“We have been tracking and reporting on our quality measures and meaningful use for years,” he says. “More recently, we have consolidated our various reports into a projection of our anticipated performance under MACRA.”
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At NHPP, in addition to generating scorecards about clinicians’ performance with regard to quality, productivity and patient experience, the practice also uses other scorecards for management purposes. They cover various operational metrics such as charge lag, days in accounts receivable and percent collection, as well as patient access measures such as the average number of days to get a new patient appointment. The practice updates the quality data and the data on patient experiences on a quarterly basis.
“Quality data are shared with clinical leadership who then share it with their staff,” says Nash. The data, updated monthly, is also available to clinicians online through a reporting tool.
Scorecards should reflect the regulations
To create scorecards, says Nash, demands a good understanding of the MACRA regulations, what metrics will be used and how they will be scored. He points out that some of the details are quite complicated, especially in a large organization such as his own, that has more than one tax identification number.
“We spent a lot of time and effort to make sure we understood how we would be evaluated on each of the major areas—quality, [advancing care information], etc.,” he says. Their next step was gathering the necessary data. At times, this meant creating new ways of collecting information that they were not routinely collecting before. “The final part of the process is about compiling and displaying the information in ways that people find useful, and which can yield insights into where performance needs to improve,” says Nash.
Nash emphasizes that using these analytical tools is not all about finding flaws. “We all tend to focus on areas of deficiency and say, ‘Oh! We have to fix that.’ But it’s also important to see who is doing what well and what we can learn from their practice that we can extend to others,” says Nash.
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“The way we approach that is not necessarily punishing low performers but endeavoring instead to raise the performance of all so our patients all benefit,” he says.