Claims-Based vs. MDS-Based Insights: What’s the Difference?

In the post-acute care (PAC) space, it’s often necessary to distinguish between data sources that appear to measure the same thing, but actually are different. The challenge for REITs, Accountable Care Organizations (ACOs) and Health Systems managing a network of skilled nursing facilities (SNFs) is to understand the key characteristics of the available data sources without becoming mired in minutiae.

Our ebook Understanding Claims-Based vs. MDS-Based Insights for SNFs covers a number of key areas that help us determine the following:

• How do claims data and MDS data sources differ?
• Is one data source better than the other?
• Which quality measures should you monitor?

When a SNF quality measure is referred to as “claims-based,” a common misconception is that the data source is billing claims that were submitted by the SNF for services provided in the facility.

In contrast, quality measures based on data from the Minimum Data Set (MDS) assessment reflect clinical outcomes that occurred during the SNF stay.

With a more in-depth look at these two key areas, you’ll be able to understand these key components in skilled nursing facilities more effectively. Make sure to access the ebook below for further information.