More Related Content Similar to How to Eliminate the Burden of Provider Quality Measurement: Able Health (20) More from Health Catalyst (20) How to Eliminate the Burden of Provider Quality Measurement: Able Health1. How to Eliminate the Burden
of Provider Quality Measurement:
Able Health
May 27, 2020
The only solution for provider quality measures that’s truly comprehensive
2. © 2020
Health
Catalyst
The Problem
Provider quality measurement is complicated because it’s incomplete
Incomplete
Picture
Complexity
(too many holes to fill)
Incomplete
Workflow
• Monitor
• Improve
• Submit
• Debate
• Doubt
• Delay
• Data
• Measures
• Visualizations
3. © 2020
Health
Catalyst
The Solution
A truly comprehensive quality measures platform is the only solution
Complete
Picture
Truly
Comprehensive
Complete
Workflow
• Data
• Measures
• Visualizations
• Monitor
• Improve
• Submit
• Accuracy
• Certainty
• Authority
Complete
Picture
Truly
Comprehensive
Complete
Workflow
4. • Problem (10 mins)
• Solution (5 mins)
• Demonstration (20 mins)
• Next steps with Q&A (15 mins)
Agenda
5. © 2020
Health
Catalyst
Poll Question #1
5
What department within your organization do you support?
• Quality – 24%
• Analytics / IT – 26%
• Finance – 5%
• Executive Leadership – 9%
• Other – 36%
7. © 2020
Health
Catalyst
Problem
7
Research that Health Affairs published in March 2016 quantified the burden of provider quality
measurement on medical groups as 15.1 hours per provider per week.
78,500
hours per 100 providers
per year
$4,000,069
per 100 providers
per year
8. © 2020
Health
Catalyst
Problem
8
Deliver
care
• Clinical teams can’t
identify care gaps
during encounters
• Clinical teams forget
to close care gaps
during encounters
• Patients don’t follow
through on provider
recommendations
Document
data
• Clinical teams don’t
document quality data
• Clinical teams don’t
document quality data
correctly
• Coders miss quality
criteria in the note
Calculate
performance
Current tooling does not
calculate quality
performance:
• Accurately
• Timely
• Across all measures
• Using all discrete
claims and clinical
data
Improve
performance
Stakeholders can’t
identify the highest-
priority improvement
opportunities:
• Measures
• Sites
• Providers
• Patients (care gaps)
Report
performance
• EHR reporting files
(QRDA’s) exclude
claims data and some
clinical data
• Claims-based
reporting excludes all
clinical data
• Some payers only
accept clinical data in
unique file formats
Every step of quality measurement presents new problems that multiply the total burden.
9. © 2020
Health
Catalyst
Problem
9
Deliver
care
• Clinical teams can’t
identify care gaps
during encounters
• Clinical teams forget
to close care gaps
during encounters
• Patients don’t follow
through on provider
recommendations
Document
data
• Clinical teams don’t
document quality data
• Clinical teams don’t
document quality data
correctly
• Coders miss quality
criteria in the note
Calculate
performance
Current tooling does not
calculate quality
performance:
• Accurately
• Timely
• Across all measures
• Using all discrete
claims and clinical
data
Improve
performance
Stakeholders can’t
identify the highest-
priority improvement
opportunities:
• Measures
• Sites
• Providers
• Patients (care gaps)
Report
performance
• EHR reporting files
(QRDA’s) exclude
claims data and some
clinical data
• Claims-based
reporting excludes all
clinical data
• Some payers only
accept clinical data in
unique file formats
Every step of quality measurement presents new problems that multiply the total burden.
10. © 2020
Health
Catalyst
Deliver
care
• Clinical teams can’t
identify care gaps
during encounters
• Clinical teams forget
to close care gaps
during encounters
• Patients don’t follow
through on provider
recommendations
Document
data
• Clinical teams don’t
document quality data
• Clinical teams don’t
document quality data
correctly
• Coders miss quality
criteria in the note
Calculate
performance
Current tooling does not
calculate quality
performance:
• Accurately
• Timely
• Across all measures
• Using all discrete
claims and clinical
data
Improve
performance
Stakeholders can’t
identify the highest-
priority improvement
opportunities:
• Measures
• Sites
• Providers
• Patients (care gaps)
Report
performance
• EHR reporting files
(QRDA’s) exclude
claims data and some
clinical data
• Claims-based
reporting excludes all
clinical data
• Some payers only
accept clinical data in
unique file formats
Problem
10
Every step of quality measurement presents new problems that multiply the total burden.
11. © 2020
Health
Catalyst
Problem
11
Deliver
care
• Clinical teams can’t
identify care gaps
during encounters
• Clinical teams forget
to close care gaps
during encounters
• Patients don’t follow
through on provider
recommendations
Document
data
• Clinical teams don’t
document quality data
• Clinical teams don’t
document quality data
correctly
• Coders miss quality
criteria in the note
Calculate
performance
Current tooling does not
calculate quality
performance:
• Accurately
• Timely
• Across all measures
• Using all discrete
claims and clinical
data
Improve
performance
Stakeholders can’t
identify the highest-
priority improvement
opportunities:
• Measures
• Sites
• Providers
• Patients (care gaps)
Report
performance
• EHR reporting files
(QRDA’s) exclude
claims data and some
clinical data
• Claims-based
reporting excludes all
clinical data
• Some payers only
accept clinical data in
unique file formats
Every step of quality measurement presents new problems that multiply the total burden.
12. © 2020
Health
Catalyst
Problem
12
Deliver
care
• Clinical teams can’t
identify care gaps
during encounters
• Clinical teams forget
to close care gaps
during encounters
• Patients don’t follow
through on provider
recommendations
Document
data
• Clinical teams don’t
document quality data
• Clinical teams don’t
document quality data
correctly
• Coders miss quality
criteria in the note
Calculate
performance
Current tooling does not
calculate quality
performance:
• Accurately
• Timely
• Across all measures
• Using all discrete
claims and clinical
data
Improve
performance
Stakeholders can’t
identify the highest-
priority improvement
opportunities:
• Measures
• Sites
• Providers
• Patients (care gaps)
Report
performance
• EHR reporting files
(QRDA’s) exclude
claims data and some
clinical data
• Claims-based
reporting excludes all
clinical data
• Some payers only
accept clinical data in
unique file formats
Every step of quality measurement presents new problems that multiply the total burden.
13. © 2020
Health
Catalyst
Poll Question #2
13
Which step in quality measurement creates the most problems for
your organization?
• Delivering care – 5%
• Documenting data – 37.5%
• Calculating performance – 25%
• Improving performance – 27.5%
• Reporting performance – 5%
14. © 2020
Health
Catalyst
Problem
14
Deliver
care
• Clinical teams can’t
identify care gaps
during encounters
• Clinical teams forget
to close care gaps
during encounters
• Patients don’t follow
through on provider
recommendations
Document
data
• Clinical teams don’t
document quality data
• Clinical teams don’t
document quality data
correctly
• Coders miss quality
criteria in the note
Calculate
performance
Current tooling does not
calculate quality
performance:
• Accurately
• Timely
• Across all measures
• Using all discrete
claims and clinical
data
Improve
performance
Stakeholders can’t
identify the highest-
priority improvement
opportunities:
• Measures
• Sites
• Providers
• Patients (care gaps)
Report
performance
• EHR reporting files
(QRDA’s) exclude
claims data and some
clinical data
• Claims-based
reporting excludes all
clinical data
• Some payers only
accept clinical data in
unique file formats
Every step of quality measurement presents new problems that multiply the total burden.
20. © 2020
Health
Catalyst
Problem
20
Current State Desired State
Ready
Establish accurate
performance calculations
Aim
Identify the highest-priority
improvement opportunities
Fire
Improve performance and
submit data to payers
The burden of that complexity is so great that most groups spend most of their time
managing constraints (ready, aim) rather than improving performance (fire).
22. © 2020
Health
Catalyst
Provider quality measurement is complicated by incomplete data, measures, visualizations,
and workflows (monitor, improve, submit).
Solution
22
Ready
Fragmented data and
incomplete calculations
Aim
Unhelpful visualizations and
delayed feedback
Fire
Unspecified care gaps and
constrained submissions
23. © 2020
Health
Catalyst
Solution
23
Ready
Fragmented data and
incomplete calculations
Aim
Unhelpful visualizations and
delayed feedback
Fire
Unspecified care gaps and
constrained submissions
Able Health combines complete data, measures, visualizations, and workflows (monitor,
improve, submit) into one comprehensive solution.
24. © 2020
Health
Catalyst
Solution
24
Aim
Unhelpful visualizations and
delayed feedback
Fire
Unspecified care gaps and
constrained submissions
Able Health combines complete data, measures, visualizations, and workflows (monitor,
improve, submit) into one comprehensive solution.
Ready
Calculates performance for a complete
list of provider quality measures using
complete claims and clinical data
25. © 2020
Health
Catalyst
Solution
25
Fire
Unspecified care gaps and
constrained submissions
Able Health combines complete data, measures, visualizations, and workflows (monitor,
improve, submit) into one comprehensive solution.
Aim
Visualizes complete performance metrics
for daily monitoring and prioritization of
high-priority improvement opportunities
Ready
Calculates performance for a complete
list of provider quality measures using
complete claims and clinical data
26. © 2020
Health
Catalyst
Solution
26
Able Health combines complete data, measures, visualizations, and workflows (monitor,
improve, submit) into one comprehensive solution.
Fire
Specifies care gaps and connects the
workflows for performance improvement
and submission to payers
Aim
Visualizes complete performance metrics
for daily monitoring and prioritization of
high-priority improvement opportunities
Ready
Calculates performance for a complete
list of provider quality measures using
complete claims and clinical data
27. © 2020
Health
Catalyst
Solution
27
Able Health combines complete data, measures, visualizations, and workflows (monitor,
improve, submit) into one comprehensive solution.
Aim
Visualizes complete performance metrics
for daily monitoring and prioritization of
high-priority improvement opportunities
Ready
Calculates performance for a complete
list of provider quality measures using
complete claims and clinical data
Fire
Specifies care gaps and connects the
workflows for performance improvement
and submission to payers
28. © 2020
Health
Catalyst
• Calculate any provider
quality measure
• Leverage all your
DOSTM data
Measures engine Performance dashboard
• Submit MIPS data
through an API
• Submit clinical data to
commercial payers
Submission engine
Solution
• Monitor performance
• Identify high-priority
improvement opportunities
The Able Health solution includes a measures engine, performance dashboard,
and submission engine.
29. © 2020
Health
Catalyst
Solution
Growing measures library that already includes over 240 quality measures
Patient Safety Effectiveness Efficiency Community Continuity Experience
• Documentation of
Current Medications in
the Medical Record
• Unplanned
Reoperation within the
30-Day Postoperative
Period
• Perioperative
Temperature
Management
• Falls: Risk Assessment
• Total Knee
Replacement: Venous
Thromboembolic and
Cardiovascular Risk
Evaluation
• Perioperative Care:
Venous
Thromboembolism
(VTE) Prophylaxis
• And 11 more
• Adult BMI Assessment
• Advance Care Planning
• Breast Cancer
Screening (Commercial
and Medicaid)
• Controlling High Blood
Pressure
• Cervical Cancer
Screening
• Poor HbA1C Control
>9.0
• Medical Attention for
Nephropathy
• Use of Spirometry
Testing in the
Assessment and
Diagnosis of COPD
• Patient Engagement
After Inpatient
Discharge
• And 127 more
• Overuse of Imaging for
the Evaluation of
Primary Headache
• Age Appropriate
Screening
Colonoscopy
• Medication
Management for
People with Asthma
• HIV Medical Visit
Frequency
• Avoidance of Antibiotic
Treatment in Adults
With Acute Bronchitis
• Emergency Medicine:
Emergency Department
Utilization of CT for
Minor Blunt Head
Trauma for Patients
Aged 18 Years & Older
• And 12 more
• Preventive Care and
Screening: Influenza
Immunization
• Pneumococcal
Vaccination Status for
Older Adults
• Body Mass Index (BMI)
Screening and Follow-
Up Plan
• Screening for
Depression and Follow-
Up Plan
• Tobacco Use:
Screening and
Cessation Intervention
• Screening for High
Blood Pressure and
Follow-Up Documented
• Immunizations for
Adolescents
• And 2 more
• Advance Care Plan
• Colonoscopy Interval
for Patients with a
History of
Adenomatous Polyps -
Avoidance of
Inappropriate Use
• Dementia: Education
and Support of
Caregivers for Patients
with Dementia
• Biopsy Follow-Up
• Maternity Care:
Postpartum Follow-up
and Care Coordination
• Total Knee
Replacement: Shared
Decision-Making: Trial
of Conservative (Non-
surgical) Therapy
• And 16 more
• Oncology: Medical and
Radiation - Pain
Intensity Quantified
• Oncology: Medical and
Radiation - Plan of
Care for Moderate to
Severe Pain
• Functional Status After
Primary Total Knee
Replacement
• Back Pain After Lumbar
Fusion
• Leg Pain After Lumbar
Fusion
• Cataracts: Patient
Satisfaction within 90
Days Following
Cataract Surgery
• Functional Status After
Lumbar Fusion
• And 9 more
Measures Engine
30. © 2020
Health
Catalyst
30 D
Comprehensive
• Breadth – compare performance
across providers, groups, or the
entire enterprise
• Depth – identify the relationship
between the various levels of
quality measurement
• Context – compare performance
rates to benchmarks, star ratings,
or scoring systems
Easy-to-use
• Compare quality performance
with just 5 simple screens
• Identify high-priority improvement
opportunities in 5 seconds
Performance Dashboard
Solution
31. © 2020
Health
Catalyst
31
Data submissions
• Submit clinical data to commercial
payers via CSV files to close care
gaps at the payer level
Performance submissions
• Report MIPS performance through
an API connection to Medicare
Submission Engine
Solution
33. © 2020
Health
Catalyst
• Calculate any provider
quality measure
• Leverage all your
DOSTM data
Measures engine Performance dashboard
• Submit MIPS data
through an API
• Submit clinical data to
commercial payers
Submission engine
Solution
• Monitor performance
• Identify high-priority
improvement opportunities
The Able Health solution includes a measures engine, performance dashboard,
and submission engine.
39. © 2020
Health
Catalyst
Which payer programs for provider quality are most important
to your organization?
• Medicare ACO – 25%
• Commercial ACO – 0%
• Other Medicare Shared Savings/Loss – 8%
• Other Commercial Shared Savings/Loss – 25%
• Medicare’s MIPS program or Commercial FFS with a link to
Quality & Value – 42%
Poll Question #4
39
40. © 2020
Health
Catalyst
The Problem
Provider quality measurement is complicated by incomplete data, measures, visualizations,
and workflows.
Incomplete
Picture
Complexity
(too many holes to fill)
Incomplete
Workflow
• Monitor
• Improve
• Submit
• Debate
• Doubt
• Delay
• Data
• Measures
• Visualizations
41. © 2020
Health
Catalyst
Why Able Health?
Able Health first creates a comprehensive quality picture by combining complete data,
measures, and performance visualizations.
42. © 2020
Health
Catalyst
Why Able Health?
Able Health then creates a comprehensive quality workflow by combining the work of
monitoring, improving, and submitting performance.
43. © 2020
Health
Catalyst
Why Able Health?
Unlike alternatives, Able Health is the only quality measures solution that’s truly comprehensive
Complete
Picture
Truly
Comprehensive
Complete
Workflow
• Data
• Measures
• Visualizations
• Monitor
• Improve
• Submit
• Accuracy
• Certainty
• Authority
Complete
Picture
Truly
Comprehensive
Complete
Workflow
45. © 2020
Health
Catalyst
• Reach out to your account manager to set up an exploratory discussion
• In this discussion, we will:
• Discuss your goals and priorities related to measures
• Ask about specific programs and measures of interest
• Answer additional questions regarding Able Health functionality
• Following this discussion, we will:
• Provide an implementation approach for your measures needs
• Provide pricing information based on your specific needs
45
Next steps
Interested? We would love to discuss your goals.