution is thus necessary to process that data to graph any analysis or extract more information over time. Each drop is composed of different files, most containing claims data. Data run for one year from the month of the drop. So a drop in July 2015 will contain data from June 2014 to June 2015, which means that each new drop will overlap with the previous one, sometimes adding more claims within the overlap, and sometimes removing some. It's up to you to sift through records and keep non-overlapping data as well as the latest claim and episode information each month.
Each drop contains files for each setting (inpatient, outpatient, skilled nursing facility, home health agency, hospice) as well as professional (carrier), denominator, dual eligibility, but also episode and episode exclusion information. It's also worth mentioning that a drop contains all potential episodes for all episode initiators under an awardee. Therefore in most cases it is your responsibility to apply precedence rules to figure out which episodes prevail and are likely to count toward reconciliation, within your episode initiators at least.
Since BPCI is a nascent initiative, things are bound to change (and did change). This further complicates data processing. The layout may change from month to month for any or all files contained in the drop, making processing new and old drops for analysis more challenging.
Archway Health provides permanent HIPAA compliant storage for participant data, takes care of automatically downloading drops and loading and transforming data for analysis while respecting every change made by CMS.
We provide tools and services to take care of all those gritty details that get in the way of answering your most important questions: How am I doing? Where are the dollars spent? What happened during a specific high costs episode?