Integration of Accountable Care Organization and Additional Hospital Data into CMS Referral Analytics System

Abstract

In recent years, the Center for Medicare and Medicaid Services (CMS) published 439 datasets containing rich information on healthcare providers, Accountable Care Organizations (ACO), Shared Patient Patterns ("referral data"), Medicare Utilization and Payments, etc. Combining these data can provide stakeholders a broader and more synergistic vision of the healthcare market. But the data integration is challenging, as the mapping between several CMS datasets was missing. In this paper, we proposed integration solutions for combining referral data with ACO, Hospital Compare, and physician-hospital affiliation data. Extending referral analysis to these new dimensions could provide more analytics insights to facilitate the decision-making processes of users including physicians, hospitals and government agencies.