3 Proven Ways to Improve Practice Profitability and Clinical Performance Using Outcomes

outcomes-blog“Why should we collect data?”

“What’s the ROI of PROs?”

“How do providers and practices use outcomes data most effectively?”

These are great questions, and we get them all the time. Prospects, clients, and partners constantly look for the most valuable and effective ways to utilize outcomes data. Our answers and advice typically vary, but we inevitably reply with a question of our own: “What are your goals?” Clinic goals, quality goals, business goals, marketing goals and others factor into play when utilizing quality data.

This article focuses on the three that, in our opinion, provide the most significant ROI potential for a PRO collection program:

  • Negotiating with payers
  • Internal physician quality reviews
  • Marketing

At OBERD, we know our role: we’re the data collection experts. And for good reason: Our clients likely don’t think about data collection nearly as much as they’re thinking about how to improve their practice, how to differentiate their providers, and how to grow margin by negotiating more favorable reimbursements from payers. Outcomes data plays a role in all three. Let’s dig in.

Below, we identify three core initiatives common at most orthopaedic institutions and discuss how quality data plays a key role each.

Payer Negotiation

When preparing for payer negotiations, administrators, QA staff and physicians can gather and utilize outcomes and satisfaction data that highlight the practice’s attention to quality and demonstrate its continuous improvement in outcomes scores.

Armed with quality data relating to patients and procedures, administrators can drill down and have data-driven negotiations with payers to gain more favorable reimbursement rates in contracts.

And it’s worth it to payers. If they know a provider has high (and predictable) quality metrics, they know the provider will, more than likely, get it right the first time. They can hedge against re-admissions and complications because they have the data that demonstrates low risk.

This is especially useful in larger metropolitan areas where competition for the patient population is fierce. Providers and institutions who can demonstrate quality and value, backed by data, are a safer bet for payers.

Physician Reviews

Administrators and quality managers may struggle with physician quality reviews if they’re not armed with data-driven quality and satisfaction metrics. PRO data, especially when blended with Satisfaction data, can give an administrator a quantified view of the quality a physician provides.

Practical use cases include identifying why a surgeon’s quality scores are high for a specific surgery (or even a specific patient cohort), and utilizing that data to refine methods for other under-performing providers.

Imagine the following conversation between an administrator and surgeon: “Dr. Smith, can no longer perform a total knee for patients with a BMI over 20 because outcomes scores are too low and it makes the practice vulnerable to margin if it affects our payer contracts. Dr. Smith needs to adjust your process, perhaps by adopting Dr. Jones’s approach because Dr. Jones’s scores are above average on benchmarking reports. Or we can change workflow triage that patient cohort (<20 BMI) out of Dr. Smith’s patient schedule.”

Data-driven Marketing

It seems like every time we hear about an orthopaedic surgeon, you also hear, “he’s the best” or “she’s the best.”

Surely not every surgeon is the best, even among their local market or patient population. But practices and providers have benefited from anecdotal reputations like, “he’s the best” for years. In the future, a claim of being, “the best” needs to be backed up.

Just like so many other consumer purchasing decisions, prospective patients are first turning to the internet for reviews and fact-finding about a surgeon prior to going for a consult. Practices and providers who collect data can also demonstrate quality by leveraging data in data-driven marketing messaging.

Savvy practices have already begun advertising their data collection initiatives. Advertising shows how providers collect quality data using patient questionnaires in order to tailor care to a unique patient, or make recommendations based on “patients like you.”

That line of advertising instills a sense of ownership in the patient. They intuitively understand that the questionnaires they complete play a role in the care they receive, giving them an onus of control in the process. Therefore, data collection is an effective, credible way to market value-based care.

As seen in OBERD’s Insights Blog.

Hackathon IV: Notes 2.0 and Beyond… A New Evolution Has Begun

Vishu Viswanathan

Vishu Viswanathan

Director of Software Engineering at SRS Health
Vishu started his career with SRS Health as the Director of Program Management, and is now the Director of Software Engineering. In this role, he is responsible for the architecture, design, and development operations for the SRS product lines.

Prior to joining SRS in 2017, Vishu was with GE Healthcare, where he was the SW Engineering Director for the Centricity Imaging PACS product. Vishu has had a successful career in the healthcare industry, with deep domain expertise in Healthcare imaging, devices and information technology, and medical software development. He began his career as a Software Engineer with GE Healthcare and has held progressively responsible roles in both product development and program management.

Vishu is an Agile practitioner and is passionate about people and product development. He holds a Bachelor’s Degree in Computer Science and Engineering, and Masters in Business Administration.
Vishu Viswanathan

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Hackathon 1Last month, SRS Health participated in an energizing, collaborative and fun-filled Hackathon IV, a company-wide event designed to stimulate the innovative mind-set and competitive spirit of the organization to explore creative solutions for client needs.

The theme for the 4th Annual Hackathon Event was, Notes 2.0 and Beyond. Technological advancements in the healthcare space has enabled the use of various mobile devices and technologies at the point-of-care. The team was challenged to come up with ideas that revolutionize the process of capturing and documenting patient encounters, while maintaining/improving accuracy, high productivity, and efficiency for the end user.

Scores of ideas were submitted from across the organization and narrowed down to six ideas that our hackathon teams focused on. At the end of the event, the organization held a traditional “science fair” to showcase the incredibly innovative solutions developed over the one-week event.

We are excited that a number of these concepts have the potential to make it into future versions of our products. We look forward to sharing them with our clients in the 2018 User Summit’s Innovation Expo in October in Las Vegas.

At SRS Health, we strive to bring innovative healthcare IT solutions to the marketplace and our hackathon events allow the team to innovate without restraints.

Hackathon 2

MIPS 2018 New Year Resolutions

Christine Schiff

Christine Schiff

Government Affairs Specialist at SRS Health
Christine has been with SRS for over 5 years, working in Government Affairs and serving as the HIPAA Privacy Officer. She is devoted to providing excellent customer service, and she translates this passion into the work she does to support government program compliance. She has an expert understanding of MU and PQRS and serves as a valuable client resource.

Prior to joining SRS, Christine worked at NYU for 11 years where she also obtained her Bachelor of Science in Healthcare Management.
Christine Schiff

Check out these top 5 tips for starting your 2018 MIPS reporting on the right foot!

  1. Focus on Quality! – 2018 new-years-resolution-mipsrequires full-year reporting. With quality being the highest valued category (50% of your MIPS score), now is the time to review your quality-reporting plan and make sure you are capturing all the necessary data to report successfully. Furthermore, this is the category where providers can really distinguish themselves. It is anticipated that ACI scores will generally be high due to MU experience, and that most providers will earn the full score in the Improvement Activities category.
  1. Understand Your Cost Position – In a change from the original proposal, the cost category will contribute up to 10% of your overall MIPS score. Look for CMS reports later in 2018 to help you understand how cost is assessed and consider ways to reduce the cost of care you provide.
  1. Plan your ACI Reporting Strategy – CMS is allowing the use of 2014-certified software in 2018. Here are your options:
    • Your EHR is 2014 Certified – report the 2017 Transitional Measure Set.
    • Your EHR is 2014 and 2015 Certified – report either 2017 Transitional Measure Set, the ACI Measure Set, or a combination of both.
    • Your EHR is 2015 Certified – report the ACI Measure Set.

Compare the two measure sets and evaluate which set will likely earn you higher performance scores.

  1. Pick Your Improvement Activities – CMS has included some additional Improvement Activities for 2018. Review the list and make sure you will be able to attest to completing them for at least 90 days in 2018.
  1. Strive for Better Performance – Improvement in the Quality (and Cost) category for 2018 over last year will earn you bonus points this year. Review your CQMs and readjust workflows as necessary to support higher performance.

 

 

May your holidays and new year be filled with peace and prosperity!

Happy Holidays

Now is the perfect time to reflect upon the past year and those who have helped to shape our business. You!

We are truly inspired by physicians and healthcare professionals who are dedicated to providing the best care for their patients, and delighted to help them do so now and in the future.

May your new year be filled with good health, happiness, and success!

Happy Holidays,
Your SRS Health Team

Like Holiday Gifts, “Patient-centric Care” is about Quality, Not Quantity

The end of the December is a time for reflection on the closing year, and for making plans for the new one. It’s a time for top-ten lists and New Year’s resolutions. But for now, let’s focus on one of the top buzzwords of the year in healthcare: Patient-centric care. 

It’s actually been several years now that patient-centric care has been gaining buzz-worthy status, and like most trendy new concepts, it has often been used without a clear consensus on what it actually means. Most recently, for instance, it has become a catchall term for any care that offers a more comprehensive focus on the patient. And that should make us pause and think—how in the world did medicine ever lose its comprehensive focus on the patient? There have been many factors, to be sure, but the primary driver seems to have been physicians’ and practices’ need to align themselves with payment models that rewarded the volume of visits over the value of care.

This has permeated all levels of healthcare for many years. Whether it was the development of healthcare IT strategies, the crafting of EHR systems, the HIMSS stages of adoption and utilization, or the use of performance scorecards and data warehouses and analytics—all the focus was on maintaining high volumes of patient care, while a comprehensive approach to the patient often got lost in the flood of individual symptoms, tests, and treatments.

That is, until the recent sea change in the industry that shifted payment models from rewarding for quantity to rewarding for quality. This was a necessary correction, but the resulting increase in focus on value-based contracts puts healthcare providers at risk for the total cost and quality of care provided.  It has also highlighted significant holes in IT and data strategies that need to be addressed if an organization is successful in this new payment paradigm. At the top of that list of necessary improvements is patient engagement.

How to Engage? 

Patient engagement isn’t something that takes place at one point on the healthcare continuum—it’s a way of reorganizing the care continuum so that patient input and feedback are integral parts of the process at every step. Proper patient engagement aims to:

  • Involve patients in their own healthcare, leading to better outcomes and increased patient satisfaction;
  • Meet patient expectations for better ways to access and engage with their healthcare information and data;
  • Automate patient intake and other processes, helping to secure ROI;
  • Leverage patients to enter data, freeing practice staff to focus on patient care;
  • Improve communication between patients and caregivers;
  • Improve compliance with government regulations; and
  • Provide a global platform for patient access that spans multiple facets of the practice, i.e. physical therapy, urgent care, and other office locations.

This means that, when it comes to IT issues, practices need to choose the right vendor if they want to make patient engagement a reality. They need a vendor who does more than just sell a one-size-fits-all solution; they need a partner in the process of restructuring established workflows for greater efficiency, reduced costs, and better patient engagement. Achieving this is a big enough task on its own, so it’s important to minimize any potential challenges to adoption. The solution has to be:

  • Easy-to-use for both patients and practice staff;
  • Vendor neutral (not limited to the products of a specific manufacturer);
  • Data standardized, so the data can be accurately exchanged between different systems, increasing confidence of both doctors and patients; and
  • Able to connect and communicate with EHRs, HIEs, and ACOs.

As we move from volume- to value-based reimbursement, it is critical to understand how to best utilize the available tools and solutions to get patients actively engaged in their healthcare. Achieving this goal won’t be easy, but we will be creating better outcomes for both patients and for the practices that care for them. Is this at the top of your list for the New Year?

I Want My…I Want My VBC

Scott Ciccarelli

Scott Ciccarelli

CEO at SRS Health
Scott Ciccarelli, Chief Executive Officer at SRS, has more than 20 years of diverse management and operations experience garnered as a senior executive at GE, where he headed two of the company’s businesses—most recently, GE Healthcare’s Services, Ambulatory and Revenue Cycle Solutions. His areas of expertise include business strategy, leadership development, operational rigor (Lean Six Sigma), and the delivery of enhanced value for customers through quality improvement and innovation.
Scott Ciccarelli

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I-want-my-vbc-blog

Launched with the iconic “I Want My MTV” ad campaign, Music Television was born in 1981 – and the music industry changed forever. For the first time, we could do more than hear music; we could see it being executed in a new visual medium. And the most successful bands were the ones who took advantage of this new opportunity to engage with audiences. Fast-forward to today, and technology has helped our music consumption continue to evolve in ways we could never have imagined.

So why am I talking about the 80s, what does this have to do with our annual User Summit, and how does Value Based Care (VBC) fit into all of this? Yes, we had an awesome 80s-themed party at last month’s summit. (I may or may not have been dressed as Slash, the guitarist from Guns N’ Roses at one point…) But there’s a better reason: we are in the midst of a healthcare revolution – and we are all making history. Together.

“Together” is a key word to tomorrow’s value based success. It’s how SRS Health is going to help our clients prepare for VBC, so they can benefit financially from the data-driven rewards – and more importantly, so they can utilize that data to provide even better medical care. We are continuing the SRS tradition of collaborating with our clients to create agile solutions designed to maximize today’s opportunities and pave the way for value-based success.

How are we doing this? With intelligent data solutions that cultivate the high levels of patient engagement, operational efficiency, and demonstration of quality that are critical to VBC. Working toward improved outcomes benefits your patients, and it benefits your businesses.

Here’s how some of our amazing clients are adding their ingenuity to our flexible data solutions, to provide improved care at lower cost – and create rock star VBC results:

  • Informed Decision Making. Bayview Physicians Group, a multi-specialty practice in Chesapeake, VA, is using data-driven evidence to mitigate the potential reimbursement shortfalls in the Medicare Advantage HCC Program. By developing protocols for various high-risk categories that help justify higher-cost treatments, Bayview is positioning themselves to be ahead of the cost factor curve. Why? Because the data shows that they are only recommending higher-cost treatments when they are medically necessary, which ultimately justifies the expense.
  • Operational Efficiency. Illinois Bone & Joint Institute has been using data to standardize best care practices across all of their physicians to provide the best and most effective results – in both the Medicare Federal Programs and commercial markets. For the past year, they’ve been investigating the factors that most influence orthopaedic outcomes, and how to use outcomes data to drive better care at lower cost. Now they want to combine the power of their EHR and their Outcomes solution to provide real-time evidence-based information at the point of care – and OBERD is on board to help us turn this vision into a real VBC-inspired game changer for them and for the industry.
  • Driving Growth. In South Carolina, Charleston Ear, Nose, and Throat & Allergy is maintaining their competitive edge in a different way. They’re leveraging their center of excellences operational process, IT capabilities and professional organization to expand by offering other practices access to the experience, tools, and solutions required for VBC success. This has led to a group of practices that can negotiate cost savings, better reimbursements and referrals – and it’s helping to create a sort of registry that will provide better data to help inform ENT physicians and improve outcomes in the new healthcare economy.

While VBC may not have the same cache as MTV, it really is something to get excited about. We are on the cusp of an entirely new way of providing healthcare – and with our intelligent data solutions and your innovative medical expertise, we’ve got what it takes to top the charts.

Change is always scary, but it also brings opportunities. And we’re ready to start singing “I want my VBC!” (80s attire optional.)