We've helped both large hospital systems and small provider practices stay compliant with Meaningful Use, the Physician Quality Reporting System, Patient Centered Medical Home and more.
Our Quality Services team works with providers to prepare them for the changes that are coming with the newly finalized Quality Payment Program (QPP). We engage with clients on a fee-subsidized basis through various state and federal grant programs, and on a nonprofit, affordable fee-for-service basis, as well.
Our team of professional, subject-matter experts are on hand to take the mystery out of payment reform. We know what it's going to take to keep hospitals, clinics and practices competitive and compliant.
MEDICARE PAYMENT REFORM (QPP/MACRA)
Medicare payment policy has evolved from the cost- and charge-reimbursement approach to a policy that rewards improved patient care and increase operational efficiency. The enactment of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), and its 2016 policy ruling, establish the Quality Payment Program (QPP).
To help providers navigate the QPP's Merit-based Incentive Payment System (MIPS), Purdue Healthcare Advisors is guiding 3,500 Indiana providers toward value-based care through the Great Lakes Practice Transformation Network (GLPTN). If you are not enrolled in the GLPTN, but need assistance understanding how the QPP will impact your organization, our subject-matter experts can help you:
- understand upcoming MIPS Payment Year 2019 reimbursement changes;
- enhance your participation in legacy program such as the Physician Quality Reporting System (PQRS), the Medicare Meaningful Use (MU) Incentive Program, and the Value-Based Modifier to transition into MIPS performance;
- determine implications of MIPS Pick Your Pace options in 2017; and
- establish a Chronic Care Management program to leverage new Medicare billing code changes.
Are you seeing lower-than-expected MIPS Composite Quality Measures (CQMs)? We can work with you to improve those metrics, and your overall score, with the application of Lean Daily Improvement (LDI). LDI is a continuous improvement process run at the point of service so it doesn't disrupt your day-to-day activities.
PATIENT-CENTERED MEDICAL HOME (PCMH)
Research confirms Patient-Centered Medical Homes (PCMH) can lead to higher quality and lower costs, and can improve patients’ and providers’ experience of care. Purdue Healthcare Advisors has experience helping clients achieve PCMH recognition by helping practices enhance their ability to manage their patient populations; track/coordinate care; and measure/improve performance.
Formal recognition as a PCMH has many benefits. The majority of PCMH practices recognized by NCQA receive financial rewards from their state Medicaid agencies or commercial insurance companies. PHA has subject-matter experts who can guide you through the process by providing:
- a review to determine PCMH eligibility;
- guidance in transforming your practice using PCMH standards and guidelines; and
- assistance with preparing your submission for recognition to the NCQA or other recognizing body.
PHA helps two nurse-managed clinics achieve Level 2 Patient Centered Medical Home designation (Purdue Nurse, Summer 2015, p. 18)
MEDICAID MEANINGFUL USE (MU)
For the past 6+ years, Purdue Healthcare Advisors has guided thousands of Indiana providers to successful compliance with Meaningful Use (MU) standards, first under a 2009 grant from the Health Information Technology for Economic and Clinical Health (HITECH) Act to manage the Purdue Regional Extension Center (PurdueREC), and later under a 2014 grant from the Indiana Family of Social Services Administration (FSSA) to extend MU assistance to Indiana-based, Medicaid-eligible healthcare providers.
Ongoing FSSA funding provides a combination of remote and on-site services for ambulatory providers, including the Indiana Medicaid MU Help Desk. Providers enrolled in this program benefit from:
- interactive education/training workshops
- attestation support/consulting and metrics monitoring
- attestation Documentation Review
- readiness assessments
- workflow analysis
- HIPAA-compliant Security Risk Assessments
If you do not quality for subsidized assistance, PHA experts are on hand to offer unbiased guidance to MU incentives-eligible, healthcare physicians (both primary care and specialty) with EHR support for both Medicare and Medicaid; and expertise in working with all ONC-certified EHR vendors. Contact PHA Managing Advisor Brian McCammon at (844) 742-3678 (toll free) for contract pricing.
Check for MU updates here.
- Director-Healthcare Analytics
- Principal Advisor-Healthcare Analytics
- Senior Advisor-Lean Healthcare
- Managing Advisor, e-Learning Specialist