ACO MSSP Measures
Product Overview
ACO MSSP Measures tool supports accountable care organizations (ACO’s) participating in the Medicare Shared Savings Program (MSSP). This tool supports monitoring and managing actual performance against CMS required measures for ACO’s throughout the year. The ability to measure performance and drill into each measure anytime, not only after a required reporting period, provides the ability to identify inefficiencies and opportunities for improvement in a timelier manner.
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Features
- Ability to look at measures and see how many patients need attention to move to the next percentile. Provides insight into opportunities for process improvements around measures and associated workflows.
- Ability to look at a provider’s patient population.
- A provider can review patient’s compliance prior to being seen and take preventative care steps as appropriate while the patient is in the office.
Benefits
Benefits Include:
- This tool gives accountable care organizations the opportunity to assess and improve performance prior to reporting to CMS, which represents a critical advantage given the dollars tied to an ACO’s performance against the CMS measures.
- Quickly view performance on measures using the measure summary. Performance indicators direct your attention to underperforming measures.
- Measures can be analyzed individually to support finding problem areas and providing details leading to better understanding of what aspect of the patient interaction might be lacking.
- This tool provides details to view provider measure performance and individual patient details either of which could lead to improved measure performance, providing potential for specific actionable details about how to improve scores.
Measures
Available Measures Include:
- Patient/caregiver experience
- Care coordination/patient safety
- At-risk population
- Preventive Care
Data Sources
- Electronic Medical Records (EMR)
- CMS Claims
- HCAHPS – Patient Experience
Background
Accountable Care Organizations were authorized in 2011 through the Affordable Care Act. The goal of an ACO is to deliver seamless, high-quality care for Medicare beneficiaries, instead of the fragmented care that often results from a Fee-For-Service payment system in which different providers receive different, disconnected payments.
ACO’s will be responsible for maintaining a patient-centered focus and developing processes to promote evidence-based medicine, promote patient engagement, internally and publicly report on quality and cost, and coordinate care.
What types of problems does ACO Measures address?
Accountable care organizations lack the capability of assessing their patient’s data to improve performance on measures throughout the year prior to reporting. This inhibits their ability to improve performance on those measures.
Use Cases
ACO Metrics is intended for those responsible for tracking, reporting, and analyzing the CMS specified metrics required for participation in the MSSP. This generally includes ACO administrators, clinicians, and practice managers.
Anticipated Improvements
This tool gives accountable care organizations the opportunity to assess and improve performance prior to reporting to CMS, which represents a critical advantage given the dollars tied to an ACO’s performance against the CMS measures.
Success Measure Examples
Opportunity Identification:
- Identify patients that are near or out of compliance in specific care processes
- Identify providers and clinics that have the largest areas of opportunity for improvement
- Identify financial impact of current performance
Process Improvement:
- Increase data distribution of performance 50% by providing monthly snap shot of performance to clinicians and ACO administrators
- Increase compliance for preventive care measures by 20% using the patient detail list as a key informative work list
