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Clapping Audience

​Intelligence Brief: High-Value FFS Toolkit Part 1

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In this Part 1 of a three-part series, we explore high value FFS codes to support enhanced care management services, detailing eligibility and service requirements, billing and best practices.

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What's New

What's New In Health Endeavors 

Stay up-to-date with the latest enhancement and feature updates. 

Acuity Navigator​

The Acuity Navigator is designed to provide directional data on how well your population's true clinical complexity is being captured in CMS risk scoring. The navigator provides details at the following aggregated views: 

  • Population Stats​

  • TIN Summary 

  • NPI Summary 

  • Patient Summary 

  • Details by Diagnosis

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Note the HCC Details and Summary quick report will be retired as all the data will now be accessible via the Acuity Navigator.

 

Learn more on Acuity Navigator

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Target Release Date: 4/16/2026

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Quick Report Updates

Discharge Location  

 

We’re excited to announce that the Discharge Location quick report has been updated with new facility types, additional location and network information, and new visualizations to help users better analyze discharge patterns to Inpatient Rehabilitation Facilities (IRFs). 

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The purpose of this report is to provide insight into discharge dispositions following an admission, including facility type, location, and network status. These enhancements improve visibility into discharge destinations and support analysis of in network versus out of network utilization. 

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The following updates have been implemented:  

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  •  Added Short Term Hospital, LTAC, and Hospice as facility types. 

  • Added the Place of Service State and Next Claim Place of Service state columns to identify the state in which the place of service is located. 

  • Added the Next Claim in Network column to indicate whether the next claim was In Network or Out of Network. 

  • Added a new ACO level- Discharge to IRF graph displaying the percentage of discharges to an IRF facility type that were In Network versus Out of Network. 

  • Added a new TIN level- Discharge to IRF graph displaying the same In Network versus Out of Network comparison at the TIN level. The graph displays only the Top 10 Initial Claim facilities ranked by total IRF discharge volume. (In Network + Out of Network). 

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Anticipated Release Date: 08/03/2026

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Admission Details  

 

We’re excited to announce that the Admission Details quick report has been updated with new fields and a new summary report to provide greater visibility into patient admissions and the discharges that follow. 

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The purpose of this report is to provide users with detailed information about admissions and the subsequent claims associated with those admissions. The latest enhancements include additional claim types, network status indicators, and a new summary report that offers a high-level view of patient discharge dispositions.  

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The following updates have been implemented:  

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  • Added Short Term Hospital and LTAC claim types 

  • Added a new column indicating whether the Next Claim was In Network or Out of Network 

  • Created a new Admission Details Summary report that provides a quick view of: 

  • Where patients admitted to a facility were discharged. 

  • The type of facility they were discharged to 

  • Whether the discharge facility was In Network or Out of Network 

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Anticipated Release Date: 08/03/2026

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All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions (UAMCC)  

 

The UAMCC report is based on the CMS specifications and will provide insights on patients that are qualified as a denominator and whether they qualified as a numerator for the overall measure.  

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The following updates were implemented in the Provider Summary Level export: 

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  • Total count of unplanned admissions 

  • Total count of qualifying unplanned admissions 

  • Total patient count with multiple chronic conditions (this includes all providers assigned patients with 2 or more chronic conditions within the selected UAMCC category) 

  • Directional Score - providing the directional measure score 

  • Total count of potentially avoidable ED visits 

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Release Date: 07/28/2026

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PMPM Spend Summary Quick Report Update   

 

We’re excited to announce that the quick report formerly known as “PMPM Specialist Spend – Summary" has been updated. The report's name has been changed to reflect the latest updates: “PMPM, PMPQ, PMPY Specialist Spend Summary” 

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The purpose of this report is to provide monthly, quarterly, and yearly averages of claim payments per specialist type, for the year selected. Additionally, new tabs have been added, offering visuals for PMPM, PMPQ, and PMPY averages.  

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The following updates have been implemented:  

  • Report name change from PMPM Specialist Spend – Summary to PMPM, PMPQ, PMPY Specialist Spend Summary 

  • New summarized columns to reflect PMPQ (quarter) and PMPY (year) 

  • New tabs to reflect visuals for PMPM, PMPQ and PMPY  

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Release Date: 7/23/2026

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Emergency Visit   

 

This quick report details emergency department visit claims by parts A and B. This report can be used to develop trends around volume by facility, for what procedures and diagnoses as related to emergency department encounters. The latest enhancements include summary exports and visuals.

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  • ​Patient details (export)

  • Summary by Facility (export)

  • Summary of avoidable ED visits by attributed provider (export)

  • Summary by diagnosis (export)

  • Average spend (visual) 

  • Total spend (visual) 

  • ED visits vs avoidable ED visits 

  • ED visits vs ED visits that led to admission

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Release Date: 06/10/2026

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PMPM Specialist Spend - Summary  

 

This report outlines PMPM (month), PMPQ (quarter), and PMPY (year) average costs and total spends for each provider specialty and claim type. The Visuals represent the PMPM, PMPQ, and PMPY averages for the year selected. 

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Release Date: 06/03/2026

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Recorded Webinars

2025 CMS Final Rule Webinar – Join the nationally recognized health policy expert and director of Managing Director of Medicare Services at HMA, Amy Bassano, for a in depth discussion about the 2025 CMS Final Rule. Watch Recorded Webinar

Thursday, December 5th at 2:00 EST

2024 All About Quality Webinar – Join our quality team as we break down all of the options and the step-by-step process of making your reporting season smooth and easy. Watch Recorded Webinar

Thursday, December 12th at 2:00 EST

Planning for 2025 Quality Webinar –Join our quality team as we break down your options and requirements for 2025.  Watch Recorded Webinar

Populations and Programs
  • ACO REACH 

  • Primary Care First (PCF) 

  • Medicare ACO 

  • Medicare Blue Button FHIR

  • Medicare DPC FHIR

  • Medicaid

  • Commercial

  • Medicare Advantage (MA)

  • Self-Insured Employer TPA

  • Remote Patient Monitoring (RPM)

  • Chronic Care Management (CCM)

Health Endeavors

P.O. Box 27290

Scottsdale AZ  85255

  • LinkedIn
888.862.0366

2024 Health Endeavors

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