In part one of this series, we framed the problem many organizations are struggling with in regard to ACO reporting practices. We also briefly discussed the areas that most often need attention in order to improve patient engagement and operational efficiency. In this article, the focus is on providing a little more detail on the three key areas that we previously discussed. I’ll also be giving you a few concrete steps you can take to help improve ACO reporting and patient engagement.
As discussed in the previous article, identifying all the sources of information is probably the most difficult step in the process, but it’s also the most important to get right. Without the right data in the proper place, it will be impossible to get quality reports. The investment required to integrate all the data is extremely critical and once installed, pays dividends through the life of the ACO. There are several ways to handle ACO reporting solutions in order to fulfill the objectives of the MSSP ACO 33 measures while allowing the operational processes of doctors and patients to be incorporated into one cohesive system. Having all the data in one place allows reporting to drive change in the organization. Bringing all the data together with the right level of detail provides one single source of truth. The data for the ACO 33 measures is typically in several different sets that must be integrated at the patient level. The first set is Claims data, which is usually sourced from the Professional or Hospital billing system. The second set is Clinical Data. This normally comes from the EMR system and/or claims system based on the measure. Some measures require data from clinical and the claims data to get a complete picture of the patient and identify their gaps in care. Finally, there is external data. This data includes files like Patient Satisfaction Surveys that the payer will provide (in an ACO within the MSSP program this would be coming from Medicare). These external files need to be incorporated into one single source or record in order to provide a single view of the ACO. Ideally, all the data above should be at the patient level. Unfortunately this isn’t always feasible; especially when the data comes from the payer and the ACO has little control over the format or the content provided.
Once the data is brought into a single system the presentation layer can become the focus. Ensuring the providers have quality reports that are easy to interpret allows them to take meaningful steps to engage patients. There are several other key considerations that need to be kept in mind when building a tool for providers: The data must involve an easy to use tool. The providers should have a single presentation layer where they can see all their patient data. Physicians can be easily frustrated if they need to go several places in order to get their data. A good example report would be a list that provides data for patients per measure and performs patient outreach per measure. An alternative approach would be to create an overall view of the patient across different measures. Security is a key component to this piece as well, since doctor data and patient level data can’t be shared. If Doctor A has his list of patients, Doctor B shouldn’t be able to see it. Also, the administrators monitoring the ACO performance need a mechanism to see the performance of individual providers as well as the entire ACO as a whole. As I said earlier, the reporting must be at the patient level. In order to drive patient engagement it isn’t enough to hand a rate card to providers and expect them to drive the analysis required to identify missing patients and gaps in care. That is why the presentation layer with the most value must have secured patient lists per provider, which can be accessed at the click of a button.
It is important that the required data is shared frequently with the doctors. I recommend delivering reports to physicians at least monthly. Providing quality metrics on a regular basis will provide a constant barometer for practice performance. This will help drive necessary change throughout the year and avoid a mad dash for data at the end of the reporting cycle. Improved patient care means engaging patients all along the way, not just at the end of the year. Additionally, providers’ use of reports should be tracked. Reports and analytics should be produced that show administrators which providers have accessed the patient lists and the time of their last engagement with the patient.
Improved patient care is the obvious reason for adopting the ACO model for your organization, but it’s not a simple process. A lot of data collection and manipulation goes into providing the key metrics that measure not only patient engagement, but also operational efficiency. In order to get the best results possible, be sure to pay attention to the three key areas we just discussed. This will ensure your organization is able to deliver the right reports at the right time to improve patient engagement and make the most of your staff’s resources.