CCLF content will vary depending on the type of agreement you have with signed with CMS. In order to understand what information you can glean from your CCLF data it is important to understand the specifics of the data CMS is providing to you. Also, keep in mind that the CMS changes the content frequently.
These are some things to keep in mind with regard to MSSP CCLF feeds
- The feeds are provided monthly and lag by roughly 45 days. This means that when you receive a June feed you will have received most of the data through the end of April.
- Every feed will have claims which are several months (and sometimes years) old. This means the when you look at your historical numbers they will change month to month.
- Not all claims are included in the CCLFs. For example CMS doesn't send substance abuse data or data for patients who opt to not share their claim data.
- CMS attributes patients to more than one TIN. Their attribution criteria changes and is published on their website but it is an inexact attribution.
- Attributions or assignments are sent up to 6 times per year: First the prospective attribution for the coming year, four quarterly attributions and the final attribution which is provided along with your cost savings and performance results. It is not unusual for the attributions to vary by 20-30% from year to year.
Clinigence also uses limited data from other data sources when generating the CCLF reports. The data is currently limited to Practice and Provider names, NPI's and TIN's. This data is mostly provided by the Clinigence customers when first setting up an organization. Publicly available NPI look-ups are also used to supplement this data.