ACO Analytics Software to Achieve the Highest MIPS Quality Scores

Large Accountable Care Organizations (ACOs), serving tens of thousands of patients, are already using ACO analytics solutions that focus on providing the proper care to the proper patients at the right time. They report improvements, for example, in the number of patients receiving cancer screenings. This allows them to achieve the highest MIPS quality scores and save Medicare millions beyond its target. What strategies do they implement to drive sustainable changes?

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If Accountable Care Organizations manage to improve healthcare quality and reduce costs, they are rewarded with a share of the generated Medicare savings. To be eligible for that share, ACOs pass an annual assessment and prove their efficiency in thirty-four categories.

However, a lack of relevant tools that would allow ACOs to estimate progress on the way and make timely improvements often prevents them from scoring high. As a result, ACOs fail to reach their aims and get a share of the generated Medicare savings. Applying data analytics and several other organizational measures helps tackle such issues.

Challenges of Data Access for Analytical Purposes

The benchmarks for the ACO annual performance assessment become higher with every new year. That is why the quality and transparency of the data from each provider inside the ACO are vital. It should appear timely and be easily accessible for further analysis and sustainable results.

While tackling those demands, ACOs face the following issues:

  • Delays in getting actionable data to engage patients
  • Some providers receive the data about their ACO group aggregated performance once a month
  • Some clinics have limited access to data, which restricts the possibility to use it for improvements—for example, if only one person has access to the information
  • Limited access to data leads to delays in sharing the results about the performance and a lack of knowledge about how to use the analytics and how to apply the insights generated by it
  • Limited access to the analytics app also leads to concerns regarding the data accuracy
  • Insufficient transparency results in the inability to track the high performance of peer providers. This creates an impression of unachievable goals and an absence of possibility to provide mutual coaching and training
  • Lack of different information levels about performance for various stakeholders
  • Absence of holistic approach to motivate providers to improve for sustainable results

Features of Data Analytics Software to Track ACO MSSP Measures

ACOs should be able to track and manage the performance of their providers during the year and check the compliance with the CMS requirements.

A necessary precondition for that is wide access to analytics software for business executives, practice managers, doctors, nurses, and other stakeholders. They should be able to:

  • Identify the specific measures that need to be completed for each patient (by integration of the provider schedule with patient-specific data into the analytics application)
  • Evaluate both individual and general clinic performance
  • Examine the data in the analytics application before the patient visits. It allows medical experts to select the right measure that has not been yet applied
  • Be able to specify each measure at any moment and improve it before the dates of the reports
  • Based on their roles, analyze visualizations that demonstrate performance assessment results and get actionable insights on possible ways of improvements and required numbers of patients who need care to be able to show better measures. Clinician visualizations allow for peer comparison, in the result of which providers may contact the top performers to understand how to improve

ACOs, in partnership with reliable healthtech software product companies, develop a strategy to drive improvements in data analytics. This may even include reaching out to CMS to clarify measure requirements, clearly identifying the inclusion criteria, exclusion criteria, and denominator for each measure.

Organizational Measures to Implement Analytics Software

It’s not enough just to implement any analytics software to automate workflows. A lot of organizational efforts are required. Some of them are critical because they directly affect the quality, on top of which the high-quality analytics is laid.

  • Provider workflow should be standardized, ensuring consistency in documentation within the EMR

  • All stakeholders should pass personalized education. It is important to understand how to apply filters to find and visualize the most relevant data, create bookmarks for the information that is often referred to, such as individual performance dashboards, and see the comparison with other providers in the group.

  • At regular weekly meetings, reports and visualization dashboards are presented to providers so they can assess performance, compare it with previous data, validate information iteratively, and make improvements before preparing internal or external reports.

What Benefits Can Practices Expect from Using Data Analytics?

The ACOs that had already benefited from the analytics software notice such improvements as:

  • increased indicators of influenza immunization and pneumonia vaccination

  • raised numbers of population who passed body mass screenings

  • increased screenings for future risk of falls, tobacco use, and cessation intervention

  • better monitoring of the patients with clinical depression and developing a follow-up plan for them

  • increased number of patients with blood pressure monitoring

  • prescribing antithrombotic drugs, such as aspirin, for those suffering from ischemic vascular disease

  • improvement in diabetes HgbA1c poor control, and in the number of patients with diabetes receiving eye exams

  • improvement in the documentation of current medications in the medical record

Improved above-mentioned measures may result in achieving the top position among national ACOs.

How Else Can Practices Use the ACO Analytics Software?

ACO analytics software may indicate lower-than-expected metrics, for instance, for breast cancer screenings. Thanks to this insight, practices may focus on raising awareness among the population about the necessity of completing mammograms – by proactively contacting patients who have not yet passed screenings. During a patient visit, the care team can see that a patient hasn’t received a required mammogram. The procedure may be scheduled for the same day. In case of detection of an early stage of breast cancer, lifesaving treatment starts as early as possible. Without the patient data from the analytics software, the treatment might never happen.

Analytics software also helps to identify knowledge gaps. For instance, the clinic may perform required counseling, however, it may fail to save this data correctly. As a result, the measured performance can be assessed negatively even if patients received proper care. Analytics applications help to find the errors in the documentation and correct them before the deadlines.

Not only do members of ACOs benefit from the ACO analytics software. Some specialized providers do not have to report ACO measures but may still use the tool to identify patients who, for example, could achieve improved blood pressure control. Therefore, the distribution of best practices in preventative care results in better patient outcomes.

How Belitsoft Can Help

Belitsoft is a full-cycle software development and analytics consulting company that specializes in healthcare software development. We help top healthcare data analytics companies build robust data analytics platforms.

For integrated data platforms developed to collect, store, process, and analyze large volumes of data from various sources (Electronic Medical Records, clinic management systems, laboratory systems, financial systems, etc.), we:

  • Automate data processing workflows (cleansing, standardization, and normalization)
  • Configure scalable data warehouses
  • Set up and implement analytical tools for creating dashboards, reports, and data visualizations
  • Ensure a high level of data security and compliance with healthcare regulations such as HIPAA
  • Integrate machine learning and AI into analytics.

We also help build specialized analytical applications like ACO MSSP Measures to:

  • Monitor 34 quality measures covering various domains such as patient experience, care coordination, preventive health, and management of at-risk patient populations
  • Compare their performance metrics against industry standards and best practices, identify areas for improvement, and track progress over time
  • Understand complex data and quickly identify trends and anomalies with interactive dashboards and visualizations
  • Prepare reports for submission to the Centers for Medicare & Medicaid Services (CMS) by automating data collection and generating necessary documents

If you're looking for expertise in data analytics, data integration, data infrastructure, data platforms, HL7 interfaces, workflow engineering, and development within cloud (AWS, Azure, Google Cloud), hybrid, or on-premises environments, we are ready to serve your needs. Contact us today to discuss your project requirements.

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