PurpleLab identified HCOs other than those previously identified by the Department of Justice who appear to have violated the National Coverage Determinations (NCDs) establish by Medicare regarding the appropriate use and billing/reimbursement for Implantable Cardioverter Defibrillators (ICDs).

In 2015, the United States Department of Justice reached 70 settlements involving 457 hospitals in 43 states for more than $250 million related to cardiac devices that were implanted in Medicare patients in violation of Medicare National Coverage Determinations (NCDs). The NCD provides that ICDs generally should not be implanted in patients who have recently […]

Studies demonstrate an inverse relation between volumes of surgical procedures performed in hospitals and related mortality.

Major Findings: While there are low-volume hospitals that provide excellent care and high-volume hospitals that provide relatively poor care, numerous studies confirm that patients undergoing Coronary Artery Bypass Graft (CABG) surgery by a low volume HCP provider or at a low volume HCO provider have a significantly higher risk of mortality compared to patients undergoing […]

Risk Readiness

Ultimately, what PurpleLab enables is to understand which providers are ready and able to manage the “risk” they will incur under value-based reimbursement programs such as “bundling”. As reimbursement models shift from Fee-For-Service to “Bundling”, risks shift from the payers to the providers. PurpleLab provides a “lense” over each provider’s (HCP, HCO Group and HCO […]

Get Started Today

Get access in minutes. Gain insights instantly.