Roji Intel Blog

Theresa Hush 0
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ACO ReportingClinical Data RegistryFuture of Health CarePerformance ImprovementRegistry ScienceResearchValue-Based Health Care
January 26, 2016

Why Traditional VBHC Trouble Shooting Will Get You in Trouble with Performance Improvement

You’ve heard the phrase. You know it’s a key goal in Value-Based Health Care. But many providers don’t understand the full meaning of performance improvement. All too often, health care systems rely on piecemeal, troubleshooting approaches that emphasize short-term gains over meaningful, improved outcomes. Here’s a common example: Almost every hospital has adjusted its discharge process to avoid readmissions. But unless they can explain why patients were readmitted—few actually can—gains will diminish. New patients presenting with the same high-risk conditions will challenge reduction of readmissions because efforts addressed the symptom but not the root cause. Improving performance means more than…
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Robert McNutt, M.D. 0
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Clinical Data RegistryFuture of Health CarePerformance ImprovementRegistry ScienceResearch
January 19, 2016

The CDR Advantage: Why Registry Research Minimizes Study Bias for Performance Improvement

The Clinical Data Registry is a powerful research tool for improving patient health. But what makes Registry-based study design better than pre-post study design? The answer has far-reaching implications for how we will use data to determine treatment effectiveness in the future, as well as how we will meet the challenge of improving health outcomes. Research can be built on the case-control study, observational study designs, N-of-1 study designs, randomized trials or the N-of-1 population study. Most of these approaches—except those facilitated by a Registry—will be limited by small patient samples due to the patient selection process. But that’s a…
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Thomas Dent, M.D. 0
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ACO ReportingClinical Data RegistryMeaningful UsePerformance ImprovementPQRS ReportingRegistry ScienceValue-Based Payment Modifier
December 8, 2015

Want Real Performance and Outcomes Improvement? Track Interventions and Results Over Time

Time will explain it all. He is a talker, and needs no questioning before he speaks—Euripides For many providers, reviewing performance data is just another distraction from practicing medicine, rather than a valued tool for making better medical decisions. And who can blame them? Performance or outcome data reviewed in isolation, as static results, aren’t all that useful. The exercise is akin to looking at a single photograph of an event and inferring cause and effect without any corroborating evidence. To be an effective resource that leads to actual outcome improvements, data must be tracked over time. Most often, however,…
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Theresa Hush 0
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ACO ReportingFuture of Health CarePQRS ReportingQualified Clinical Data Registry ReportingRegistry ScienceValue-Based Payment Modifier
September 15, 2015

No More Status Quo: How the New CDR Will Change Health Care

As CMS streamlines its Value-Based Reimbursement programs, the pressure is on for providers to participate. A better foundation is needed to support those changes, so providers can actually succeed. And Medicare’s expansion of Clinical Data Registries (CDRs) may just be the answer. CDRs could be the tipping point for transforming health care. Here’s why: With better capabilities for performance measurement, more comprehensive databases, and expertise for more advanced outcomes analyses and research, CDRs can provide tools that have been missing for all stakeholders—providers, health plans and consumers. What’s a CDR and Why Is It Different? The Clinical Data Registry has…
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Theresa Hush 0
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ACO ReportingFuture of Health CarePopulation HealthQualified Clinical Data Registry ReportingRegistry ScienceResearchValue-Based Payment Modifier
August 4, 2015

ACOs and the Referral Revolution Part 2: How to Align Objectives and Referral Practices

There’s no getting around it. Disruption in referrals under new Value-Based Health Care programs will upset both primary care and specialty practices under any change scenario. Physicians with historical relationships will undoubtedly resent an edict to redirect referrals, if they don’t understand or believe comparative data on cost and quality. On the other side of the equation, physicians who accept that aligning referrals with outcome data is part of being in an ACO will object if they see that referrals are driven, instead, by physician employment status. Every participant in an ACO must eventually accept that achieving shared savings will…
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Thomas Dent, M.D. 0
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ACO ReportingFuture of Health CareValue-Based Payment Modifier
July 28, 2015

Are Your Specialists and ACO Ready for the Referral Revolution? Part 1

The practice of physician-determined referrals to specialists is deeply embedded in the culture of medicine. But it no longer works under Value-Based Health Care. A revolution in referrals is underway, one that will dramatically change physician alignment and engagement in ACOs and other Pay for Performance models. Outcome measures can distinguish the performance of one specialist versus another—and this performance data is available to both health systems and physicians. We all know that pure comparative performance data has a lot of flaws. But Medicare is publishing provider-specific performance for PQRS and group performance for ACOs, and calculating comparative scores under the…
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Robert McNutt, M.D. 0
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Registry ScienceResearch
July 21, 2015

Are You Measuring Effectiveness of Your ACO’s Population Health Interventions?

It’s time to reboot your method of deploying population health initiatives, if you really want a return from your ACO efforts. Despite the intense focus on data and analytics in health care, most start-up ACOs adopt identical population health initiatives, such as intensive case management for high cost patients. The choice is not made because of proven outcomes and lowered costs from these initiatives, but because everyone else is doing the same thing. It’s ironic that we adopt evidence-based performance measures, but rely on anecdotal results in population health. With a research-capable Registry and reliable data, we can be smarter…
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Theresa Hush 0
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ACO ReportingPQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
July 14, 2015

Will Medicare’s Published Physician Quality Data Push Your Patients Away?

CMS isn’t the only group scrutinizing your quality and cost data any more. As the next step toward value-based health care, Medicare has begun publishing provider performance data for PQRS under “Physician Compare.” Now patients and their families can make their own data-driven choices about health care providers with an online search. The website is a game-changer. Performance variation between providers is startling. There are 50 provider groups with performance at or lower than 65 percent for at least one published measure. By contrast, a handful of groups show all four measures over 95 percent. The 2013 data are limited and do…
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Dave Halpert 0
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ACO ReportingPQRS ReportingQualified Clinical Data Registry ReportingValue-Based Payment Modifier
June 30, 2015

Orthopedists’ Survival Kit: How to Succeed with Medicare PQRS and VBPM

Pay for Performance success takes careful thought and management, particularly for specialty practices. Under Medicare’s PQRS and Value-Based Payment Modifier (VBPM), specialties have fewer measures available, which narrows reporting options—making it harder for you to meet PQRS and compare well against your peers. For Orthopedics, this is especially true. Nearly 200 PQRS measures have a Registry reporting option, but many orthopedic surgeons still have a difficult time finding nine measures across three National Quality Strategy (NQS) Domains (including one cross-cutting measure), where performance is good enough to report. All too often, orthopedic surgeons get trapped, reporting on measures where performance…
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Theresa Hush 0
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Population HealthRegistry ScienceResearch
May 19, 2015

Population Health: Fact or Fiction?

For the past couple of years, “population health” has become a popular catchphrase.  Everyone is talking about it, adopting it or selling it. But if you ask anyone what it means, you’ll get very different answers. That’s because there seems to be only one point of consensus—we need to focus health care efforts on specific populations. Should you care? I think so, and here’s why: Providers and ACOs are beginning to spend a lot of money on population health, yet no one is measuring the effects of those efforts and whether they actually achieve positive outcomes. Fuzzy Definitions Can Lead…
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