Creating a buffer between reporting requirements and work that improves outcomes

MIPS is coming and physicians are unsettled.  Programs with the best of intentions can have unintended side effects. Healthcare providers across the U.S. have justified complaints regarding the multiple reporting requirements as the Centers for Medicare and Medicaid Services (CMS) work to consolidate their programs and provide a signal to the nation that we would all benefit from consolidation and consistency.

While I’m pleased by the move toward consolidation, we have so far to go that the interim will continue to place tens if not hundreds of reporting requirements in front of busy primary care physicians (PCPs). This is a problem because the work associated with tracking and reporting these measures places a significant burden of work on a stressed work force and diverts them from actually doing the work for their patients that could help them achieve better outcomes.

This is where a technological solution could help. If documentation was easy, if data extraction and encoding automated, if inclusion/exclusion rules engines built, if electronic reporting seamless, then we could absolve the front lines from this work and let them focus on providing the care their patients need.

This technological intermediary views data management as a strategic imperative. They manage and respond to the myriad requirements of external entities: government and private health plans, accrediting associations. Because of the evolving requirements of physician specialty societies, this intermediary could provide the physicians with the data they need for Maintenance of Certification requirements (e.g. tracking a cohort of patients to demonstrate improvement over time).

With the automated process in place, the healthcare provider, physicians and other clinicians can work on those attributes of high-performing healthcare delivery that truly impact outcomes and not spend their time chasing metrics of small value. In many cases the small metrics will improve as interventions impact fundamental systems of care delivery. For example, improving timely access to care while improving continuity with an identified PCP can improve vaccination rates, colorectal cancer screening, chronic care management and more.

The entity providing a seamless back-office for this work will be a hero. A hospital system lifting this burden off of the shoulders of its primary care employees and affiliated physicians will have no difficulty expanding its primary care base. A health insurer providing this service will discover that their physician network has become a net promoter of their plan. The IT company providing this solution will make their stockholders very happy.

L. Gordon Moore, MD, is senior medical director for Populations and Payment Solutions at 3M Health Information Systems.