Our Client Results / Quality and MIPS
A Federally Qualified Health Center (FQHC) Quality Improvement Project
Year-over-year quality improvements by percentage of eligible patients screened helped this FQHC
maintain care standards such as:
Cervical cancer screenings
Nutrition and physical activity for children
Closing the referral loop
BMI screening and counseling
Overview of FQHC
This FQHC serves over 4,500 members of the uninsured, underinsured, and underserved population of the greater Sandusky, Ohio area. Its specialties include pediatrics, adult medicine, family medicine, obstetrics, geriatrics, behavioral health, and includes dentist and other specialists.
The practice participates in quality programs including Medicaid Meaningful Use (MU), HRSA Uniform Data Service (UDS), Merit-based Incentive Payment System (MIPS), Patient-Centered Medical Home (PCMH), Commercial Insurance (HEDIS) and several additional private grants with other specific quality metrics.
The quality workflow and database assessments, reports, and measure crosswalk completed in the assessment phase assembled a complete picture of the current status of the quality program. It was found that the practice was well below the metrics thresholds for 48% of their measures and barely above thresholds in another 11%. The causes of the problems were multifold:
Incorrect mapping of quality measure data and missing Logical Observation Identifiers Names and Codes (LOINC) codes in the database
Missing processes related to quality measure reporting in workflows
Misunderstanding of how the quality measures connect between programs
Non-compliance in patient population
Medical Advantage proposed the following solutions:
Database Modifications— Map quality measure data, update LOINC codes on labs and imaging, build/move structured data for mapping corrections
Workflow Training— Staff training in all quality measures, quality team reporting, workflow change documentation
Patient Population Cooperation— Establish messenger and patient portal reminders for services due, establish policy for tracking orders and referrals, train staff on different methods of patient follow up, train staff on how to discuss services (such as immunization, cancer screenings with patients)
Medical Advantage Can Help
Medical Advantage is an innovator in healthcare. Our years of experience, data driven strategies and in person approach drive change, improve outcomes, and maximize ROI. Our team has the expertise to provide customized, actionable solutions to decrease the cost of care and improve quality for your practice.