Quality Improvement

Outcome reporting is the future of healthcare. With an EHR, your practice has a sizeable advantage in both increasing quality and reporting it. Participation in clinical quality initiatives allows providers to be recognized and in some cases reimbursed for high quality clinical outcomes. Not participating can result in negative payment adjustments. Maintenance of Certification (MOC) for many medical boards may involve the review of patient data and implementation of a quality improvement plan.

A new Harvey L. Neiman Health Policy Institute study shows that fewer than one-in-five healthcare providers meet Medicare Physician Quality Reporting System (PQRS) requirements. Those that meet PQRS thresholds now receive a .5 percent Medicare bonus payment. In 2015, bonuses will be replaced by penalties for providers who do not meet PQRS requirements. As it stands, more than 80 percent of providers nationwide would face these penalties.

There is a post go-live quality improvement process that will continue indefinitely. To maximize the benefits the system, practices will need to develop a strategy to move beyond simply using the features of their EHR and start focusing on the data. Measuring care is only the beginning of identifying areas where improvement is needed. While the ultimate goal is quality care, there often are gaps within a practice’s clinical IT infrastructure and applications, and between Meaningful Use standards and other quality programs.

RMS clinical consultants have over 30 collective years of experience with quality reporting in physician practices. They have delivered customized solutions for participation in clinical quality initiatives and practice evaluations for Board Certification including:

  • Physician Quality Reporting System (PQRS)
  • Patient Centered Medical Home (PCMH)
  • Patient Specialist Centered Practice (PSCP)
  • Physician Organization Reporting
  • Clinician recognition programs such as the Diabetes Recognition Program (DRP) and Heart/Stroke Recognition Program (HSRP)
  • Practice Improvement Modules for MOC such as the American Board of Internal Medicine (ABIM)
  • Population Health Management

We will deliver a tailored solution to address your needs for participation in quality improvement initiatives by performing:

Assessment

  • Evaluation of a Practice’s Workflow, Objectives and Goals
  • Review of Practice’s EHR System Reporting Capabilities
  • Identify Areas of Conflict across Private and Public Sector Clinical Quality Initiatives

Education

  • Education on Selected Clinical Quality Initiatives
  • Education on New Workflows Required for Data Capture

Practice-Specific Action Plan

  • Perform Gap Analysis Related to Clinical Quality Initiatives
  • Monitor Clinical Data Required for Participation in Clinical Quality Initiative
  • Redesign Practice Workflows as Needed
  • Assist Practice in Data Submission

 


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