CPX Data: How It Works

The CPXTM collaborative is built on AMGA’s longstanding history of bringing members together around shared learning and providing granular benchmarking data for performance improvement.

In this collaborative, participating organizations submit EHR data, billing data, and adjudicated claims feeds, to be mapped and normalized in order to create apples-to-apples benchmark measures along four key “domains:”

Total Cost of Care

Total Cost of Care

Practice Efficiency

Practice Efficiency

High-Risk Patients

High-Risk Patients

Clinical Quality and Safety

Clinical Quality and Safety

Participants then select which domain they will focus on and create an action plan around the benchmark measures within the domain. Once selected, AMGA works directly with the organization over a three-year period to make sure they see measurable improvement in that area.

What is an action plan? [+]

Which domain should I choose? [+]

How are measures created? [+]

Why Clinical & Claims Data?

In health care, there are so many ways to measure your performance. You can self-report the data, but the method of “pulling” data can vary greatly among organizations, making benchmarking comparison difficult. What makes CPXTM different is our mapping and normalizing of EHR and billing (outbound claims) data, together with adjudicated claims feeds to create apples-to-apples comparison.

Clinical data provides our analysts the ability to look at patients you have treated, reflecting services provided by your organization but that does not necessarily capture all services these patients received. Sometimes your patients will seek care outside of your system or see specialists who are not employed by your medical group. By combining adjudicated claims feeds, we can see all covered services that were billed (typically within a benefit year) for that patient. That way, we’re able to see a more comprehensive view of your patient populations, particularly important for those whom you hold risk, and take that a step further, by comparing your data to other high-performing systems across the country.

Data Sources for Benchmarking

Each CPXTM measure and its accompanying benchmark rely on either EHR and billing data or adjudicated claims (payer claims) data as a data source.

How It Works

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