The fact that the Medicare Access and CHIP Reauthorization Act’s (MACRA) Quality Payment Program (QPP) and the two pathways within—the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs)—are complex comes as no surprise. The entirety of managing and improving patient outcomes while maintaining cost efficiencies is no small feat. Providers’ understanding of and readiness to operate within QPP requirements is paramount to successful implementation of value-based care. Moreover, if you are a healthcare provider required to report under the QPP, your current performance will absolutely impact your future payment adjustments. Accurate clinical documentation will be essential to success under MIPS.
Data-driven analytics can support quality reporting requirements under the QPP by offering actionable insights into expected performance and improvement opportunities, as well as helping identify and evaluate the impact of improving performance on key measures to inform goals. For instance, “data silos”—common in provider organizations—prevent physicians from receiving comprehensive data on patient outcomes, impacting overall quality performance. But sophisticated data visualization and reporting capabilities can offer a “single source of truth” into the compilation of all the disparate data—quality measures, utilization trends, gap assessments and enrollment data—you need to drive improvements in quality measurement, reporting and overall health outcomes to succeed in this program.
The ability to assess the impact of measure-level changes in performance and influence strategy in real time, enabled by relevant and focused data-driven insights, is what will truly set healthcare organizations apart and ensure QPP readiness and success in the constantly evolving healthcare landscape.
For more on the challenges of implementing MACRA and how the final QPP rule addresses them, read part 1 of this series.
To learn more about the changes in the final QPP rule and how they impact strategy and planning among organization across the healthcare ecosystem, read part 2 of this series.