South Florida Hospital News
Friday February 26, 2021
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October 2013 - Volume 10 - Issue 4
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Clinically Integrated Networks Use Data as a Cornerstone to Improve Care

The ongoing measurement of outcome and efficiency in health care will play an increasingly important role as the Affordable Care Act is implemented and the national reimbursement system continues its move away from “fee for volume” to “fee for value.”
 
Participants in Holy Cross Physicians Partners (HCPP), a physician-led clinically integrated network of 285 physicians in Broward and Palm Beach Counties, agree to collect and share clinical data, develop clinical protocols and institute clinical improvement efforts.
 
HCPP finalized its first value-based contract in January to participate in the Florida Blue Accountable Care Program. Data regarding outcomes of patients under the contract is now available internally and is being analyzed.
 
The data is derived from three diabetes measures (HbA1c indicating the average level of glucose over the previous three months, lipid panel screening and nephropathy indicators) as well as three preventative screening measures (mammography and cervical as well as colorectal cancer screenings).
 
Approximately 60 primary care physicians in HCPP have been responsible for collecting and reporting this data via a clinical performance reporting system and web-based portal HCPP provided and which is easily accessible to physicians and office staff.
 
Assisting in patient care in the day-to-day workflow, the system alerts providers to which patients may not have completed preventive screening measures or received the recommended testing. When patient information is reported by the physicians back into the system, HCPP develops a growing database which is enhanced by claim data provided by health plans and lab results from national reference laboratories. When data from all sources is combined, it results in a more complete picture of patient outcomes.
 
At this early stage, data analysis indicates that total medical costs have been trending downward for the population in our value-based agreement.
 
We are also seeing improved outcomes and compliance in the six areas being objectively measured. Clearly, some of the improved performance has come from better physician data collection and reporting. However, we are seeing evidence that proactive outreach through our Population Care Management team and interventions at the point of care are having the intended effect of improving quality.
 
As HCPP progresses and increases its data collection on more measures, analysis derived from the system will drive clinical best practices guidelines and protocols. A network performance improvement team will provide physicians and their staffs in-person and web-based educational sessions introducing new clinical initiatives and associated performance measures. In a process of continuous improvement, each member of the health care team will understand the reasoning behind each initiative, be able to identify patients in need of that service and track progress against goals.
 
The transparency of the web-based quality reporting system provides physician and practice level quality performance reports as well as peer and national performance comparisons. As has been established by the HCPP Network Operating Committee, performance on metrics is a key component to the determination of annual quality and efficiency incentive payments to physicians.
 
These reporting capabilities, and the ability of HCPP to align incentives around them, enable payers and employers to quantify the value their constituents receive through value-based contracts.
 
HCPP will soon enter into additional value-based agreements with payers. The ability to proactively manage a population of patients using data while simultaneously caring for each patient as an individual enables HCPP physicians to continue to deliver high quality healthcare in a quantifiable manner that reduces costs, improves outcomes and results in higher patient satisfaction.

Shawn Franklin is the Executive Director of Holy Cross Physician Partners in Fort Lauderdale. He may be contacted at (954) 776-3261 or Shawn.franklin@holy-cross.com.

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