Webinar recap: “Why data integrity matters for MACRA success”

By nThrive | Posted: 10/09/2017

Contributors: Bonnie S. Cassidy, MPA, RHIA, FAHIMA, FHIMSS, Principal, nThrive Advisory Services and Moshe Starkman, Sr. Consultant, nThrive

With so much emphasis on how to report 2017 MACRA Quality Payment Program (QPP) data, it is easy to lose sight on what to report and whether your data is sound. 

nThrive’s recent webinar, “Why data integrity matters for MACRA success,” focused on both, with expert Moshe Starkman, nThrive senior value-based reimbursement (VBR) consultant, discussing ways organizations can be strategic in their choice of metrics to report.  Bonnie Cassidy, MPA, RHIA, FAHIMA, FHIMSS, principal director of nThrive Advisory Services, focused on why health information governance and clinical documentation integrity are foundational to any MACRA reporting effort.

Go here to access the on-demand recording.

Choosing wisely on specific measures to report is important, Starkman said, because, with MACRA, you are competing against others not just yourself. “The Centers for Medicare and Medicaid Services (CMS) research has changed the ground rules, with scoring now based on how you compared against other organizations,” he explained. “What you might have considered a good score before could actually hurt you if your competition is performing at a higher level.”

In order to judge performance fairly and accurately, Cassidy noted that MACRA places a much higher premium on the integrity of clinical information generated during patient care. “MACRA offers providers the opportunity to focus on quality health care rather than simply more care,” she explained, “however, it is also dependent on secure information sharing and patient access through an emphasis on technology and practice improvement.” 

This is where the role of health information management (HIM) comes in, helping to protect and ensure ethical use of data, regardless of whether organizations choose a Merit-Based Incentive Payment System (MIPS) or Alternative Payment Model (APM) path. 

The central value of accurate and complete data has never been greater given the implications of MIPS and APMs, with trust in health information for either option dependent upon information governance as a single source of truth. Four key areas health care providers should focus on include:

  1. Accuracy - Does the coding represent information correctly?
  2. Completeness - Is the codified information representing the clinical concept to its fullest capacity?
  3. Preserved context - Does the coding appear separate from the context in the clinical record?
  4. Currency - How up-to-date is the clinical information in the patient’s record of care?

Ultimately, Cassidy and Starkman agree that collaboration throughout the organization is key to improving patient care, revenue and compliance. Weak links anywhere along the clinical documentation value chain will contribute to poor data quality and ultimately impact QPP performance.

To meet the demands of these rigorous dependencies, implementation of MACRA’s QPP ultimately increases the need for better clinical documentation improvement (CDI) in both acute and non-acute patient settings.  Because little attention has been paid to CDI in the physician practice setting, this is an area that is expected to increase in importance.

Go here to view the on-demand recording of “Why data integrity matters for MACRA success.” HIM professionals, this session has been submitted to AHIMA for one CE credit. 

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