Value-based care is more than just a buzzword. This quality-over-quantity philosophy is gradually replacing the old fee-for-service model in the U.S. and worldwide for healthcare industry.
The federal government, via the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS), encourages and supports adopting value-based care. They do this through quality initiatives such as the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).
Value-based care, emphasizing efficiency, equity, patient engagement, and preventative treatment, aligns perfectly with the precision medicine approach. Rather than receiving standardized care, patients are treated according to individual factors (e.g., socioeconomic background, genetic makeup, and lifestyle), so they are given the most effective treatment at the ideal time.
Suppose your practice wants to make the most of value-based care and benefit from the financial incentives attached to quality initiatives. In that case, you must set goals and implement quality measures to gauge your success. These CMS-defined tools can examine healthcare outcomes, procedures, strategies, and patient insights to help you decide which areas need improvement.
What Are Some of the Most Important Quality Measures to Look For?
Your specific quality measures will depend on the goals of your practice. For example, oncologists may target MIPS-approved efforts such as:
- Reduction in ED admissions
- Reduced proportion of patients receiving chemotherapy near end-of-life
- Cost-effective drug choices
- A relevant quality measure can be as cancer-specific as Polymerase Chain Reaction (PCR) Test With MR2 or Greater Result (BCR-ABL1 transcript level <= 1% [IS]) for Patients Receiving TKI for at Least Six Months for Chronic Myelogenous Leukemia (CML), or as generally applicable as the patient-reported quality of life. Ultimately, you want to improve patient outcomes, broaden healthcare equity, and use resources more efficiently.
How Data and Technology Can Help Track Quality Measures in Precision Medicine
Information helpful in tracking quality measures includes EHR, timetabling, drug trials, admissions, telehealth, mHealth data, population data, patient evaluations, billing, claims, and more. While all this is a lot to keep track of, modern technology has become increasingly effective at gathering, analyzing, and visualizing complex interacting data sets and translating them into actionable ways to inform your decisions.
The following are just a few features that a dedicated healthcare tech platform can use to track quality measures in a precision medicine practice:
- Data that covers the whole patient journey, from diagnosis to end-of-life.
- Analytics that can predict ED, in-patient, and end-of-life models within six months .
- Reports to support Care Management teams as they work to lower risk, improve quality of life, and increase survivorship.
- Leverages claims and clinical data from the EHR, lab, and pharmacy to generate insights that support accurate and timely decisions.
- Detailed dashboards that enable providers to identify appropriate and cost-effective treatment options.
Utilizing these tools will help you select the most effective quality measures for your practice and show you their impact in real-time, allowing you to answer questions like:
- Is our precision medicine approach effectively reducing costs/ED admissions in the long term?
- How do we close the gap on this measure for MIPs claims?
- Did our investment in this drug improve patient outcomes in this patient population?
- How do we benchmark patient cohorts so that the practice is standardizing value-based care?
For best results, it is recommended that you partner with a software vendor with proven experience in your specialty. This can help you find tools optimized for your practice right from the start.
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