With the significant planned increase in participation in risk-based payment models over the coming years, provider groups and health systems need greater transparency and greater focus on physician quality improvement that extends beyond their four walls.
To make change a reality, leaders and administrators need to involve physicians early and often in the quality improvement process because they are the linchpins of improvement and directly control care delivery. But getting them on board isn’t easy. Although physicians respond well to peer comparison, they are tough critics, often questioning the quality and relevance of data, and the accuracy of dashboards and associated metrics.
To manage performance effectively, you must have a solid foundation. As mentioned, physicians are hard to convince, and their engagement relies upon having a healthcare analytics program that is unquestionably reliable.
The following best practices will enhance provider groups’ and health systems’ ability to engage physicians in quality improvement.
Quality improvement requires more than dashboards and loads of data. You need meaningful performance insights that engage your clinicians to deliver the value you need—when you need it. For reports to be clinically meaningful and timely, your data must be, as well. Rather than starting with what data is available and building reports based on that, begin with the end goals in mind, and ask these questions:
Incorporating a wide variety of data sources, such as basic clinical data from the EMR, as well as operational, financial, and patient-reported data, into your quality improvement approach will result in insights that you can use for decision-making. Keep in mind, the quality of the data and the fidelity of the analytics are almost more important in a physician engagement strategy than the data itself.
Physicians trust reports and data that are clinically relevant, valid, and timely. Reports should facilitate transparent comparisons to physician peers using evidence-based measures of efficiency, case mix and quality outcomes specific by specialty and procedure. Transparent measurement should include:
While physicians are intrinsically motivated to take excellent care of patients, comparing their performance to peers and tying performance to income are powerful change agents. Yet a 2018 Medical Group Management Association (MGMA) poll with more than 1,300 respondents found that only 36% of respondents tie compensation to quality performance metrics that include patient satisfaction, cycle time, chart completion and peer review.1
Organizations aren’t always in a position to align financial incentives with performance; you have to function within the boundaries of set at-risk programs, such as Bundled Payments for Care Improvement Advanced (BPCI-A). But what if the incentives are not where they should be? The opportunity to find the holy grail lies in aligning payment incentives with known good performance.
Providing high-value care is the key for succeeding under any reimbursement model, and elevating clinical and financial performance to deliver high-value care equips your organization to make informed decisions about what type of risk to take on and how to manage it successfully. To get there, you need to know how your clinicians are performing, how clinical decisions affect your financial performance, and what changes need to be made at both a local and an organization-wide level.
Engaging physicians in quality improvement is an essential step. That can only happen when they are involved throughout the process, when they believe the data is accurate, clinically valid and transparent, and when the data incorporates timely and meaningful insights from a wide array of sources, including critical patient-sourced data to close the loop.
A healthcare analytics software that can support and report performance improvement throughout the organization helps you engage physicians and provides powerful evidence of your organization’s ability to deliver value to providers, payers and patients. It lays the foundation for driving higher margins, optimizing patient outcomes, enhancing patient and provider satisfaction and strengthening your negotiating position with payers.
Check out our latest whitepaper for a more in-depth take on how to engage physicians in quality improvement to make change a reality. You will learn strategies help you reap the benefits of delivering high-value healthcare such as identifying and implementing ‘best practices’ that reduce cost and improve patient outcomes, and driving higher margins from alternative payment models, such as Bundled Payments for Care Improvement-Advanced (BPCI-A).
At ArborMetrix, advancing healthcare through data science is our mission, and delivering high impact, intuitive technology and analytics is our passion. Our leading healthcare analytics software solutions are proven to deliver targeted, clinically-deep insights that improve clinical outcomes, optimize financial performance, increase stakeholder value, and measure the real-world effectiveness of treatments and procedures, as well as medical device technologies. The ArborMetrix Performance Management Solution arms provider groups and health systems with the tools they need to deliver high-value healthcare, simplify their participation in value-based care, and chart their own course with alternative payment models.
1. “MGMA Stat: More than one-third of practices tie quality performance metrics to physician compensation plans.” Medical Group Management Association (MGMA). Poll conducted July 31, 2018.