U.S. Healthcare Payment Reform

Applying HPCC Systems to Medicare’s Bundled Payments Innovation Program

• Centers for Medicare & Medicaid Services (CMS)

• Today :“Fee for Service” model • Providers don’t have incentives for saving money or

coordinating care across providers. • Rewards quantity of services vs. quality of care

• The Bundled Payments for Care Initiative (BPCI)

• Payment arrangements • Based on financial and performance

Bundled Payments Overview

10/3/14 3

3

time

Episode #2

Episode #1

Episode #3

BPCI: Episode Overlap

Episode #2

Episode #1

Episode #3 time

Episode #2

Episode #1

Episode #3

PROCESSIN

G

A

B

C

4

Hadoop & Pig

• Pig: procedural and relational-centric

• Cannot process data at the record level

• Slow

• Cannot specify inline data

• Cannot (unit) test within Pig

5

HPCC & ECL

• ECL: non-procedural and record-centric

• Record-level processing

• Fast*

• Inline data

• Unit Tests in ECL

6

Unit Tests

simplified_ip_claim_layout := RECORD UNSIGNED INTEGER bene_id; UNSIGNED INTEGER claim_id; STRING claim_type; STRING provider_number; INTEGER4 through_date; STRING status_code; INTEGER4 admission_date; INTEGER4 discharge_date; STRING ms_drg_code; END;

// Using inline dataset

simple_ip_claims := DATASET([

{1,1,'0','010001',20000201,'',20000120,20000201,'61'},

], simplified_ip_claim_layout);

ip_claims := Samples.ip_claims(simple_ip_claims);

// OR passing NAMED parameters

ip_claims := Samples.ip_claims2(

bene_id := 1,

claim_id := 1,

claim_type := '00',

...

ms_drg_code := '61');

7

Beyond Processing Data

• Security & User Authentication

• Share “jobs” with other developers

• Custom visualizations of results

8

Timeline View

9

Problem with the (learning) curve

• Not as steep as expected

• Lots of great tutorials, documentation and white papers online

• Data distribution and SKEW(…) errors

• Activity Graph is your friend

10

Wish list

• Less cryptic error messages • Error: System error: -1: Graph[13], if[15]: SLAVE 172.31.40.116:20100: No access

to Dali - this normally means a plugin call is being called from a thorslave, (0, 0), -1,

• (Unit) Testing Framework

11

Thank you!

Questions ? Feedback ? • www.linkedin.com/in/lucpezet

• mezzetin.blogspot.com