Quality Improvement and Reporting: Succeeding in a Value-Based Environment

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Throughout the last ten years, there has been significant energy and policy focused on improving patient outcomes across all populations. This has resulted in increased focus on reporting, quality improvement, and close collaboration/integration across providers. Providers now must manage an overwhelming, and often confusing, set of reporting requirements and standards required by their contracts and regulatory agencies.

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PCDC can help providers and organizations understand value-based programs, insurance incentives, and reporting requirements. Specifically, PCDC will work with your team to:

Understand Medicare reporting requirements, penalties, and incentives Medicare’s Quality Payment Program (QPP)  releases constant updates for their Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model programs.  PCDC can support providers to be responsive and engaged so that reimbursement is not affected for QPP and other quality reporting requirements
Improve its ability to participate and succeed in state Medicaid programs PCDC’s experts can help you navigate Medicaid waiver, Delivery System Reform Incentive Payment (DSRIP), Patient-Centered Medical Home, Health Homes, and other State-based programs for maximum benefit to your patients and practice.
Understand commercial/ private insurance benefits and incentives Every contract has a different incentive structure for providers. The PCDC team can support practice staff to review health plan generated  clinical-quality reports, improve performance in gaps in care, and implement evidence-based interventions (EBIs).
Patient and Member Experience PCDC’s coaches can support your practice to implement the survey tools and processes to improve your patient experience (CAHPS, HOS), as required by health plans or government programs.

Whatever the challenge, PCDC’s Clinical and Quality Partners team can guide your practice/organization through the many Federal, State, and private insurance program and incentive options.