As executive teams look to diversify, there is one challenge that comes with every new service—identifying and managing new performance measures. The range of performance measures—and how to set up a system that can adapt to a wide range of measures, was the focus of a new white paper, Maximize Success With Performance And Quality Measures, that I wrote with Scott Green, senior vice president and general manager of human services at Netsmart.
How different are the performance measures? It depends on your service lines. A recent analysis of performance measures found there were 558 unique mental health performance measures. This includes the “alphabet soup” of measurement systems like the Merit-Based Inventive Payment System (MIPS), Meaningful Use (MU), Certified Community Behavioral Health Clinic (CCBHC), Inpatient Psychiatric Facility Quality Reporting (IPFQR), and the Treatment Episode Data Set (TEDS) initiatives (see Reducing The Cost Of Reporting 558 Unique Performance Measures).
At the service line level, what do performance reporting requirements look like? Take just these three examples—health homes, CCBHCs, and long-term services and supports (LTSS). Medicaid health homes are required to report on eight quality measures and three utilization measures to receive payment. Some measures on the table include initiation and engagement of alcohol and other drug abuse or dependence treatment, controlling high blood pressure, screening for depression and follow-up plan, follow-up after hospitalization for mental illness, all-cause readmissions, adult Body Mass Index assessment, and the Prevention Quality Indication (PQI) 92: for chronic conditions. CCBHCs are tracking follow-up after hospitalization for mental illness, adherence to antipsychotics for individuals with schizophrenia, initiation and engagement of alcohol and other drug dependence treatment, and suicide risk assessment for major depressive disorder.
In contrast, LTSS provider organizations need to measure metrics related to assessment, care planning, and care coordination through comprehensive assessments and care plans. Some of the specifics include shared care planning with the primary care professional; reassessment/care plan update after inpatient discharge; and screening, risk assessment, and plan of care to prevent future falls.
The constant comment from provider organization executive teams is that there are too many different performance measures—with different requirements depending on the service, the consumer type, and the health plan. I don’t see that changing any time soon. Rather, management teams need to build a technology infrastructure with flexible reporting capabilities. There are six key elements to a “best practice” infrastructure: a shareable electronic health record (EHR); integrated workflows; customizable measures for each type of contract; identified gaps in care; visual dashboards; and the ability to calculate everything in real-time.
A shareable EHR—On-demand data interoperability is essential to care coordination and managing transitions of care, and for a provider organization to truly be high-functioning, it needs everyone on the care team to have access to the metrics that can build and support a whole-person approach to care. Developing a shared platform across all users equips the team to identify behavioral health concerns exposed by the data, and then to align the treatment plans.
Integrated workflows—Feeding data into the daily workflows across all clinical, financial, and operational decisionmaking is at the heart of increasing efficiency and leveraging the potential to meet metrics requirements, increase quality, and capture the requisite outcome measurement scores. Building this “new” workflow approach should focus on clinical form consolidation, point-of-service access to health records, increased record compliance, and enhanced health record reviews and audits.
Customizable measures for each type of contract—When it comes to measures, not all contracts are created the same, and many executives will have to embrace and remain diligent in the face of “measurement fatigue.” But it’s an inescapable reality that every contract will have its own requirements and quality measures. Investing in collection methods and tools that can flexibly allow executives to target and report different data is a must.
Proactively identify gaps in care—There is no competitive advantage if provider organizations don’t have the ability to put performance measures to good use in improving consumer care. That is the key competitive advantage in a data-rich, performance-based world. Shared data and integrated workflows alone are good but run the risk of being reactive instead of proactive. A targeted investment in predictive analytics allows executives to look ahead and identify the gaps in care that threaten to keep the care team from achieving its goals.
Reporting and visual dashboards—The key to the effective use of any data is automating the data collection and analysis, and then delivering actionable information through customized reporting and dashboards for end users. These are the hands-on tools that can take large chunks of unwieldy and dense data and deliver them in a “digestible” way.
Calculate everything in real-time—Real-time data is far more valuable than lagging indicator data because it supports a proactive approach to outcomes management. It allows managers to change performance rather than just discussing why poor performance happened.
As executive teams look to build strategies for recovery and sustainability, innovation and new service lines are certainly going to be part those plans, which means that new performance measures are likely. The key is to make investments in a best practice tech infrastructure now, to be ready for the metrics-based reporting and management requirements of the future. For more on reporting requirements and metrics management, check out these resources in The OPEN MINDS Industry Library:
- When It Comes To Performance Metrics, Not Any Measure Will Do
- From Metrics To Action—Making Strategy A Reality
- A Data Driven Strategy – A Blueprint For Organizational Success
- Performance Management Is Never ‘Done’
- Using Data Dashboards To Manage Organizational Performance
- Don’t Underestimate The Culture Change In Becoming Data Driven
- Building An Infrastructure For Data-Driven Performance: An Executive Guide For Success In A Value-Based Market
- What You Can Learn From CCBHCs In The Era Of COVID-19
- Leveraging Virtual Capacity & Moving To Use Cases Beyond Therapy
- The Convergence Of Technology & Crisis Management: Lessons Learned While Responding To A Pandemic & Planning What Your Organization Should Be Doing Right Now
And for even more on best practices in establishing service standards and key performance measures, join us on October 8 at 1:00 pm EDT for the web briefing, Measuring & Improving Consumer Experience, Consumer Engagement & Consumer Performance – A Best Practice Approach, led by OPEN MINDS Executive Vice President Kimberly Bond. The web briefing is offered as part of The OPEN MINDS Executive Blueprint For Crisis Recovery, a program designed to help executive teams prepare, respond, and navigate the disruption caused by a market in turbulence.