OCM Performance-Based Payment Pricing Model: What You Need to Know—Webinar Recap

Last Wednesday Archway Health presented a webinar on OCM Performance-Based Payment Pricing Model: What You Need to Know. Ed Bassin, PhD, Chief of Analytics, presented. In OCM, practices will receive performance-based payments when target prices exceed actual costs. Every patient is priced through a complex regression-based formula that uses data from fee-for-service claims. The codes that you use, particularly diagnosis codes, can have an impact of thousands of dollars on your bottom line in ways that they didn’t under fee-for-service billing. In this recent webinar, we discussed:

  • How pricing is almost completely unrelated to target prices under OCM
  • The formula CMMI uses to calculate prices in plain English
  • Specific implications of the OCM Risk Stratification/Pricing Model
  • How practices need to code patient visits in order to get full credit for the complexity of their patients
  • "Gotchas" and traps in the pricing model that could adversely impact practices
  • Archway's approach to baseline claims data analysis

We also showed examples from Archway's Baseline Assessment.

A link to the video replay of the webinar is available on request. Please contact us to learn more about how Archway can help your practice prepare for OCM.