GetWell Loop’s QCDR Certification Means Full Credit for MIPS Improvement Activities

As healthcare continues to emphasize quality over quantity, some providers are still grappling with the day-to-day realities of new payment models for treating patients and new quality metrics they must report to maximize reimbursements and avoid penalties.

And, as medical practices sprint to keep up with the changes, CMS continues to refine the rules. Among the recent changes is a new category of patient outcome reporting that rewards physicians for using new approaches for engaging patients outside the walls of clinics and hospitals.

This new category, included in what CMS has dubbed “Improvement Activities,” makes up a meaningful part of the variable compensation outlined in the government’s Merit-Based Incentive Payment System (MIPS), one of the pillars of value-based care. Currently, the category of Improvement Activities alone translates to 1.35% of the average clinician’s income, and this figure is expected to grow.

If your practice can easily demonstrate to CMS it has implemented Improvement Activities, it means fewer hurdles on the road to quality care. It means better reimbursement and the delivery of better care. Fortunately, providers using software that’s CMS approved as a Qualified Clinical Data Registry (QCDR) can accomplish this by simply attesting to their use of the software.

Why does more patient engagement equate to an improvement?

In the new category CMS has designed, there are several areas where providers can demonstrate they have improved operations and the quality of care delivered. One important area focuses on engaging Medicare beneficiaries in between their episodes of care.

Why does CMS place such a high value on patient engagement?

Patients want and expect easy access to their care team, and care teams know that more engaged patients achieve better outcomes. This is not limited to certain patient groups, or patients of a certain age or economic status. Engagement is something that all patients want and deserve.

Providers have their own reasons to want to engage with patients in between care episodes. The more physicians learn about their patients, the more effective they can be at intervening before a small health concern escalates into a bigger one. Accomplishing this cuts costs and allows providers to focus their time on the right patient at the right time.

Now that CMS is attaching rewards and penalties to patient engagement, providers have yet another reason to extend their engagement with patients beyond the care setting.

How GetWell Loop simplifies Improvement Activities

With GetWell Loop, patient engagement is one component of a frictionless process to activate patients in their care and provide a window into their recovery. Our system keeps providers and patients in daily contact through automated check-ins. These check-ins give providers a wealth of information about the patients they treat. They also give patients a voice and enable them to participate fully in their own healthcare.

Additionally, we’ve looked ahead to some of the challenges that providers would face fulfilling CMS mandates, and we’ve certified GetWell Loop as a QCDR. This move was intended to maximize the benefit that providers can reap by reporting positive patient outcomes. Reporting outcomes through a QCDR offers benefits that other reporting techniques do not. 

The benefits of the Qualified Clinical Data Registry

There are various ways that healthcare providers can report to the federal government on patient outcomes, including using an EHR, a CMS Web interface, CMS-certified survey vendors or insurance claims data.

But using a QCDR enables physicians to report performance for all patients, not just their Medicare population. Physicians can also report outcomes that are specific to their medical specialties, which can boost their overall performance rate.

How this eases the transition to quality

Using GetWell Loop to engage patients daily — and making use of our QCDR reporting system — will satisfy the new CMS category under MIPS. Doing this will have a measurable impact on the reimbursement rate set by the government for your organization.

Reforms to healthcare were intended to enable providers to deliver a higher quality of care at a lower cost. Although the essential value proposition is simple, the many reporting requirements and changing rules can be daunting for providers.

Falling behind is not an option. Failing to meet the criteria means penalties, which no health system, hospital or physician wants to absorb. 

Let’s put the focus where it belongs

Caring for the sick and the injured is a noble calling. But it’s also a business. Providers of healthcare must always put the wellbeing of the patient above all else. But they also need to keep their fiscal houses in order if they intend to keep doing what they’re doing.

It’s simple. The less time providers spend thinking about compliance, the more time they can spend making patients healthier.

With GetWell Loop, we are enabling a closer relationship between the provider and the patient, something that we know drives better outcomes. Doing the right thing to improve patient experience can also have a financial upside.