The Kentucky Department for Medicaid Services is collaborating with healthcare associations, advocates, and employers to align quality improvement measures and streamline reporting procedures for healthcare providers across the state. This project will reduce administrative burdens for physicians and provide more uniform data for comparisons.
“Quality measures are critical as we become more data-driven in our efforts to address outcomes and improve patient care,” said Cabinet for Health and Family Services (CHFS) Secretary Vickie Yates Brown Glisson. “This is the first step toward applying a greater level of consistency among reporting so that everyone is collecting the same data, requirements are less burdensome for the healthcare community and ultimately we have a clearer picture of what is going on in our state’s healthcare landscape.”
In recent months, DMS has worked closely with numerous partners from a variety of healthcare backgrounds to explore a quality measure set, which was unveiled today during the annual Kentucky Medicaid Group Management Association (MGMA) conference in Louisville. The initiative addresses burdensome and often conflicting reporting requirements as well as streamlines data collection and reporting to improve healthcare outcomes.
“Every insurer and government program defines quality in their own way. They require different information to be submitted by physicians, which increases administrative burdens and costs, while confusing patients about how the healthcare system defines quality,” said Patrick Padgett, executive director for the Kentucky Medical Association (KMA). “KMA is happy to assist the Cabinet in reducing these administrative burdens and helping to create a better system of quality measurement.”
The Cabinet reached out to numerous other partners for collaborative work on this project, including Qsource, the Kentucky Primary Care Association, Kentuckiana Health Collaborative, commercial insurers, employers, healthcare providers and various other organizations.
“In collaboration with the Kentucky Cabinet for Health and Family services, Qsource has created a crosswalk between MIPS measures and other reporting systems for many Medicaid managed care plans,” said Tammy Geltmaker, state director for Qsource. “Our goal of course is broader, in that we want to help align practice quality improvement efforts and eliminiate the quality improvement data collection burdens on practices. At the same time we’re working to make sure measures are meaningful and relevant to patients.”
DMS staff said the collaboration among various entities was an integral piece in the development of the new reporting measures.
“I interviewed some of our Medicaid providers regarding the complexity of quality reporting. Hearing how difficult it is to report differently to so many different payers, I knew Kentucky Medicaid needed to align our quality reporting with others to reduce this burden while still getting the quality data needed,” said Judy Baker, branch manager for the DMS Division of Program Quality and Outcomes.
Specifically, DMS has aligned its quality measures with the Merit-Based Incentive Payment System (MIPS), which is one of two payment tracks designed by the federal government for Medicare and the Children’s Health Insurance Program (CHIP). MIPS defines four categories of eligible clinician performance, contributing to an annual MIPS final score of up to 100 points:
- Advancing Care Information (ACI, renamed from Meaningful Use)
- Improvement Activities (IA)
“Measurement alignment is a priority that is best achieved by bringing together key business, government, and healthcare sectors,” said Stephanie Clouser, a Kentuckiana Health Collaborative Data Scientist. “The more we can get these public and private organizations to align around the same measures, the better we can focus improvement efforts toward shared areas. We are committed to developing this common measurement set through a deliberate process where key experts collaboratively agree on Kentucky’s priority measures.”
“The partnership between DMS and the provider groups across the state is a positive step in improving the health of the Medicaid members,” added Joe Smith, Kentucky Primary Care Association (KPCA) Chief Executive Officer. “KPCA member clinics are pleased with the leadership at DMS for providing a Kentucky driven direction on health care quality measurement. “
Moving forward this partnership will help ensure consistent quality measures for Medicare, Medicaid, as well as private insurance companies and employers.
“We value being a part of this public-private partnership to set a shared understanding of the healthcare measurement priorities that matter most to our community. By joining our public partners, we can collectively make systemic changes necessary to improve the health of our employees and communities,” said Randa Deaton, corporate director, UAW/Ford Community Healthcare Initiative, Ford Motor Company.
“It is impossible to drive systemic improvements in the quality of healthcare without payer, purchaser, and provider alignment around a common measurement set,” said Diana Han, M.D., Global Medical Director for Louisville-based GE Appliances, a Haier company. “We are committed to public-private partnerships to enhance efficiencies for all healthcare stakeholders, with the end goal of driving improvements in the health of our employees, their families, and the entire community.”
Today’s presentation will be available online on the cabinet’s Department for Medicaid Services website. It can also be viewed at the CHFS Facebook page.
The Cabinet for Health and Family Services is home to most of the state’s human services and healthcare programs, including the Department for Medicaid Services, the Department for Community Based Services the Department for Public Health and the Department for Behavioral Health, Developmental and Intellectual Disabilities. CHFS is one of the largest agencies in state government, with nearly 8,000 full- and part-time employees located across the Commonwealth focused on improving the lives and health of Kentuckians.