quality metrics for improved practice management: there’s an app for that!
TRANSCRIPT
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Quality Metrics for Improved Practice
Management: There’s an
App for That!
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CECity Executive Summary
Emdeon Executive Summary Healthcare Reform Drivers for Enhanced Practice
Management Tools Review of Clinical Quality Measurement, Reporting and
Improvement Solutions
Agenda
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CECity
Executive Summary
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CECity Executive Summaryleader in enterprise quality reporting, registries, improvement & lifelong learning
Healthcare’s leading social enterprise cloud platform to address needs under healthcare reform by aligning, simplifying, integrating and cost-effectively scaling
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• Performance Improvement• Pay for Performance • Professional Certification
CECity is…
• Neutral - layer or bolt onto EMR/HIT as collaborative value-added partner
• Dot Connector – gateway between EMR, society partners and payors; link to world leaders in performance improvement
• #1 Footprint - own largest footprint in professional certification, quality reporting & performance improvement space
CECity Deployment Options…
Multi-Tenant Private Portals
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CECity’s Performance Management Solution…At the Point of ConvergenceAligning solutions across the “3Ps” to engage providers in improvement
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CECity’s Cost-Effective, Scalable Solution Layers onto EMRsaddressing the burgeoning needs under reform in synergy with existing HIT
GAPS
ePortfolio
Feed Dataforward from EMRs and
other Data Sources
Feed Useful Analytics, Gaps, Outliers and Quality Reports
BACK for qualityimprovement & research
Performance Learning
Incentives
Health Plans
EMRs
PMS
Patient Surveys
National Registries
Data Aggregators
Health Systems
Web Forms
Registries
Patient Surveys
Hybrids
Goal: enhance the value of EMRs by seamlessly layering or integrating unique, exclusive and/or necessary services that support the EMR’s quest to measure and manage quality, report for
payment or other incentives, and move providers from measurement to improvement
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Regulating Boards and Quality Assurance
Organizations
Payors
Professional Organizations
Pharmacies
Provider Organizations
Pharma and Others
Commitment Quality & Professionalism
Johns Hopkins Armstrong Institute and CECity partner to Scale AI Continuous PI Programs Across the AI and MedConcert Enterprise
Support ABIM PIMs, Patient Surveys and other Products for Continuous MOC
ABMS Strategic Partner, including MOC:PQRS
ACP and CECity sign MOU to launch MedConcert for multiple registries, MOC, PQRS, PCMH Medical Home Builder and more
MGMA and CECity sign MOU to launch MedConcert Products and Services
PQA & CECity partner on EQuIPP…pharmacy’s national performance reporting and benchmarking platform focused on adherence and compliance
HCI3 selects CECity as Exclusive Performance Assessment Platform for Bridges to Excellence pay for performance program and work with Data Aggregators (Including top EMRs)
AAMC and NBME select CECity for PIVIO, national portfolio and primary data source “lockbox” platform for medical students, residents, etc.
CECity’s unique footprint and partnershipsmore than technology…relationships, experience, and trust
Partnerships
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Why are we here today?
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Why are we here today?
Meaningful Use Stages
• Healthcare reform is rapidly shifting from early stage data capture, collection activities (EMR, eRX) to later stage requirements driven by payment reform (MU Stage 2, 3) for ACO, IDN, VBP, MA Stars, and other shared-risk models
• Customer needs and focus shifting to performance measurement and management (pop health, patient care gap analysis, patient (CG surveys) and practice improvement), value-based payment, external (to EMR) reporting to national specialty registries, rapid cycle learning and compliance
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Specialty BoardsProfessional Self Regulation
State Licensing BoardsProtect Public from Harm
Physicians / GroupsProfessional, Financial, Self Regulation
PO (Physician Org) QI and P4P Program
Group / HospitalQI and P4P Program
Group / HospitalCare Redesign
Hospital AccreditationProtect Patient
Quality
Credentialing /Re-Credentialing
Improve Patient Experience of Care
OPPE/FPPE
Private Payors
Attract/Protect Members
& Own P4P
Medicare Advantage Star Ratings
Physician VBPFederal: PQRS & VBMCommercial: BTE & P4P
Meaningful UseCQM, Specialized Registries
Shift from FFS to Value Based Contracts and
Shared Risk (ACO)
CME RequirementsMOL Coming Soon Board ExamsMaintenance of Certification
Hospitals VBPReadmission,Never Events
Public PayorsProtect
Members& Own P4P
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Why are we here today?Payment, compliance requirements growing & converging beyond the EMRProviders don’t know what to do, where to turn, how to handle them all!
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E/RX EMR/MU/MU2 PQRS VBP
E/RX NO E/RX
EMR/MU (medicare)
($k) No EMR/MU PQRS PQRS+MOC No PQRSValue
modifier
2009 2.00% – – – 2.00% – – –
2010 2.00% – – – 2.00% – – –
2011 1.00% – $18K – 1.00% 1.50% – –
2012 1.00% (1.00)% $12 – 18K – 0.50% 1.00% – –
2013 0.50% (1.00)% $8 – 15K – 0.50% 1.00%Based on 2013 data
Based on 2013 data
2014 – (2.00)% $4 – 12K – 0.50% 1.00%
2015 – – $3 – 8K (1.00)% – – (1.50)% TBD
2016 – – $2 – 4K (2.00)% – – (2.00)% TBD
2017 – – (3.00)% – – (2.00)% TBD
2013/2014Year of the
Penalty
Why are we here today? Penalties and Requirements are being ratcheted upwards!Providers need help now, but most are struggling to meet them all on their own
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There’s An App for That
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Quality Measurement, Reporting and Compliance Solutions Comprehensive suite of quality products and services to help providerssatisfy their healthcare reform requirements via one integrated, cost-effective solution
Integrated Products Satisfy Multiple Requirements
Federal VBPPQRS via Qualified
Clinical Data RegistryMOC:PQRS
Professional Certification
MOCPerformance Improvement
Fed
eral
VB
PC
omm
erci
alV
BP
Pro
fess
iona
lM
eani
ngfu
l Use
Sta
ge 2
Menu Item 6Specialized Registry Reporting
Clinical Quality MeasuresReporting via Registry
PQRS via QualifiedClinical Data Registry
Standalone Product Modules
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EHR
ImpaQt™ One-to-Many Clinical Quality GatewayConnect to a network of specialized registries via one clinical quality gateway
ImpaQt™ One to ManyClinical Quality Gateway Registry
MU
Quality Report
Feedback
Value
Data
Exchange
And More includingthe Societyof Societies
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Meaningful Use Stage 2 Menu Item (3-6) requirements mandate data exchange external to the EMR, including reporting to national specialty society registries.
Penalties begin w/ 2014 reporting
CECity uniquely positioned as gateway between EMR & multiple National Society Registries…Including top Primary Care societies (ACP and AOA) which represent nearly 250,000 physicians
CECity offers one national turnkey solution to meet MU2 requirement, solving problem of EMRs having difficulty stitching together of state by state registries
Opportunity to align and build one EHR to CECity data pipeline for MU, other payment programs (e.g. BTE), as well as professional certification programs (e.g. MOC)
Meaningful Use Stage 2 – Continuous Reporting to Specialized RegistriesCECity’s position provides unique opportunity to bring value to customers, access to sustainable model for MU2 and QI
ImmunizationRegistry
SpecializedRegistry Gateway
(option to add PQRS, CQM)
Data
ValueEMR Data
Data
Specialized ClinicalRegistries
CancerRegistry
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Bridges to Excellence® #1 Commercial P4P Program
• #1 US Pay for Performance Program to Commercial Health Plans
• Data pipelines established with leading EMRs and HIT companies (GE, Meridios, NextGen, eCW, Athenahealth)
• Key States: Texas, California, NY, Carolinas
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Multiple Data Entry Options & Dynamic Progress Monitor
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Detailed Progress Report by Practice and Provider
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Performance Measures -Clinician View
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BTE Recognition Scoring
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PQRSwizard® like Turbo-Tax® for PQRS - mandated federal Value-based Purchasing program
• #1 Cloud-Based PQRS Registry Platform
• #1 Payment Success Rate (>99.5%)
• Proven Business Model, Revenue Share for Partners
• Only 25% eligible provider participation
• CMS Qualified for Registry, DSV, GPRO, and Qualified Clinical Data Registry (QCDR)
• CECity is bringing it all together – BTE, PQRS, QCDR, MU2 CQM and Specialized Registries with Societies
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ACP Specialized Registry MU2, CQM, PQRS
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Patient SurveyPatient Centered Satisfaction, Outcomes, Risk Assessments
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MGMA DataDiveMetrics for Practice Management
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Patient Population AnalysisAggregates demographic and diagnoses information
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Practice PerformanceFeatures process and utilization measures with flexible benchmarking.
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Financial AnalysisRevenue, cost, profit based on billings/cost allocation models
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Financial InformationDrill down into any item to view the basis of the calculation.
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Track Changes Over TimeRevenue, cost, profit based on billings/cost allocation models
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Data ConnectivityChoose to automatically populate data through one of the connected data feeds.
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Professional Compliance (Maintenance of Certification) multi-faceted Apps incorporate or link to MOC Part IV and other compliance programs
Send upstream to ABIMSelf Directed PIM for Credit
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Performance Improvement Apps via CECity Access tools and resources from the world’s leaders in quality improvementDeliver them to providers in practice to move from measurement to improved outcomes
Quality Training PCMH Survey PI Toolkits
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Thank You
CECity Contact:
Ariann Polasky, Director, Provider Products
Emdeon Contact:
Matt Koerlin