New Alchemy: Healthcare Quality Measures Into Revenue

Annual costs per physician are calculated at roughly $40,000 just to manage and report on healthcare quality measures!  In the March edition of Health Affairs, Lawrence Casalino and his co-authors (1) revealed these shocking survey results.

Physicians spend almost 3 hours a week managing and reporting on external quality measures of physician service delivery.  Industry insiders are questioning how this movement will affect the medical profession.  On the impact of the Health Affairs report:

“To what extent will quality-tracking requirements and similar practice intrusions reshape who physicians are, how many physicians there are, and how they practice? In turn, how will these changes affect patients’ access to care? Data derived from the 2014 Survey of America’s Physicians: Practice Patterns and Perspectives, make it clear that physician practice patterns are evolving. Responding to an increasingly intrusive practice environment, physicians report that they will choose a variety of practice models [that will likely] reduce patients’ access to care or that they will retire early, which will exacerbate the physician shortage and fundamentally change the nature of the medical profession. ” (2)

While the challenge of managing quality measure compliance will be a growing task for medical providers, “the cost to physician practices of dealing with quality measures is high and rising.” (3)

Visualize Health is on point to be a critical asset for the medical providers, their group practices, and accountable care organizations who are struggling to be more efficient, and effective in the face of their accountability to increased proactivity, increased reporting on their activity, and the need to increase their volume of work to maintain profitability.

Insurance payors, both Medicare, and private health insurers have fully leaned into the value-based care model. The model will continue to gain traction and the standardization of quality measures is already a joint effort between CMS and the America’s Health Insurance Plans (AHIP), a representative industry trade group.  For physician groups that have not moved to that contract model yet, the time to begin planning is now.

The challenges of quality measures and the value based care model are due to the lack of resources in the physician’s repertoire to manage and track their compliance to them.  The measures continue to standardize and improve but the efficient means to maintain visibility and capitalize on these programs has been elusive.

The upside to all this?  Show me a physician group that is maximizing compliance across healthcare quality measures and I will show you a group that leverages higher reimbursement rates, negotiates favorable shared savings contracts, and maximizes their value-based contract bonuses.  A practice like this is excelling at documentation and employing EMR workflow optimization and training, supplemental reporting and communication, and human resources dedicated to these processes.  What if Visualize Health reduced the costs of these investments and automated most of this affordably?  What if we improved physician engagement with quality measures and documentation?

Our clients have received some of the highest bonuses on a per provider / per month basis paid by CMS and commercial payors.  We have taken the challenge of healthcare quality measure compliance and reporting head on. Insurance payors will bring in analysts to communicate on gaps in care and talk through your healthcare quality measure compliance scores of course.

But what if you were in the driver seat?  The bottom line is, you cannot measure or manage what you cannot see.  We are delivering visual control and provider engagement that is producing better margins.  Let us put you squarely in position to turn quality measures into revenue indicators.