Roji Intel Blog

Dave Halpert 1
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ACOsAPM Performance PathwayClinical Data RegistryValue-Based Health Care
November 30, 2022

Catapult Your Performance Using the APP and Achieve Data Sufficiency

In a previous post, we demystified the Alternate Payment Model Performance Pathway (APP) and explained how, by partnering with a Clinical Data Registry experienced in data aggregation and result submissions to CMS, you can avoid the bugaboos falsely attributed to APP reporting—perceived high costs and impossible timelines. Here we’ll show you how to leverage your new skills to elevate your ACO’s performance across the board, from quality scoring to effective patient management—and achieve data sufficiency, in the process. Achieve Better Scores and Insights from Quality Reporting Once your ACO’s data from all practices is aggregated, you will be ready to…
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Dave Halpert 0
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Roji Health Intelligence Alternate Payment Model Performance Pathway APP
Alternative Payment Models (APM)APM Performance PathwayClinical Data RegistryPerformance Improvement
November 16, 2022

No Worries About ACO APP! It’s Your Pathway to Improvement

With the release of the 2023 Physician Fee Schedule Final Rule, CMS upheld its commitment to sunset its Web Interface for ACO quality reporting after 2024. Beginning in 2025, ACOs will be required to report through the Alternate Payment Model Performance Pathway, or APP. Some have expressed concerns about the APP. But this new reporting process actually has some significant advantages. It presents ACOs with a valuable trove of data to advance along the path toward better outcomes, health equity, and curtailed costs. In fact, the baseline for APP—data from provider systems, including their EHR data—is the foundation for data…
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Dave Halpert 0
0
ACOsClinical Data RegistryMerit-Based Incentive Payment System (MIPS)Performance ImprovementValue-Based Health Care
July 18, 2018

No More MIPS Cost Score Details? 5 Ways Providers Can Still Take Control of Costs

CMS is urging providers to participate in ACOs with downside risk, but they might be eliminating one of the keys that providers need to prepare. It couldn’t come at a worse time, when providers already stand to lose under risk-based models if they can’t identify where their cost issues lie. That data is only available from claims data made available by payers. Up until now, practices have had access to indispensable data on costs that are attributed to their providers, showing specifics of where they are above the norm. These were previously part of Quality and Resource Use Reports (QRURs)…
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Theresa Hush 0
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Clinical Data RegistryFuture of Health CareMedical Decision-MakingValue-Based Health Care
November 15, 2017

Choose the Right Strategies and Technology to Improve Cost Performance in Health Care

Fee for Service (FFS) reimbursement is going the way of the dinosaurs, but many providers are ignoring the signals. Here are two clear indicators: Medicare’s adoption of episodic cost models and the planned movement to financial risk models for both Medicare and Medicaid. Indeed, most Medicaid plans have now transitioned the majority of beneficiaries into managed care plans. Private health plans, many of which were burned by capitated HMO plans in years past, are aligning with providers to develop ACOs and moving again toward risk. Recent health care mergers and acquisitions evidence a blurring of lines between health plans and…
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Dave Halpert 0
0
Alternative Payment Models (APM)Clinical Data RegistryMerit-Based Incentive Payment System (MIPS)Qualified Clinical Data Registry ReportingValue-Based Health Care
June 28, 2017

10 Takeaways from the Proposed Rule for MIPS and APMs Year 2

We are already more than halfway through the initial year of Medicare’s new Quality Payment Program, which includes MIPS and APMs. Yet already we are seeing some changes from the new administration that will relax requirements for providers, eliminating the need for some to participate and making quality reporting, in particular, easier. Regardless of how Medicare plays these rules, top providers should maintain a strong strategic focus on Value-Based Health Care initiatives that emphasize performance improvement in cost and quality. Even as Medicare may step back from the leadership role it has taken in this arena, private insurance and employers…
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Theresa Hush 0
0
Clinical Data RegistryFuture of Health CarePatient EmpowermentValue-Based Health Care
May 3, 2017

Health Care Providers Need Performance Data Audits to Market Trust

Health care systems once thought it was crude and undignified to use marketing to attract patients. No more. Now they use qualitative anecdotes to promote status at a time when data is king and consumers view comparative quality data on the Internet. Why not use quantitative evidence? Because their data doesn’t promote their cause—and even they don’t believe it. That avoidance behavior is a huge mistake. Health care organizations need to take steps now to turn performance data into valid indicators of both quality and cost. Otherwise they will risk losing control over their stories as providers of excellence. Consumers…
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Thomas Dent, M.D. 0
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Clinical Data RegistryMACRAMedical Decision-MakingMerit-Based Incentive Payment System (MIPS)Performance ImprovementQualified Clinical Data Registry ReportingRegistry ScienceResearch
July 19, 2016

MACRA Match-up: How EHR Source Data Will Benefit Registry Research

At the core of MACRA and MIPS requirements, Electronic Health Record (EHR) source data will soon become a key component for Registry research. Specifically, Clinical Performance Improvement Activities (CPIAs) are a required component of MIPS. Performance improvement efforts will no longer be optional. Quality data will be essential. EHRs present an excellent data resource, but the data is not flawless. Registries are well suited for validating data and assessing performance using a continuous improvement model—testing an idea by changing a practice and measuring its impact. When done on a small scale, testing performance improvement activities and the feasibility of population-based…
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Dave Halpert 0
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Alternative Payment Models (APM)Clinical Data RegistryMACRAMeaningful UseMerit-Based Incentive Payment System (MIPS)PQRS ReportingQualified Clinical Data Registry ReportingValue ModifierValue-Based Health Care
June 28, 2016

What’s the Score? Decoding the MIPS Scoring Methodology

CMS is calling MIPS the “First Step to a Fresh Start.” When it comes to scoring, that’s an understatement. Although MIPS’s foundations are rooted in existing programs, the MIPS algorithm is a significant departure from today’s quality, cost and health information technology scoring. Not only new, this scoring methodology is complex. Providers will receive one aggregated MIPS Composite Performance Score (CPS), but remember—this one score is going to account for three existing programs, plus a component for ongoing improvement. The real first step: learn how the scoring is done. With penalties starting at 4 percent the first year, growing to…
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Theresa Hush 0
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ACO ReportingClinical Data RegistryFuture of Health CarePerformance ImprovementRegistry ScienceResearchValue-Based Health Care
April 26, 2016

Your Health Care IT Investments: How to Purchase for Performance Improvement

Health care technology (HIT) is frequently oversold. That may be a surprising message coming from a Registry CEO, but it’s the truth. In the quest for answers, too many providers search for a system that can “do it all,” a dream technology that exists, well, only in your dreams. There is intense pressure on providers to prepare for undertaking the financial risk of patient care, while maintaining or improving patient quality and outcomes. Two factors are driving the push for HIT purchases to meet this demand: providers’ strong wish for easy and straightforward solutions that can mesh with existing technology,…
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Robert McNutt, M.D. 0
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Clinical Data RegistryRegistry ScienceResearch
April 19, 2016

Does Data Say All You Need to Improve Health Care Performance?

Can data lie? In a word, yes. The answer also depends on whom you ask. That goes for all forms of data analysis, including how we evaluate health care. This presents a tough dilemma for providers, patients and other stakeholders at a time when the industry and government are heavily invested in using data to compare provider performance, attach payment to “good” providers and penalties for the others. The fact is that the health care data “revolution” is in its infancy, and it is not so easy to identify two key facts: what causes outcomes, and what fixes them. Situations…
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