Accountable Care Organization Measures

On December 19, CMS announced the selection of 32 Pioneer ACO organizations, five of which are Boston-based: Beth Israel Deaconess, Mt. Auburn, Steward, Atrius, and Partners Healthcare.

To participate in the shared savings model, we'll need to compute 33 different quality metrics and submit them via survey, claims or the group practice reporting web interface (GPRO).

What are these metrics?

7 measure the Patient/Caregiver Experience based on survey
6 measure Care Coordination/ Patient Safety 6 based on claims or submissions to the GPRO web interface
8 measure Preventative Health based on submissions to the GPRO web interface
12 measure care to At Risk Population based on submissions to the GPRO web interface

Here's a comprehensive list of what needs to be computed, how, and when.

At Beth Israel Deaconess, we'll use our all-payer claims warehouse and quality data center. My role as CIO has been to prepare the necessary analytics for panel and population health, as described in this overview

As I posted from IHI, our challenge ahead will be navigating the new business model while still maintaining the stability of the old business model during the transition.

From a CIO perspective, use this simple equation: ACO = HIE + Analytics and you'll be ready for whatever tomorrow will bring.

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Attesting to Meaningful Use Quality Measures

I was recently asked how eligible professionals should report the Meaningful Use Clinical Quality Measures if there are zero denominators (i.e. you do not have any hypertensives, adults, or patients with 2 or more visits in the measurement period) Here's the answer as I understand the regulations and FAQs: 1. Report on the 3 Core measures if you can, which include *Hypertension: Blood Pressure Measurement *Tobacco Use Assessment and Tobacco Cessation Intervention *Adult Weight Screening and Follow-up 2. If any of the 3 Core measures has a zero denominator, replace them one-for-one with one of the 3 alternate core measures. If you can’t get to 3 non-zero denominators between the core and alternate core, report on all 6 (even if it means that you have to report 6 zero denominators) *Weight Assessment and Counseling for Children and Adolescents *Preventive Care and Screening: Influenza Immunization for Patients ≥ 50 Years Old *Childhood Immunization Status 3. Regar...

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