By Justin Barnes, Partner, iHealth Innovations
Twitter: @HITAdvisor
Twitter: @RevenueSherpa
Host of This Just In
The financial, clinical and technical underpinnings of implementing an effective Quality Payment Program strategy have introduced a new level of complexity to many healthcare organizations. Providers have made big investments in IT infrastructure designed to help bring a modern, data-driven business approach to an industry ready to quantify healthcare outcomes. Unfortunately, many providers struggle to find and dedicate the time and resources required to maximize return on those investments. For many, internal expertise is the missing link.
Navigating new reimbursement models, health information best practices, and IT implementations without dropping the ball on patient care requires finesse. Limited staff resources are prompting many clinicians to align with outside partners to help shoulder the burdens of strategic planning and IT. Whether internal or external, securing dedicated staff resources to help your practice execute on QPP participation initiatives is a central tenet to finding success under MIPS, APMs and other quality-based payment programs.
As your healthcare organization looks for QPP experts to lead the charge, look for partners who will:
- Proactively evaluate payment model options and specifics for your specialty
- Educate practice stakeholders along the way while still allowing them to focus on patients as priority number one
- Offer coaching on how to negotiate with payers on risk-based contacts
- Help the leadership team flesh out strategic initiatives rooted in a firm understanding of QPP requirements and available resources
- Go at-risk with you – one that gets paid based on what you get paid – to guarantee keen attention to meeting your organization’s unique needs
- Manage any IT customization or workflow augmentation that QPP participation may warrant
- Involve staff members to make sure the team has a collective understanding of practice objectives so everyone is working toward the same goal
- Detail potential costs and weigh those against earnings potential
- Manage patient care according to specific populations and identified risks
Identifying partners that you can rely on will be vital to finding success in the uncharted waters of MACRA. The greatest asset practices can invest in during this critical time is expertise to help address the new, manifold needs of an evolving medical practice business. Take advantage of resources such as Medicare’s Physician Compare and Quality Resource Use Reports to benchmark your performance and reporting practices against peers along the way.
Practices who rise to the challenge, embrace new business models and proactively work towards a solid QPP strategy with partners well-versed in goals and deliverables will undoubtedly be better positioned for success under value-based care and evolving reimbursement programs.
Earlier blogs in this series touched on the financial, clinical, and technical aspects of QPP success.