Applied Analytics in the Transition to Value-based Care

October 13, 2015

One medical group successfully transitioned from volume to value-based care using a complete analytics offering to track performance metrics.

Practices continue to look for tools to aid in their transition from volume-based to value-based care. At this year’s Medical Group Management Association (MGMA) Conference, held in Nashville, Tenn., Bradley Bekkum, medical director of Marshfield Clinical Information Services (MCIS), and Kate Konitzer, chief informatics architect of MCIS in Marshfield, Wisc. outlined their approach to using applied analytics for the transition to value-based care. MCIS is a wholly-owned subsidiary of Marshfield Clinic, a leading provider of healthcare services in northern, central, and western Wisconsin with two hospitals and over 50 clinic locations.

Following its success in Medicare’s Physician Group Practice demonstration, Marshfield joined Medicare’s Shared Savings Program in 2013. The clinic’s Medicare Accountable Care Organization benefits from the organization’s past investment in advanced primary-care infrastructure and disease-specific care management capabilities, which have yielded reductions in hospitalization and readmission rates.

Bekkum said starting out on a volume-based to value-based journey seems insurmountable at first. “You need to take a deep breath and assess your current situation,” Bekkum said. “Take a look at your existing contracts and compile a list of any quality reporting or performance metrics. Assess your practices ability to analyze it performance and track it over time. That information will give you an idea of the effort, resources, and time to start the journey.”  

A critical component to MCIS’s success is their internally developed EHR system and enterprise data warehouse, which allow internal performance reporting and identification of best practices that have galvanized physician support for quality improvement efforts. (MCIS achieved certification for stage 2 of meaningful use in 2014.)

In addition to their internal business intelligence, Bekkum said that MCIS has partnered with an analytics vendor for the majority of their data. MCIS Clinicals, the practice’s cloudbased integrated EHR, also combines with that software solution for an overall analytics offering.

Bekkum said MCIS’s general approach is applicable to any sized practice, including small practices. He also suggested practices should begin with the end in mind-for population health, chronic care management, or bundled payments. “This means knowing which metrics, at least in general, you want to manage and control,” Bekkum said. “Then make sure your EHR allows capturing that as structured data, and that your EHR communicates with your analytics engine.”

Bekkum said if a practice lacks analytics data, a good starting point is the 'bridge' codes-chronic care management and transformation care management-from CMS. “These allow traditional fee-for-service billing for non-patient seeing activity, that simultaneously builds competency in identifying, tracking, and reporting,” Bekkum said. “These are the basics needed to develop an analytics skill set.”