Quality and Performance Management

 

In order to successfully manage an ACO, you must continuously measure performance, and seek opportunities to improve.  ACO Health Solutions has developed solutions that enable your team to identify gaps in care, and to validate that your process improvements initiatives are being followed. While partnering with ACO's over the last three years, we have optimized the following products to handle CMS's complex rules and data requirements, allowing your ACO to focus on quality care management. 

Quality Registry

ACO Health Solutions Quality Registry Solution will help your ACO manage performance and ensure quality care throughout the year. This solution enables your team to validate that process improvements initiatives are being followed in order to avoid surprises during the annual GPRO Audit process.

 

Leveraging your claims data, the QR will identify patients within your population that will likely qualify for the annual GPRO Audit. Our flexible solution allows the ACO to either proactively or reactively collect quality metrics via paper or electronic records to allow you to control the care management process. As you collect this data, the system will store this information and provide the ACO updates on performance issues.

 

AHS has developed a series of performance reports that will identify trends and issues, realtime, as your ACO collects the data. As your ACO matures, fulfilling the CMS quality benchmarks becomes more essential. 

 

Once identified, the QR will capture clinical quality metrics and store the data for quality reporting throughout the year, and for the annual audit process.  Subscribing to the QR will provide you will all of the services to fulfill the annual GPRO Audit process. 

 

What's the Value In Measuring Quality Year-Round?

 

  • Ensures share savings goals are met

  • Reduces human effort during 8-week GPRO audit

  • Validates quality improvement initiatives

  • Complete the annual GPRO audit in a few days, 

       instead of weeks

  • Eliminates surprises from the GRPO audit

  • Consistent quality measures that ensure compliance

  • Quickly identify and resolve quality issues (within PY)

CMS WI/GPRO Interface

ACO Health Solutions has developed an innovative platform for the GPRO Audit that supports MSSPs, Pioneer ACOs, and physician groups participating in the PQRS incentives.  Our unique solution helps manage the entire GPRO Audit process from start to finish! 

 

How We Help You Manage Your GPRO Audit

 

  • ACO Health Solutions collects your sample set of beneficiaries from CMS

  • We then populate personalized online audit forms for your participating practices

  • The personalized audit forms are then organized and made available through our secure web portal by practice and physician

  • The web portal will guide your team through the audit by supplying information that will help your auditors answer questions more accurately 

  • Track your progress while your practices perform the audit  

  • Once the audit is complete, ACO Health Solutions submits the audit data to CMS

  • ACO Health Solutions works with your ACO to run reports through our system from the data you collected during your audit 

What Our GPRO Audit Tool Does For You!

 

  1. Increases accuracy- The solution we have created keeps in mind that human error is a reality.  We have included specific validation features to help avoid inaccuracies.  

  2. Our system supports unlimited users- Your ACO can have as many user logins as needed.  Different authoriztion levels are determined by your ACO administration.  Anyone from administrators to doctors, nurses and staff can gain approved access through your management group. 

  3. We track progress by practice- At any given time you can determine the progress by practice.  Each patient will have a status indicator based on the progress in the process.  A performance report can be generated on the ACO level, practice level, physician level and patient level.  

  4. Cost effective solution- Our platform saves your group time and money by organizing the process through our web portal and eliminating paper. 

  5. Optimized for performance-  ACO Health Solutions consulted with end users to design the most efficient and effective tool to perform the GPRO audit. Prepopulated patient data will display on our user friendly web portal, and will seamlessly guide the auditor through the process.   

  6. Green solution- The system is 100% based online. There is no need to print multiple pieces of paper. 

MIPS Reporting

As CMS Qualified Registry, we are able to fully support all MIPS Quality measures.  Leveraging our Quality Registry, we will quickly configure the unique rules and specs for each quality measure to evaluate against each patient within your ACO's population.  

Quality Audit Solution

Leveraging the CMS WI/GPRO interface, our Quality Audit solution allows system administrators to create custom quality sample populations to perform mid-year audits.  Pictured above is our configuration screen that locates qualified patients (2+ PCP visits) that are likely select for the CMS WI/GPRO audit.  This solution will track progress, results of each patients and allows the ACO to confirm performance within their organization.  

Risk Adjustment Factor (RAF)
Chronic Care Management Module

RAF (Risk Adjustment Factor) module will ensure that our customers

maximize their shared savings and avoid penalties (associated with high risk program tracks).

  • Increase or maintain ACO benchmark

  • Provide a custom workflow to improve the management

  • Document for patient with chronic conditions

  • Maximize share savings opportunities

ACOHEALTHSOLUTIOS

  • Create custom patient populations by Cohort & Plan

  • Upon patient engagement, care managers can quickly Service Mgt. Mgt. Patient review patient history via our Medical Experience  Explorer

  • Track key metrics for evaluating outcomes

  • Improve quality and lower expenses

Visit

383 E Main Street, Ste 140

Hendersonville, TN 37075

Call

T: (781) 81-MYACO

 

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ACO Health Solutions

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