In value-based care, the reporting of data drives all decisions and actions. When practices do not have sufficient reporting material, or they do not fully leverage the analytical tools they have, they quickly learn what a challenge it can be to keep patients healthy and drive success in a value-based model.
Reportable and actionable data management can be a challenge to many private practices. It consumes a lot of time and administrative resources to collect and analyze data so that providers can make informed healthcare decisions. Without back-end support to manage data, practices often fall behind, which leads to negative consequences in areas such as quality scores. This may lead to missed care opportunities for patients and impact the practice’s bottom line.
Data analysis and reporting is critical, as it helps to pinpoint areas where practices fall short in meeting benchmarks and shows providers where to focus their efforts on closing care gaps, improving patient health, and even maximizing incentives.
According to Carmen Spanier-Hoar, Senior Manager of Quality Improvement at Innovista Health, “One of the important things about collecting data is that it allows us to identify trends so we can see what providers struggle with most. When we get the data, we send reports out to the offices and encourage them to proactively get their patients in for visits to close care gaps.”
Providers that need support in data analysis and reporting—or any other aspect of value-based care integration—often turn to managed service organizations, which help them every step of the way as they embark on their value-based care journey.
The power of this type of partnership is well illustrated by the collaborative relationship between Innovista and a large independent physician association (IPA) located in the western suburbs of Chicago, working together to transform the group’s quality program.
This particular IPA is a high-caliber medical group, but even so, they were linear in terms of their quality performance for many years. A few key quality metrics consistently remained low, which prevented the group from improving overall.
The cause came down to lack of data reporting and tracking. In fact, some practices were submitting incomplete data or no data at all. Without complete or consistent data from every practice under this IPA’s umbrella, it was hard to determine the specific challenges that were preventing the group from increasing their quality scores.
Innovista’s quality team got to work by visiting providers’ offices to collect outstanding data from electronic medical records (EMRs) and explore why the data had not been reported.
They documented each practice’s established workflow for collecting and compiling data. Once they gathered substantial results, weekly reports were delivered to providers, offering a granular view of how their practice was performing on various quality metrics. This was a new concept to this group, and Innovista as whole.
In addition, a Clinical Director from Innovista started to attend quarterly provider and senior-level meetings to convey the importance of those quality metrics and to offer deeper insights into best practices for the physicians to act on.
She brought educational tools into these meetings, including insights from a stoplight-style provider reporting system that used a simple “green, yellow, red” approach and gave providers a clear look at their quality performance. An educational delivery method of “The How, The When, and The Why” was used to explain the importance of using a payer-agnostic model when delivering care and striving to meet the set quality targets.
These approaches allowed all the providers to clearly see who was holding the medical group up with high quality scores, and who was struggling with low scores. Motivation increased, as the group collectively wanted to achieve greatness and not risk inhibiting overall progress.
Remote EMR access was granted, and along with frequent email exchanges, virtual meetings were held with the offices when face-to-face interaction was not possible.
Once all the providers had access to actionable data, the transformation was near immediate.
Providers were trained on how to establish a consistent rhythm of data collection. The lower-performing practices were encouraged to focus on improving quality metrics that would move the needle toward success. Three specific measures needed work: immunizations, blood pressure, and diabetes.
This is where the value of “tangible” data really became evident. Providers received consistent quality data reports that allowed them to identify patients who needed to be contacted to come in for a wellness check or to follow up on treatment adherence.
Outreach and engagement also allowed for the identification of several patients who ended up benefiting from a care management program.
Overall, the providers became more engaged with the Innovista quality team, their patient populations, and other providers across practices—all of which collectively allowed them to succeed in meeting goals.
Innovista started these efforts in 2018, and even amid the COVID-19 pandemic was able to help this medical group significantly improve several quality metrics.
The most dramatic improvement was seen in Childhood Immunization Combination 10 metrics, which improved 22% from 2018 to 2022. Never before had this IPA met the benchmark for immunizations. And despite the worldwide pandemic, they met every single quality measure in 2020.
Blood pressure and diabetes metrics also improved or remained constant, despite the challenge of the pandemic. Prior to the pandemic, the group was able to increase by 3%, which was a great milestone for this organization.
The group once again made exceptional scores in 2022. Only missing one measure, they continued their extraordinary performance post-pandemic.
Now, in 2023, this IPA continues to drive results. “They have been scoring well across the board for several years now,” says Spanier-Hoar.
Through continued follow-ups and interactions, these providers remain engaged, leveraging data to proactively care for their patients and close care gaps. This has led to the medical group earning a 5-star rating two years in a row from one of the major payers with whom they’re contracted.
Data are the conduit of success in value-based care, enabling providers to make well-informed decisions about patient healthcare. For providers who struggle with managing data, partnering with an organization like Innovista can help not only with analysis and reporting, but leveraging data to improve quality scores and health outcomes. It is a win for patients and providers alike.