Quality Payment Program Implementation Success Factor2018-06-29T10:10:25-04:00

Quality Payment Programs (QPP) Implementation Success Factor

The Challenge

Our client is a physician services company that interacts with many payers, including the Centers for Medicare & Medicaid (CMS). In 2013 CMS issued new rules on the reporting of Physician Quality Reporting System (PQRS) measures. This required changes to the methods available in the 2014 reporting year to successfully report avoiding penalties and potentially earn incentives for future payment. The penalties associated in the first year of the program (2014) projected to be more than ten million dollars and expanded each subsequent year. To facilitate clinical change to improve patient care and enhance reporting performance, the client had to engage clinicians and clinician leadership. Management Solutions was tasked with building a PQRS registry that will help address these changes.

The Solution

Management Solutions developed a cloud-based solution for aggregating a unified data set for a single source Quality Payment Program reporting across 18,000 clinicians. This registry allowed for successful reporting of the Quality Payment Programs measures and compliance with the requirements established by CMS. Management Solutions successfully completed the registry 45% faster than the client’s original schedule.

The Outcome

  • Our client was able to capture all required data and avoided penalties while targeting specific incentives worth pursuing. We were able to mitigated $10 million in 2014, and greater than $20 million in 2015 and 2016
  • Our client continued to use established solutions for reporting after initial reporting year and used them to train on-boarded full-time employees to the client

Impact Stories

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