As a Health Information Exchange (HIE), The Health Collaborative serves customers who consume data from its suite of technology services, others who have agreed to work with us as sources of health data, and still others who utilize our expertise in analyzing and interpreting data. A few weeks ago, we had the opportunity to offer all three to a single organization within a customized solution that leveraged our data analysis expertise.

The Urology Group is a Greater Cincinnati clinical practice delivering expert urology care in a number of locations across the region, and is one of the largest single specialty groups of urologists in the United States. As a participant in the Centers for Medicare & Medicaid Services (CMS) Quality Payment Programs (QPP), they have agreed to adopt a pay-for-value model in an attempt to improve health outcomes and keep people well, minimizing visits to the hospital or doctor’s office.

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“I’m especially energized by helping our partners improve their processes which ultimately impacts patient outcomes. We look forward to more opportunities to assist clinicians and practices in meeting MIPS requirements for 2018.”

– Romi Wang, Senior Data Analyst

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The QPP track the Urology Group has chosen is known as Merit-Based Incentive Payment System, or MIPS, one of two tracks available through CMS. MIPS is a new approach to paying for Medicare Part B items and services in which clinicians may receive an increase or decrease in their payments based on the quality of care delivered. They report their data to CMS to receive a score which is determined by their performance in four major areas; the final score then determines what the practices’ payment will be.

What is a Qualified Clinical Data Registry?
The performance measures and reporting requirements for MIPS can be cumbersome, particularly for smaller practices, independent physicians, and clinicians who may not necessarily have data analysis expertise. That’s where The Health Collaborative (THC) comes in.

In 2017 THC was certified as a qualified clinical data registry, or QCDR, which is provided under the hb/analytics service line. This means we are a CMS-approved entity that collects, analyzes and audits clinical data on behalf of clinicians for the purposes of data submission. Our staff was able to work with The Urology Group to reduce their reporting burden while also making recommendations that could help them maximize their MIPS reimbursement.

Applying data analysis expertise for more robust data submission
While the Urology Group is able to calculate measures for MIPS internally via its Electronic Health Record (EHR) system, they recognized the benefit of leveraging THC’s expertise in optimizing and submitting data on their behalf in order to stay compliant with MIPS. THC performed an onsite randomized audit to compare patient record data with submitted data and to ensure QPP measures were accurately reported upon, based on the appropriate measure specifications.

Romi Wang, Senior Data Analyst
Romi Wang, Senior Data Analyst

Through expert data analysis by THC staff, we were able to submit more a robust data set on behalf of The Urology Group that better tells the story of their work. Romi Wang, THC’s Senior Data Analyst, compared The Urology Group’s quality measure results with QPP quality benchmarks and provided feedback on selecting measures that would maximize their performance scores.

“We are so glad that The Health Collaborative had the opportunity to assist The Urology Group with their QPP/MIPS data submission by utilizing our hb/analytics service line,” Wang affirmed. “We compared their quality measure results with QPP quality benchmarks and provided feedback on selecting measures that would maximize their performance scores. I’m especially energized by helping our partners improve their processes which, ultimately, positively impacts patient outcomes. We look forward to more opportunities to assist clinicians and practices in meeting MIPS requirements for 2018.”

THC is proud to have met The Urology Group’s needs in this instance with a customized, tailored solution that exceeded expectations on achieving their goals with the hb/analytics QCDR service. For more information, please contact Sean Flynn at sflynn@healthcollab.org or 513.247.5257.