The Merit-Based Incentive Payment System (MIPS) drives many quality reporting strategies for healthcare institutions. It can be an excellent goal to work toward and can help increase revenue, but your quality reporting shouldn’t end with MIPS. Meeting quality standards can qualify you for many other incentives and improve your quality of care and cost-effectiveness. If you want to improve care and meet your goals, strong quality reporting is essential.
Let’s look closer at healthcare quality measurement and reporting and explore what they can do for your institution beyond a MIPS incentive.
What Is Quality Reporting in Healthcare?
Quality reporting in healthcare refers to using data to assess performance across various measures and standards. Quality standards, typically established by government agencies or third-party organizations, contain benchmarks that reflect maximizing positive outcomes and minimizing costs, often through measures like collaboration, resource utilization and outcomes. They offer objective, fact-based information about a facility’s performance.
In many cases, such as MIPS, these standards are tied to incentives that benefit an institution when it meets or exceeds the benchmark. MIPS, for example, provides benefits to facilities serving patients with Medicare Part B. To qualify, an institution must conduct quality reporting and show year-over-year improvements. Quality reporting programs and initiatives from the Centers for Medicaid and Medicare Services (CMS) can address specific areas, like inpatient psychiatry, nursing home quality, primary care and ambulatory surgical centers.
Of course, incentivizing progress helps to improve care, but it can also help institutions boost their reputations and overall quality. Along with higher reimbursements, the financial benefits of quality reporting include the potential to leverage better reimbursement rates from private insurers. When you can prove the efficacy of the business, you have more justification for your costs.
Since quality reporting can encompass a huge collection of data, it can touch on all aspects of the organization, including:
- Patient safety
- Resource utilization
- Intervention success
- Patient satisfaction
- Cost savings
- Staff turnover
The Link Between Quality Reporting and Value-Based Care
As the healthcare industry shifts away from fee-for-service and toward value-based reimbursement models, quality reporting can help you meet those goals. Value-based care is about offering more value to patients with lower costs, usually through a proactive approach to care. Ideally, value-based care reduces the number of services a patient needs. Thus, reimbursement models are offsetting this need by evaluating a practice’s success toward this goal. Evaluating success calls for data and quality reporting.
By collecting data and qualifying you for incentives regarding your overall performance — including outcomes and resource utilization — quality measures encompass more than just the number of services you’re offering.
Good scores demand a value-based approach. If you want to receive those incentives, you’ll need to offer value-based care and collect data on it. Fortunately, value-based care comes with its own benefits, with savings for everyone in the healthcare system, including providers, patients, payers and taxpayers.
This kind of care rewards you for fewer visits, so you can spend more time providing complete, effective care and less time cramming in as many visits as possible. Value-based care incentives are geared toward continuous improvement, so they go hand-in-hand with the data collection demands of quality reporting. Of course, better care can also improve your reputation and standing among partners, like insurance companies, other clinicians and suppliers.
Population Health Management
You can’t address a problem if you don’t know it exists. Quality reporting involves mountains of data, which can bring population health issues to the surface. It might reveal problems with your approach to interventions, prevalent conditions in your area or resources that could help address barriers to care.
For example, if your facility is in a location with poor public transit and many residents don’t drive, they may have trouble getting in the door. You could respond by advocating for better transit, partnering with local organizations for assistance or offering telehealth services. Data is crucial in addressing large-scale issues like population health and identifying where to best focus your efforts.
Data Collection Within Your EHR
Most data collection for quality reporting comes from your electronic health record (EHR), but many different factors can contribute to how effective this strategy is. If providers aren’t properly recording data or your information is too disorganized to understand, you’ll struggle to get valuable insights. Pulling data from the EHR can be a challenge, too. Manual collection and analysis can be time-consuming, if not impossible, depending on the size of your practice.
To support your quality reporting efforts, EHR data collection should be set up appropriately. You’ll need to assess data input methods, documentation practices and workflows to ensure reliable and up-to-date information. If you’re not sure where to start, our experienced team can help. Effective data collection can offer unparalleled visibility into your performance categories to support wide-reaching improvements and higher scores.
How the Right Partner Can Help
See Happe-Analytics in Action
As the healthcare industry becomes more complex, we gain access to more data than ever. Unfortunately, it can be difficult to sort through and understand, let alone report on quality measures for incentive programs. Happe-Analytics and Tangible Solutions can help you implement a comprehensive, in-depth approach to data collection. We address quality measurements at all levels, from how clinicians enter information to how you report data to government and third-party organizations.
To see what Happe-Analytics can do for your group, reach out to us today!