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Quality Metrics for Improved Practice Management: There’s an App for That!. Agenda. CECity Executive Summary Emdeon Executive Summary Healthcare Reform Drivers for Enhanced Practice Management Tools Review of Clinical Quality Measurement, Reporting and Improvement Solutions. Confidential.

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Presentation Transcript
slide2

Agenda

  • CECity Executive Summary
  • Emdeon Executive Summary
  • Healthcare Reform Drivers for Enhanced Practice Management Tools
  • Review of Clinical Quality Measurement, Reporting and Improvement Solutions

Confidential

slide3
CECity

Executive Summary

slide4

CECity Executive Summaryleader in enterprise quality reporting, registries, improvement & lifelong learning

Healthcare’s leading social enterprise cloud platform to address needs under healthcare reform by aligning, simplifying, integrating and cost-effectively scaling

  • Performance Improvement
  • Pay for Performance
  • Professional Certification
  • CECity is…
  • Neutral - layer or bolt onto EMR/HIT as collaborative value-added partner
  • Dot Connector – gateway between EMR, society partners and payors; link to world leaders in performance improvement
  • #1 Footprint - own largest footprint in professional certification, quality reporting & performance improvement space

CECity Deployment Options…

Multi-Tenant

Private Portals

Confidential

Confidential

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CECity’s Performance Management Solution…At the Point of ConvergenceAligning solutions across the “3Ps” to engage providers in improvement

slide6
CECity’s Cost-Effective, Scalable Solution Layers onto EMRsaddressing the burgeoning needs under reform in synergy with existing HIT

Goal oriented

Incentives

Feed Useful Analytics, Gaps, Outliers and Quality Reports BACK for qualityimprovement & research

GAPS

Feed Dataforward from EMRs and other Data Sources

Performance

Learning

Communities of practice andcommunication networks

ePortfolio

Goal: enhance the value of EMRs by seamlessly layering or integrating unique, exclusive and/or necessary services that support the EMR’s quest to measure and manage quality, report for payment or other incentives, and move providers from measurement to improvement

slide7

CECity’s unique footprint and partnershipsmore than technology…relationships, experience, and trust

Partnerships

Commitment Quality & Professionalism

why are we here today
Why are we here today?
  • Healthcare reform is rapidly shifting from early stage data capture, collection activities (EMR, eRX) to later stage requirements driven by payment reform (MU Stage 2, 3) for ACO, IDN, VBP, MA Stars, and other shared-risk models
  • Customer needs and focus shifting to performance measurement and management (pop health, patient care gap analysis, patient (CG surveys) and practice improvement), value-based payment, external (to EMR) reporting to national specialty registries, rapid cycle learning and compliance

Meaningful Use Stages

slide10

Why are we here today?

  • Payment, compliance requirements growing & converging beyond the EMR
  • Providers don’t know what to do, where to turn, how to handle them all!

Public Payors

Protect Members

& Own P4P

Physicians / Groups

Professional, Financial, Self Regulation

PO (Physician Org)

QI and P4P Program

Group / Hospital

QI and P4P Program

Group / Hospital

Care Redesign

Credentialing /

Re-Credentialing

Medicare Advantage Star Ratings

Private Payors

Attract/Protect Members

& Own P4P

OPPE/FPPE

Hospital Accreditation

Protect Patient Quality

Meaningful Use

CQM, Specialized Registries

Hospitals VBP

Readmission,

Never Events

Physician VBP

Federal: PQRS & VBM

Commercial: BTE & P4P

Improve Patient Experience of Care

Shift from FFS to Value Based Contracts and Shared Risk (ACO)

MOL Coming Soon

CME Requirements

Maintenance of Certification

Board Exams

State Licensing Boards

Protect Public from Harm

Specialty Boards

Professional Self Regulation

10

Confidential

slide11

Why are we here today?

  • Penalties and Requirements are being ratcheted upwards!
  • Providers need help now, but most are struggling to meet them all on their own

2013/2014

Year of the Penalty

slide13

Quality Measurement, Reporting and Compliance Solutions

Comprehensive suite of quality products and services to help providerssatisfy their healthcare reform requirements via one integrated, cost-effective solution

  • Integrated Products Satisfy Multiple Requirements
  • Standalone Product Modules

CommercialVBP

Menu Item 6

Specialized Registry Reporting

Meaningful UseStage 2

Clinical Quality Measures

Reporting via Registry

PQRS via QualifiedClinical Data Registry

Federal VBP

Professional

slide14

ImpaQt™ One-to-Many Clinical Quality Gateway

  • Connect to a network of specialized registries via one clinical quality gateway

And More includingthe Societyof Societies

ImpaQt™ One to ManyClinical Quality Gateway Registry

EHR

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Meaningful Use Stage 2 – Continuous Reporting to Specialized RegistriesCECity’s position provides unique opportunity to bring value to customers, access to sustainable model for MU2 and QI

Immunization

Registry

Specialized ClinicalRegistries

Cancer

Registry

Data

SpecializedRegistryGateway

(option to add PQRS, CQM)

Data

Value

EMR Data

bridges to excellence 1 commercial p4p program
Bridges to Excellence® #1 Commercial P4P Program
  • #1 US Pay for Performance Program to Commercial Health Plans
  • Data pipelines established with leading EMRs and HIT companies (GE, Meridios, NextGen, eCW, Athenahealth)
    • Key States: Texas, California, NY, Carolinas
pqrswizard like turbo tax for pqrs mandated federal value based purchasing program
PQRSwizard® like Turbo-Tax® for PQRS - mandated federal Value-based Purchasing program
  • #1 Cloud-Based PQRS Registry Platform
  • #1 Payment Success Rate (>99.5%)
  • Proven Business Model, Revenue Share for Partners
  • Only 25% eligible provider participation
  • CMS Qualified for Registry, DSV, GPRO, and Qualified Clinical Data Registry (QCDR)
  • CECity is bringing it all together – BTE, PQRS, QCDR, MU2 CQM and Specialized Registries with Societies
slide24

MGMA DataDive

Metrics for Practice Management

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Practice PerformanceFeatures process and utilization measures with flexible benchmarking.

slide27

Financial Analysis

Revenue, cost, profit based on billings/cost allocation models

slide29

Track Changes Over Time

Revenue, cost, profit based on billings/cost allocation models

slide30

Data Connectivity

Choose to automatically populate data through one of the connected data feeds.

slide31

Professional Compliance (Maintenance of Certification) multi-faceted Apps incorporate or link to MOC Part IV and other compliance programs

Send upstream to ABIMSelf Directed PIM for Credit

slide32

Performance Improvement Apps via CECity Access tools and resources from the world’s leaders in quality improvementDeliver them to providers in practice to move from measurement to improved outcomes

Quality Training

PCMH Survey

PI Toolkits

thank you
Thank You
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