CMS Initiatives

The rapidly-changing healthcare landscape rewards value and quality. And as CMS develops programs to monitor, quantify and incentivize quality improvement, providers should be equipped with the resources to improve performance and outcome measurement, and leverage value-based opportunities.

Quality Program Optimization and Reporting

The foundation of HealthEC’s quality program reporting is our ability to access virtually 100% of all available electronic patient information across the care continuum – from any system, any setting of care, and in any format. The platform applies sophisticated analytics to the data to calculate numerators and denominators, and identify care gaps. Reports and dashboards simplify the interpretation of data, and inform performance improvement strategies.

HealthEC coordinates care teams to ensure compliance with various CMS performance reporting requirements, including Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) programs, Primary Care Plus (CPC+), Oncology Care Model (OCM) Registry, state-based Health Homes, Healthcare Effectiveness Data and Information Set (HEDIS), Transforming Clinical Practice Initiative (TCPI)/ Practice Transformation Networks (PTN), and more.

By integrating data on a single platform and supporting it with a library of standard reports and a flexible reporting tool, providers can meet strategic, financial and regulatory reporting requirements with relative ease.

Accountable Care Organizations (ACOs) participating in Medicare Share Savings Program (MSSP), MSSP Track 1, Track 2 and Track 3, and NextGen ACOs
Group Practice Reporting Option (GPRO) for CMS MIPS data by ACOs
Reporting for the Merit-Based Incentive Payment System (MIPS) for Medicare Access and CHIP Reauthorization Act (MACRA)
CMS Innovation projects including Comprehensive Primary Care Plus (CPC+) and the Oncology Care Model (OCM)
Health Homes
Medicaid-based Health Homes program to coordinate care for people who have chronic conditions
Clinical Quality Reporting to Payers for Value Based Payments by Provider Entities (IDNs, CINs, Hospitals)

Performance Improvement Assistance

HealthEC’s subject matter experts provide comprehensive advisory services to develop or refine strategies for CMS initiatives and programs, including:

CMS Program Registration and Provider Enrollment. We can manage the entire process from enrollment and registration to education and training. With expertise in Medicare Shared Savings Programs (MSSP), CPC+, OCM and other Center for Medicare and Medication Innovation (CMMI) initiatives, we can provide guidance on successful governance/infrastructure models; assist in establishing the Accountable Care Organization’s (ACOs) structure, board and committees; and help define financial and quality metrics to meet and exceed CMS objectives.

Provider Clinical Transformation, Education and Outreach. Our subject matter experts can provide a full array of support services, from provider-level education about Patient Centered Medical Home (PCMH) participation to organization-wide ACO measure selection and management. We facilitate the creation of quality improvement goals and objectives, and mentor providers throughout the transformation process to drive results.

Audit and Reporting. With access to a comprehensive data warehouse and industry-leading analytics tools, HealthEC helps organizations manage their ongoing CMS Initiative-related performance. As a 2018 CMS-approved Qualified Clinical Data Registry (QCDR) capable of submitting data for organizations under the Group Practice Reporting Option (GPRO), HealthEC’s advanced analytics and GPRO audit tools capture all required quality measure data fields for each assigned Medicare beneficiary, eliminating manual tasks and dramatically simplifying the submission process.

Care Optimization. HealthEC’s clinical care management services drive effective population health management programs that ensure compliance with recommended best practices and quality measures across all CMS-driven quality programs. Through a comprehensive patient care record across providers and care settings, HealthEC’s advanced analytics identify gaps in care and promote timely resolution of incomplete quality measures. Organizations can also take advantage of HealthEC’s care coordination tools and services to actively manage high-risk, high-cost patients to reduce unnecessary utilization of resources.

HealthEC delivers comprehensive support for CMS initiatives through:
  • Integration of all electronic patient data on a single platform
  • Robust reports and dashboards to drive transparency and accountability
  • Provider engagement strategies to educate and transform practices
  • Advisory services to evolve programs and improve performance
  • Care optimization support for measure compliance and risk management

Population Health Management Suite

HealthEC helps organizations improve patient outcomes, optimize quality of life and manage costs through data integration, analytics tools, and workflow support for clinicians, patients and executives.

Learn More