Quality in Healthcare - CMS Solutions
An effective Quality Improvement Program requires:
skilled data aggregation and analysis,
realistic timed achievement goals,
focused on the provider site’s patient population needs,
involves thoughtful and intricate planning,
persistent and intentional implementation, and
reassessment to determined QI success.
CMS Solutions provides comprehensive guidance throughout the QI process including data analytics, project planning and implementation, transformative training, tools and resources.
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The Institute of Medicine defines health care quality as “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”
Determined by some measurement, health care quality is a level of value provided by any health care resource. These measures are usually defined by governing agencies, and accrediting organizations based on historical data and goals for establishing a minimum standard of care. Measures used to rate the level of quality care and service delivered by a provider or healthcare resource are based on the general population served by the provider, and sub-populations further classified by particular attributes such as a demographic identifier, health problem, and health insurance plan.
Set Your Mark… Let’s Go!
CMS Solutions offers a number of services designed to help
healthcare companies set their mark in healthcare.
CMS Quality Services
Quality Payment Program
All Eligible Clinicians should particiapte in Quality Payment Programs (QPP). Report Merit -based Incentive Payment System (MIPS) measures or Advanced Alternative Payment Model (AAMP) and participate in improvement activities that optimize clinical practice.
How We Help:
Strategic approaches to sustainable success under appropriate care models
Guidance in meeting requirements under developing payment models through correct use of revenue codes
Support for measure selection aligning to your goals and priorities across MIPS categories
Reporting support through our Healthcare Data & Analytics services
CMS offers a number of consulting solutions to help your organization’s before, during and after completion of the transformation process from basic guidance of project self-management to the comprehensive project facilitation.
About the Patient-Centered Medical Home
PCMH Simplified Consulting
PCMH Simplified Project Portal
Accountable Care Organizations
Accountable Care Organizations provide coordinated care and chronic disease management while lowering costs.
Medicare offers several ACO programs, including:
Medicare Shared Savings Program – For fee-for-service beneficiaries
ACO Investment Model – For Medicare Shared Savings Program ACOs to test pre-paid savings in rural and underserved areas
Advance Payment ACO Model – For certain eligible providers already in or interested in the Medicare Shared Savings Program
Comprehensive ESRD Care Initiative – For beneficiaries receiving dialysis services
Next Generation ACO Model – For ACOs experienced in managing care for populations of patients
Pioneer ACO Model – Health care organizations and providers already experienced in coordinating care for patients across care settings
“When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.”
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Learn How CMS Solutions Helps Organizations Achieve ACO status.
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Clinical Quality Measures
Clinical Quality Measures (CQMs) are the vehicle by which organizations validate the level of quality delivered to their patients.
Promoting Interoperability (PI) Programs
Merit-based Incentive Payment System (MIPS)
Advanced Alternative Payment Models (AAPM)
Healthcare Effectiveness Data and Information Set (HEDIS)
Patient-Centered Medical Home (PCMH)
Accountable Care Organizations (ACO)
Medical Record Audit
MR Reviews are conducted by CMS Solutions’ team of experienced reviewers, which include Certified Content Experts and skilled healthcare professionals. The analysis compares the organizations care delivery and patient experience against select measures. A comprehensive report of our findings is provided upon completion.
Quality Improvement Management
CMS Solutions Healthcare Quality Management is designed to ensure healthcare providers are delivering care that is: