MACRA Measures & Insights

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Product Overview

MACRA Measures & Insights is a foundational product for integrating hundreds of measures across financial, regulatory, and quality departments. Enables proactive measures surveillance to enhance outcomes; facilitates monitoring behaviors, interventions and activities needed to influence, manage, or change outcomes.

It’s much easier to monitor a set of measures and everyone be focused on those instead of the 271(or more if other payer’s are added).

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Features

  • Ability to view multiple measures by category across contracts to uncover areas of overlap.
  • Evaluate multiple facets of measures across contracts.
  • Ability to view multiple measures by contract.
  • Align measures by various groupings including specialty, disease state, domain.
  • Evaluate historic compliance rates by provider practice groups.
  • Identify measures with sufficient data completeness.

Benefits

Technical Benefits:

  • Data easily integrated or exported.
  • Measures data can be exported to help with regulatory reporting requirements.
  • Patient/member level measure data easily integrated into other EMR's or Health Catalyst products.

Strategic Benefits:

  • Increase strategic alignment on measures upon which to base risk.
  • Increases proactive measures surveillance to enhance outcomes.
  • Increases your organization's ability to tactically and strategically identify measures to manage risk in multi-year value based contracts.

Measures

Available Measures Include:

  • Measure opportunity based on measure associations by category and impact.
  • Breakdown of the volume and quality of data for measures, so choices can be made to go at risk with measures that have reportable support data.
  • Track measure performance relative to benchmarks.
  • 271 MACRA Quality Payment Program (QPP) measures for 2017.
  • Ability to add HEDIS and other payer quality measures and/or additional MACRA quadrants.
  • Identify financial impact by group, practice, provider, dimensions, contract.
  • Enhanced measure stratification for specific reporting aggregation requirements.

See Sample Screenshots of MACRA Measures & Insights

Data Sources

  • Clinical Ambulatory EMR
  • Outpatient Claims

MACRA Measures & Insights: A Deeper View

Background

As part of a broader push to overhaul federal health spending, new rules on Medicare physician reimbursement are reforming the payment model via a quality-based payment program through bonus and penalties tied to performance.

More and more payer and provider contracts include financial risk and rewards associated with quality measures. MACRA has overwhelming bipartisan support, so it is unlikely to be repealed. While driven by CMS, MACRA will also influence commercial payers, increasing the impact on health systems and providers.

Problem Summary

Regulatory pressures are significant and increasing.  Compiling, processing and assembling regulatory measure data requires significant manual work by physicians and analyst resources.  With so many measures and often a lack of coordination between departments, the identification of aligned measures is all but impossible.  There is a need to consolidate and align measure work in order to effectively maximize quality based financial incentives and efficiently address regulatory reporting requirements.

Users

This application is intended for Chief Quality Officers/Physicians over Quality, Chief Medical Officers, Chief Financial Officers, Chief Compliance Officers, Directors of Quality Management, Directors of Regulatory Reporting and their staff.

Use Cases

Compare historical measure performance to established benchmarks to directionally inform the selection of measures to include or exclude from at risk contracts and/or government reimbursement programs.

Success Measures

Opportunity Identification:

  • Select the most appropriate measures on which to go at risk, earning the best possible financial outcome for services rendered.

Process Improvements:

  • Increase the number of measures that you calculate and for which you know your scores.
  • Integrate and align your organizations measures for efficiency.
  • Increase your organizations ability to identify areas for improvement and make informed decisions about which measures to go after.

Outcomes Improvement:

  • Increase monitoring vigilance around preventative measures, facilitating better overall care for the population.
  • Increase/provide the ability to drill into groups, practices and providers leading to discovering and pinpointing gaps.