Spine / RTM case
Build the case from sourced evidence and explicit owner requests. These are requested inputs, not measured NYU facts.
Start with the public evidence
Establish an inpatient discharge cohort and published payment exposure, then keep the remaining operating inputs explicit.
Read the cohort and post-acute analysis method
SPARCS discharge records: choose facility, year and APR cohort
TEAM participation: distinguish membership from episode eligibility
SNF, IRF and home-health payment tables: match year, geography and units
| Input and method | Owner request |
|---|---|
| Annual spine patient volume | NYU clinical analytics: Unique patients by surgical/non-surgical cohort, institution, fiscal/calendar year, inclusion rules and deduplication. Status: need; no patient volume established here. |
| Payer mix | NYU revenue cycle analytics: Same cohort and period as volume. Separate Medicare, Medicare Advantage and identified commercial plans. Public mix is a proxy until cohort correspondence is established. Status: need. |
| RTM enrollment and qualifying months | NYU RTM operations: Eligible non-surgical patients, enrolled share, active patient-months and observed qualifying days by month. Verify the proposed 16-day threshold against code and rule year. Status: need. |
| Who bills RTM | NYU billing and clinical operations: Actual billing clinician/practice, payer arrangement, code and year eligibility. Unknown eligibility blocks revenue recognition in this model. Status: need. |
| Surgical scope and baseline cost | NYU finance and case sponsor: Confirm surgical inclusion on cost-avoidance basis. Supply baseline costs, timing and avoidable fraction. Rates and charges cannot replace cost; deferred is not avoided. Status: need. |