Ultimately, what PurpleLab enables is to understand which providers are ready and able to manage the “risk” they will incur under value-based reimbursement programs such as “bundling”. As reimbursement models shift from Fee-For-Service to “Bundling”, risks shift from the payers to the providers. PurpleLab provides a “lense” over each provider’s (HCP, HCO Group and HCO Facility) ability to absorb the risk that is inevitably shifting towards them. To survive and thrive under bundling, providers must have enough Experience to develop proficiency and expertise, must have Outcomes that are predictable, must follow Appropriate care and reimbursement guidelines and must have costs in line with where reimbursement is headed. PurpleLab provides an unprecedented ability to analyze that nation’s census of providers based on the 48 Bundled Payments for Care Improvement (BPCI) “bundles” that CMS intends to implement. CMS did the easy part in identifying the 48 conditions that carry the most significance in terms of severity of Outcomes and Costs. PurpleLab did the hard part in coding up all of the 48 BPCI bundles and enabling the peer-to-peer analysis based on an examination of historic performance. Which HCPs, HCO Groups and HCO Facilities fell into the lowest quartile of Experience, High quartile of Adverse Events, highest quartile of Cost and thus lowest Quartile of Value or Risk Readiness in your area of interest? We know so you know.
Bundling will ultimately reward the highest performing providers and drive the lowest performing providers out of business lines they are marginally participating or successful in today. Bundling will change patient flows and referral patterns from marginal performers to high performers as network development changes to include high performers and exclude marginal performers. PurpleLab provides a lense that shows the anticipated winners and losers under bundling.