Our Client Results /Quality and MIPS

A Federally Qualified Health Center (FQHC) Quality Improvement Project

Results

Year-over-year quality improvements by percentage of eligible patients screened helped this FQHC

maintain care standards such as:

Increased

53%

Cervical cancer screenings

Improved

59%

Nutrition and physical activity for children

Improved

84%

Closing the refferal loop

Increased

67%

BMI screening and counceling

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. 

Challenges

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:  

Challenges Icon

Incorrect mapping of quality measure data and missing Logical Observation Identifiers Names and Codes (LOINC) codes in the database

Challenges Icon

Missing processes related to quality measure reporting in workflows

Challenges Icon

Misunderstanding of how the quality measures connect between programs

Challenges Icon

Non-compliance in patient population

Our Solutions

 Medical Advantage proposed the following solutions: 

Solutions Icon

Database Modifications— Map quality measure data, update LOINC codes on labs and imaging, build/move structured data for mapping corrections

Solutions Icon

Workflow Training— Staff training in all quality measures, quality team reporting, workflow change documentation

Solutions Icon

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.