Tech’s Crucial Role in Quality Payment Program Success

Ensuring Technology & Innovation Success

The path to value-based care and reporting under the new Quality Payment Program is undeniably paved in patient data. As clinicians dive into first-year monitoring and reporting under MACRA, the strength of their technical infrastructure will directly impact one’s ability to successfully meet reporting requirements and outcome improvement and resource utilization targets.

As providers lay the IT groundwork to support MIPS, APMs and other quality-based payment programs, a keen eye on the integration, customization and optimization of technical resources based on your practice’s unique needs and factors will be paramount. Most practices have already made substantial investments in healthcare technology acquisition, but lack time and internal resources to derive maximum benefit from those investments. The vital next step is properly putting those tech resources to use by securing dedicated HIT expertise to support your organization’s new quality reporting and clinical process improvement goals.

Providers’ ability to integrate financial and clinical data sets will set the stage for operational and patient data analysis. Bringing as much data into view as possible will establish a robust view of patient data from which to glean insights on things like care gaps, utilization trends, patient risk assessment and clinical performance metrics.

Use IT staff, or outside ex¬pertise if internal resources are limited, to take stock of IT infrastructure and data assets. Keep the rising number of patient data capture points and care coordination partners in mind as you establish your data management process to streamline integration work down the road.

Once data access needs have been met and a firm understanding of MIPS or APM reporting measures relevant to a practice of your size and specialty is established, begin the process of customizing your EHR technology to help meet specific quality reporting requirements. In some cases, EHR template and workflow customization and dashboard creation can help practices quickly and routinely target measures and KPIs pertinent to the practice.

Bear in mind that MIPS Advancing Care Information (ACI) reporting requirements vary depending on the edition of your certified electronic health record technology (CEHRT). Intimate knowledge of Quality Payment Program specifics for the healthcare organization will be required to customize tracking metrics and deliver on quality reporting objectives. Don’t underestimate the value of internal expertise.

In some instances, providers may not be able to optimize functionality in the EHR and/or health IT systems already in place. While most leading EHRs are equipped to meet MIPS and APM requirements, 25% to 50% of practices are likely to find limitations in their platforms that could necessitate an EHR replacement strategy.

Test the process for submitting reporting metrics ahead of time to garner your health organization an opportunity to address any issues uncovered. A proactive approach to testing the quality reporting system could also offer your practice a chance to see if you can meet more than minimum reporting thresholds to potentially earn bonus points and incentives, particularly during first-year “pick your pace” reporting flexibilities.

Streamline technical workflows and leverage IT wherever possible to create efficiencies for patient engagement and throughput. Using tech resources to make it easy for patients to do business with your healthcare organization will be a vital element in meeting evolving consumer demands and maintaining business viability.

Make sure you implement a technical infrastructure that supports your facility’s financial and clinical goals. Many hospitals and practices have wonderful technology resources in place that can help their organization thrive under the Quality Payment Program and other programs on the horizon. Taking the time to establish a solid data integration foundation, customize tech resources, and continually optimize workflow and the patient engagement process will be invaluable to clinicians in the new value-based landscape.

My first two entries in this series touched on financialand clinical best-practices in the march towards MACRA. The next entry in the series will address the role of staff and/or partner expertise in realizing quality payment program success.