New Medicare Access and CHIP Reauthorization Act legislation presents health care providers with the challenge of redesigning how they measure success and are reimbursed. Beginning in 2016, Salem Health Medical Group began the process of building the infrastructure to participate in MACRA, pioneering work in this untested system. They partnered with Business Intelligence, Epic Ambulatory, clinical leadership and informatics coordinators to decide upon measurements, workflow and how the required metrics could be embedded within current clinical workflows.
Dashboards
The ultimate goal was to create a dashboard to create visibility to providers on the new quality measures that Salem Health must report on for value-based care payments. Improvement efforts on the Quality & Safety A3 will be based on the opportunities visible within these new dashboards. The MACRA Dashboard will enable Salem Health to improve upon metrics in two advanced alternative payment models: the Medicare Shared Savings Program and Comprehensive Primary Care Plus (CPC+) Program.
The new dashboards are still in development. The team is currently working through the validation of the included patient population and visibility of the information so it is the most valuable for Salem Health’s providers.
Workflow changes
We still haven’t worked through all of the workflow challenges. Some of the measures we need to meet, but are out of the scope of ownership for Primary Care clinicians. How we gain ‘credit’ for the measure while making it a simple workflow for the provider is a constant balance.
Challenges have also presented themselves due to Salem Health’s status as one of the first health care organizations to work with Epic to create such dashboards.
Many breaks have been encountered that have had to be fixed by Epic, rather than by our organization alone. We have been working closely with Epic to fix those breaks or misinformation that is currently within the dashboard. According to Epic, Salem Health is one of the first organizations to delve into such deep validation of the measures.
Plans are in place to roll out the dashboards over the coming months. Clinicians will have a three-hour training later this summer which will help move Salem Health Medical Group towards a standard measurement system throughout the entire medical group. Full implementation is set for July 2017 and measurements will be tracked throughout FY2018.