At the May 2 EHPN meeting and dinner, Jamie Ketas, VP Quality, and Deb Weinstein, Director of Ambulatory Quality, provided an overview of the 2019 quality initiatives, and how they apply to each member of EHPN. The increasing importance of these quality scores was emphasized, as they relate to: (1) regulatory requirements, (2) strategic initiatives, and (3) reputation management.
- Regulatory: MIPS is the performance-based CMS program that directly affects revenue, as the government has implemented a financial penalty for lack of participation. It is a budget neutral program, so our performance can result in a penalty or bonus. In 2017, there was a bonus of up to 4% available. In 2019, the bonus is up to 7%, however, with more money at stake – the higher the bar. To meet these stricter requirements, we must work together and perform well across 14 areas of quality.
- Strategic initiatives: we have quality components incorporated into several of our payer contracts, and we selectively participate in other programs such as CPC+ and Million Hearts. These programs help us financially, as we are provided with funds to support resources to promote the health and well-being of our patients. Participation also increases our status, as compared with other networks.
- Reputation: With one click of the mouse, you can see the “star” ratings of a provider or health system. With websites such as Physician Compare, Hospital Compare, and Healthgrades, sophisticated shoppers of healthcare services can look up and compare provider to provider and hospital to hospital. The scores currently being uploaded to Physician Compare are from 2017, so we need to make sure we are positioned well with our data going forward.
To help focus our efforts, on July 1st, we are starting an internal incentive program where each EHPN provider will be responsible for his/her performance on their assigned quality measures. These scores can be monitored on your Epic dashboard. All providers, including primary care and specialty, have quality measures assigned to them based on scope of practice and organizational goals. A packet of handouts with the specific information was provided at the meeting.
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