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How powerful solutions identify at-risk populations and critical gaps in care
As the market shifts toward more value-based care agreements, healthcare groups and networks are taking on some form of financial risk. From PQRS to ACOs and private payers as well, many reimbursement programs provide incentives and penalties that are tied to quality. Across the country, these vary in level of risk, from a modest incentive, up to 100% risk-bearing (capitated payment) models.
Success in these programs depends on an active participation in managing quality. Quality is quantified by complex quality measures that vary from contract to contract, payer to payer, and provider to provider. From a leadership perspective, information gaps make it challenging to know which clinical levers to pull in order to best achieve these results. It can be difficult to manage and track quality without visibility into performance. In best cases, analysts would have real-time access to quality data, providing actionable information back to clinicians.
The benefit to managing quality is two-fold. First, at-risk and chronic patient populations can be identified, categorized and managed for best care pathways. The second benefit is in analyzing and comparing similar metrics across providers, groups, or TINs, allowing the opportunity to uncover areas of improvement.
How does an organization manage quality? For quality or outcomes management, organizations need specific tools. These tools, at their heart, should be based on solid technology and ease of use. From a practical standpoint, they need the ability to aggregate and validate clinical quality data with an analytics engine specifically tailored to clinical quality management.
Our team, tools and technology help uncover and create actionable insights, and coordinate information throughout the organization. By identifying at-risk populations and gaps in care, our Total Outcomes Management (TOM™) platform powers quality management for thousands of providers.
TOM™ is cloud-based, ONC Certified, and HIPAA-compliant. This powerful population health analytic platform is specially built with best-in-class technology to support the needs of healthcare organizations with high availability data ingestion, computation, and storage.
Care gaps are bridged by merging clinical, claims and social data into a single platform. With the power to manage multiple TINs and drill-down to the individual patient encounter, TOM™ provides real-time actionable insight.
ReportingMD solutions provide a 360-degree view of your population. The flexible measure calculation-engine provides a clear view of performance against any payer measure, CQM, eCQM, HEDIS®, or custom measures and benchmarks.
Learn why thousands of providers rely on ReportingMD and our Total Outcomes Management (TOM™) Population health platform. Schedule a demo today.