With the continual market shift from fee-for-service to fee-for-value, Accountable Care Organizations (ACO) face the challenge of aggregating data from multiple organizations to meet Quality Measures (QMs) regulations and improve the health of their patient populations.
As part of CMS’s push for simplicity, the ACO REACH program has only four quality measures, compared to past MSSP ACOs’ 33 QMs or MIPS’ menu of 200. Not only that, but three of the four are reportable through EMR integration, therefore chart chasing is no longer required. ReportingMD provides population health analytic solutions while supporting networks, groups and hospitals in the ACO Reach Model.
Here’s a quick run-down of the four measures:
- Risk-Standardized All-Condition Readmission (ACR)
ACR looks at the fraction of hospital stays that result in a readmission within 30 days of discharge. Claims-based.
- All-Cause Unplanned Admission for Patients with Multiple Chronic Conditions (UAMCC)
UAMCC is slightly more complicated, looking at the rate per 100 person years of hospital readmissions for aged Medicare patients with two or more chronic conditions. Claims-based.
- Timely Follow-Up After Acute Exacerbations of Chronic Conditions (Timely Follow-Up)
Timely Follow-Up looks at whether doctors delivered follow-up care within the timeframe laid out by clinical guidelines for patients with an ED visit or hospitalization related to six specific chronic conditions. Claims-based.
- The Consumer Assessment of Healthcare Providers & Systems (CAHPS®) Survey
CAHPS® is a standard survey to measure the quality of patients’ experiences, administered by a CMS-approved vendor in collaboration with the ACO.
Facilitating engagement with patients at admission is crucial for managing potential readmission and ensuring a timely follow-up. ReportingMD, Inc. has the expertise to get your ACO prepared so you can maximize your quality performance scoring to maintain the highest possible percent of shared savings your ACO worked so hard to achieve. Although the actual mechanics are more complex, these four measures – and the aligned economics of the REACH model – are the only quality variables doctors need to consider, freeing up their time to focus on what matters: patient care and outcomes and cost containment.
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