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How to expedite quality reporting submissions

Revathi Sankar, Rohan Choudhary, Rakshay Jain
Wed 01 December 2021
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One of the key tenets of success in value-based contracts is measuring, tracking, and improving quality scores. While we know that meticulous quality measurement is key for improved outcomes, there’s a lot of room for improvement when it comes to quality analytics and reporting. As organizations work to increase value-based care investments, they face various reporting challenges, including:

  • Segregated patient data across several EHRs
  • Yearly updates to CMS measures, codes, logic corrections, and clarifications
  • The time-consuming, error-prone process of collecting data manually
  • The 3-month time frame for completing annual MSSP performance reporting

Innovaccer’s Quality Reporting solution automates quality reporting for the 10 CMS web interface measures and helps providers close existing care gaps. Our solution saves valuable hours for our customers and makes reporting more efficient through:

  • Data aggregation and automated measures evaluation: This solution is built on top of our proprietary Data Activation Platform (DAP). We can aggregate data from more than 80 clinical and claims data sources to automatically collect and add evidence for a measure.
  • A highly intuitive user-interface:
    • Our dashboard lists patients in the order of CMS rank per measure and displays the progress of all measures face-up.
    • The evidence gathered for each patient is displayed within our detailed evidence cards. Data gaps are also displayed to enable quick reviews.
    • Our inline Notes feature helps you keep all documentation in one place to facilitate audit readiness.
    • We allow users to flag patients for review. The flag acts like a bookmark. This feature allows the users to re-visit the patient at a later point in time when they have enough evidence.

  • Up-to-date measure definitions: Measures align with the latest CMS Web Interface Measures definition. Based on the evidence and measure criteria, the measure outcome is automatically computed.
  • Seamless gap closure and export: Additional evidence can be added using our smart manual entry form:
    • The form can be customized per customer to reduce overall clicks.
    • Users can export any details gathered in a format that can be directly shared with CMS.
  • An intuitive dashboard to track progress: Users can track and review the daily progress of each facility. The dashboard provides an actionable insights on the number of patients - completed vs pending, displays progress by measure, and provides insights on disqualification criteria chosen per report.

Many ACOs still perform manual quality reporting. They face some common challenges, including:

  • Import and export formats vary across payers
  • Measures vary across payers
  • Data can’t be collected automatically from many clinical sources
  • Reporting frequency varies across payers

In order to solve for these challenges, Innovaccer’s Supplemental Reporting solution helps ACOs:

  • Import and export data to meet the standard formats of various payers.
  • Automatically map the columns of payer files to allow efficient import with fewer clicks.
  • Prepopulate evidence per measure definition and approve and export it for reporting back to the payer.
  • Choose from a list of certified reporting measures.
  • Add evidence for measure completion through the customized manual data entry form.

What’s next for Innovaccer’s Quality Reporting Suite?

CMS Web Interface reporting will eventually be replaced with electronic clinical quality measures (eCQMS). We plan to scale our reporting tool to cover 70% of the eligible population for the three eCQM MSSP measures. We also plan to ingest QRDA, non-EHR, and other claims data to help triangulate evidence.

We’re also planning to expand to other reporting categories (e.g., HEDIS IDSS submissions) and make our reporting tool modular to support reporting workflows across different payers.

Conclusion

Quality management in healthcare works towards reducing errors and improving patient care. The safety and effectiveness of treatment are two of the most critical measures of quality. Innovaccer’s Quality Reporting module automatically extracts relevant data to track and report on the selected measures and generates an easily accessible report. We enable organizations to monitor and measure the quality of care being provided to each and every patient on the go, and plan timely intervention.

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