Supporting the State Innovation Model Grant and Regional Oversight Management Committees through Actionable Analytics

Through HealtheConnections’ innovative myData analytics tool, providers receive data that is standardized, codified, deduplicated, and combined with consented community data that lives within the health information exchange. This tool is perfectly aligned to support State Innovation Model (SIM) Grant and Regional Oversight Management Committees (ROMC) through the Qualified Entity (QE) Quality Measurement Pilot.

The Tool
This is no ordinary top-level quality measurement and analytics tool. High quality data is only useful if it can be used to derive meaningful and actionable insights, enabling better clinical and operational business decisions. By creating a tool focused on clinicians and their workflows, myData is directly supporting the activities that ultimately lead to better performance on every level – better patient outcomes. It is also designed for upstream reporting, enabling healthcare organizations both large and small to take advantage of cutting-edge analytics that supply actionable information.

The Pilot
The QE Quality Measure Pilot is the logical fit for this platform, and HealtheConnections is expanding myData to support the specific needs of providers, payers, the state and the ROMC in support of New York State’s Patient Centered Medical Home (PCMH).

The pilot focuses on 4 primary areas:

  • Providing data to the payers in support of quality measurement and the NYS PCMH scorecard.
  • Providing clinicians with real-time visibility into their performance against the scorecard throughout the year, which gives a clinician the opportunity to make adjustments before the reporting period closes.
  • Providing tools to the ROMC to help them better engage with and support the NYS PCMH practices.
  • Contributing to statewide planning and consensus-building efforts. Primarily, HealtheConnections is demonstrating how effective a RHIO can be in supporting a value-based payment model, as well as laying the groundwork for a standardized approach to statewide quality measurement.

The Outcome
The current pilot focus engages practices and payers in Central New York. In conjunction with these partners and the ROMC, HealtheConnections is working to identify a set of priority quality measures and supporting clinical reports to build and deploy, as well as actively recruit practices to the program. Data quality is critical to affect positive outcomes, and the team is working with data sources to ensure that data is recorded and codified effectively to readily support payers’ reporting needs.

This approach is agile to allow practices to see immediate value, and there is clear evidence that the RHIO is an effective partner in supporting value-based payment models like NYS PCMH. Through this pilot program, HealtheConnections anticipates expanded support for providers in conjunction with other value-based payment arrangements; RHIOs providing standard supplemental data in support of HEDIS measures and NCQA-certified Electronic Clinical Quality Measures (eCQM); and streamlined provider/payer communications and enhanced collaboration.