Proficient Health Helps Multistate ACO Meet CMS Reporting Requirements
Successfully collects and merges data from incompatible sources
Good Help is an accountable care organization (ACO) formed by the Bon Secours Health System to serve patients across five states. As all ACOs, Good Help is required to submit quality metrics to the Centers for Medicare and Medicaid (CMS). Bon Secours could extract reporting data from its system-wide Epic electronic medical records platform, but many participating care providers used paper records or alternative EMR solutions. Bon Secours needed to be able to pull and consolidate records from all practices in order to meet CMS Group Practice Reporting requirements.
Proficient Health designed an online web portal to collect and consolidate the information needed to meet CMS reporting guidelines. With hundreds of pages of government decision trees to guide their work, programmers developed an electronic form that could be used to collect the required information online. “We wanted a nurse in a physician’s office to be able to pull a patient chart and quickly enter the relevant data,” says Kym Bean, Proficient Health director of client services.
As a next step, Proficient Health took Epic EMR data provided by Bon Secours and mapped it to the online form created for the Good Help ACO– creating a single, consolidated reporting database.
One challenge: Interpretation of CMS rules changed throughout the development process. “The flexibility of the Proficient Health team in helping us work through those interpretations on the fly was a key component to our success,” says Daniel Salzberg, Bon Secours director of information services. “This was an extremely challenging initiative to operationalize, but they were willing to go above and beyond to make certain we were successful.”
Good Help successfully submitted its first quality report to CMS in advance of the government’s deadline. A key factor in that success is the Web-based nature of the Proficient Health tool, which can be accessed securely from anywhere with an Internet connection. As a result, data could be submitted by team members based at a variety of locations across multiple states.
Proficient Health workflow tools allow Good Help to monitor the status of each required record and determine where it is within the timeline of work – whether it is pending, in progress or completed and whether it has been checked for accuracy by the quality assurance team. A weekly status report can show progress by market and by physician practice.
“With a single, consolidated database, we now have a single source of the truth so we can determine whether we are falling within CMS guidelines and whether we need to make course corrections,” Salzberg says.
“I can’t say enough about the Proficient Health staff. They put in weekend and evening hours, and when issues were identified, they communicated with us regularly to resolve them. It was a true partnership. Their tool is great, but it’s their people that make it world class.”
Daniel Salzberg, Director of Information Services, Bon Secours Health System
About Good Help ACO
Bon Secours Good Helpcare LLC (d.b.a. Good Help ACO) is an accountable care organization approved by the Centers for Medicare and Medicaid Services to participate in the Medicare Shared Savings Program. Good Help has participating health care providers and hospitals in five states – all committed to working together to support Medicare beneficiaries.
About Proficient Health
Proficient Health is a healthcare information technology company specializing in solutions for the secure exchange of private data. Our affordable, online services connect physicians, hospitals and other healthcare providers – helping them easily capture and share information, improve service and care delivery, drive down costs, speed reimbursement and get more out of their electronic medical records platform. For more information on Proficient Health and the solutions it provides, visit www.proficienthealth.com.
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