Population Health Analytics

A MIPS Solution to Optimize Practice Performance

Under the Merit-based Incentive Payment System (MIPS), practices receive a composite score based on their performance across four categories: (1) Quality, (2) Promoting Interoperability, (3) Clinical Practice Improvement Activities and (4) Resource Use or Cost. What eligible clinicians discovered early on is that reconciling hundreds of patient records – especially across multiple instances of the same EHR – to meet quality measure reporting requirements would be arduous and time-consuming.

To stay ahead of the curve, one large urology & radiation oncology practice headquartered in Farmingdale, NY, turned to Integra Connect’s MIPS Solution to optimize their MIPS 2018 performance. […]

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Chart Abstraction Services to Offload the Burden of Regulatory Reporting

To successfully comply with value-based programs such as the OCM, specialty practices are required to submit a wide-range of patient data in a precise file format. Unfortunately, essential data points are often buried deep within the EHR in unstructured fields, resulting in data gaps. As the deadline for the Oncology Care Model’s (OCM) Clinical and Staging data submission deadline quickly approved, one large oncology practice in Fort Worth, TX, reached out to Integra Connect to help them close their gaps. […]

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EOL Modeling to Refer Patients to Palliative Care and Hospice

The last 90 days of life are often the costliest for cancer care, as frequency of ER visits and hospitalizations increase. To address this, leading oncology practices have begun to reconsider aggressive therapy in advanced stages of illness when the possibility of clinical benefit is highly remote and instead refer appropriate patients to hospice or palliative care programs, which studies have shown both reduce resource utilization and improve quality of life. […]

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HCC Coding to Improve Patient Outcomes and Increase Revenue

Under fee-for-service models, oncologists’ clinical documentation centered around in-office encounters, with the objectives of maximizing collections while minimizing burdensome paperwork. Comorbidities were most commonly documented as part of the patient intake process for emergency visits. Under value-based reimbursement models, like the OCM, oncologists are now responsible for treating each cancer patient holistically. This includes managing patient outcomes across all conditions and care settings. […]

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How One EMS Company is Accelerating Cashflows, Faster and More Efficiently

Market forces, including a rapidly evolving regulatory environment and increasing costs are now putting unprecedented additional pressure on EMS agencies to maintain best-in-class revenue cycles. To maintain efficient billing operations while remaining focused on patient care, one agency located in Henderson, Nevada, opted to outsource its billing to a third-party vendor from the onset – but soon experienced bumps in the road. As business boomed, they realized it was time to begin the search for a true revenue cycle management partner who could “get it right” and see them through their next phase of growth. […]

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Revenue Cycle Practice Solutions

Reviving RCM Operations to Enable Value-Based Care Success

In the fee-for-service era, the typical revenue cycle mirrored a patient’s office visit and focused on obtaining appropriate payment for services delivered along the way. The emergence of new, value-based payment models is transforming that approach and, as one large urology group in the Carolinas discovered, the existing, fee-for-service approach to revenue cycle operational were no longer optimal. The practice reached out to Integra Connect to help them uncover and prioritize improvement opportunities within its existing revenue cycle, ultimately identifying talent management; documentation gaps; administrative workflow burden; and lack of forecasting capabilities as the top “high-impact” pain points. […]

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Aligning Clinical & Financial Performance

To comply with value-based reimbursement models like the Merit-Based Incentive Payment System (MIPS), specialty medical practices are now required to track, measure and report out on a host of quality measures – all while driving sustainable cost improvements. To optimize performance, practices will be compelled to rethink workflows around clinical and financial documentation, which must now provide a more detailed view of a patient’s treatment as well as reflect care delivered across all settings and conditions. As one large, multi-specialty practice in Southeastern Michigan uncovered, insufficient documentation and corresponding workflow challenges related to chemotherapy orders were directly impacting authorization and billing, resulting in avoidable rejections. […]

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Mitigating Operational Gaps Impacting Cash Flow

The rapid rise of fee-for-value models has produced new drivers for revenue cycle success, putting increased pressure on specialty practices to balance cost and quality outcomes across entire episodes of care, while continuing to maintain best-in-class fee-for-service revenue cycles. As the clinical and financial implications of MIPS began to emerge for one large urology practice with locations across Southeastern Michigan, they reached out to Integra Connect to first identify and then address the root causes of their slower-than-expected cash flows and unpaid claims. […]

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