By Kathy VanOsdol, BSN, RN, MHI, Clinical/Product Specialist, Clinigence
Twitter: @clinigence
Tis The Season for ACO Reporting!
The holiday season is here. Decorations are going up, shoppers are flooding stores, and festive music reminds us that “It’s the Most Wonderful Time of the Year”. As children eagerly compose letters to Santa, it’s likely that Accountable Care Organizations (ACO’s) have wish lists of their own. Topping the list is most likely the achievement of shared savings, but ACO reporting to the Centers for Medicare and Medicaid Services (CMS) is no doubt a close second.
CMS Reporting Inventory Naughty and Nice List
In just a few short weeks, on January 22, 2018, ACO’s will receive a greatly anticipated reporting inventory for their attributed beneficiaries for whom they must submit clinical quality measures. This reporting process is the CMS version of determining who is “naughty and nice” in the domains of Care Coordination/Patient Safety, Preventive Health, and At-risk Population.
Getting Ready for the Season is No Small Task; 15 Quality Measures, 248 Consecutive Beneficiaries in 6 weeks!
Unlike the Claims-based Administrative Data measures that are calculated by CMS on behalf of the ACO (8 measures), and the Patient Experience of Care Measures that are assembled by a CMS-approved Consumer Assessment of Healthcare Providers and Systems (CAHPS) vendor (8 measures), the ACO-reported clinical quality measures (15 measures) are reported by the ACO through use of the Group Practice Reporting Option Web Interface (GPRO).
ACO reporting represents a daunting task with which to ring in the New Year. The mission to collect data for 15 measures, with a minimum of 248 patients per disease module or patient care measure, across multiple physician practices, with data contained in many separate Electronic Health Records and/or paper charts is an enormous undertaking.
ACO Reporting Holiday Checklist: (Must-have functionality checklist)
In the spirit of good cheer, we’d like to share a hopeful holiday way to find the right partner and make your GPRO holiday season less stressful.
- Electronic health record (EHR) integration and the ability to automatically pre-populate the ACO reporting registry with clinical data.
- Data submission directly to GPRO on behalf of the ACO.
- An easy to use reporting registry that converts the sampling of beneficiaries into a dashboard for data collection.
- Cloud-based reporting registry that is accessible 24/7 by ACO administrators and practice staff via role-based user access.
- Straightforward and easy to use registry. It must show reporting progress for individual providers and practices, and across the entire ACO.
- Easy filtering of measure grouping based on completion status to quickly identify gaps in reporting.
- Uncomplicated process that allows providers to easily view and report for their individual patient population.
- Reporting status information specific to patients on a practice level.
- Includes prompts and pop-up fields that guide practices through the process.
- Guides reporting staff through chronological order of reporting steps for each measure.
- Offers smart technology to show only the measures pre-selected by CMS and required for completion per specific patient.
- The ability to add comments for a specific patient, including chart location of substantiating information or helpful notes that provide evidence of documentation in the event of a future audit.
- Save and approve as-you-go functionality.
This article was originally published on Clinigence and is republished here with permission.