PROMs Reporting: How to Maximize Incentives & Gain Insights into Patient Care

The US healthcare delivery system is undergoing a significant transformation. On one hand, technology is rapidly advancing after the COVID-19 pandemic to deliver more efficient services. On the other hand, the cost of healthcare is increasing at an average rate of 4.5% per year, according to a research study conducted by the American Medical Association (AMA). Additionally, insurance companies face the challenge of providing increasing transparency regarding pricing and reducing costs. Overall, healthcare providers face numerous challenges in providing better care for their patients and improving outcomes.

If you are a healthcare provider looking to earn incentives through value-based or quality improvement programs, capturing Patient Reported Outcome Measures (PROMs) can be a game-changer. This approach can help you with registry reporting and give you an advantage when it comes to earning incentives. In this blog post, we will take a look into the importance of Registry Reporting and explore what PROMs reporting is all about.

Understanding the Importance of Registry Reporting

Registry reporting in healthcare can bring about significant changes to healthcare delivery by providing a structured and comprehensive approach to collecting, analyzing, and utilizing health-related data.

Registry reporting is a critical aspect of healthcare that allows the collection and analysis of important patient-reported data related to the quality of care, cost-effective treatments, benchmarking against national standards, care coordination, population health management, clinical decision support, patient outcomes, and patient satisfaction. This enables healthcare providers to meet specific program requirements like Merit-Based Incentive Payment System (MIPS), Accountable Care Organizations (ACOs), etc., and strive for continuous improvement in their services, adopt value-based care, and ultimately gain additional financial rewards through various government-sponsored and private incentive programs.

Key Incentive Programs for Healthcare Providers

Here are some Centers for Medicare & Medicaid Services (CMS) programs aimed at improving the quality of healthcare while reducing costs:

1. Medicare Shared Savings Program (MSSP): Helps ACOs provide high-quality care to improve outcomes and reduce costs.
2. Merit-Based Incentive Payment System (MIPS): A program that combines multiple quality programs to incentivize Healthcare Providers.
3. Comprehensive Primary Care Plus (CPC+): Aims to strengthen the primary care medical home model across primary practices.
4. Medicaid Promoting Interoperability (PI) Program: Extends financial incentives to Medicaid providers who adopt, implement, upgrade, and demonstrate meaningful use of certified electronic health record technology (CEHRT).
5. Patient-Centered Medical Home (PCMH): Recognizes practices that have patient-centered care coordination plans and offers financial incentives to such practices, often through enhanced reimbursement or care coordination fees.
6. Bundled Payment Models: Incentivizes providers to reduce treatment costs and provide value-based services to patients, specifically in Cardiology and Orthopedics specialties.
7. Children’s Health Insurance Program Reauthorization Act (CHIPRA) with its established performance bonuses, awards healthcare providers for supporting the enrollment of eligible children in Medicaid and CHIP and supporting their retention by covering the costs.
8. Quality Improvement Programs by Private Payers offer incentives to healthcare providers who adopt quality improvement programs.

Let us Take a Deeper Dive into PROMs

Obtaining feedback from patients is a vital aspect of healthcare, and Patient Reported Outcome Measures (PROMs) are an essential tool for doing so. PROMs allow us to collect patient-reported data, which provides valuable insights into their health, satisfaction, and the quality of care they receive.

PROMs reporting fosters patient-centered care, guiding providers toward a value-based model, identifying areas for improvement, and enhancing overall patient experience. These assessments, whether generic (e.g., PROMIS, PHQ-9) or condition-specific (e.g., HOOS, NDI), offer a comprehensive view of treatment effectiveness. They are widely used in research and clinical trials, enabling benchmarking against standards.

To collect PROMs data, facilities can use various methods, including paper surveys, electronic surveys, mobile apps, or participate in research staff-patient interviews.

Earning Incentives Through PROMs Reporting

Here are the benefits that healthcare providers and facilities can see from using Patient-Reported Outcome Measures (PROMs):

• In value-based care models, PROMs feedback can qualify providers for higher reimbursement rates and bonuses, correlating with improved patient-reported outcomes.
• PROMs facilitate shared decision-making, guiding treatment choices based on patient preferences and quality of life impact.
• PROMs results can attract funding from research and pharmaceutical sectors.
• Patient-Centered Medical Home (PCMH) programs offer reimbursement and incentives for PROMs use.
• Providers can also earn financial incentives through cost-saving programs by enhancing healthcare quality and reducing overall costs.

How our Digital Solution can Help Adapt to PROMs Reporting

Taking the above into consideration, it is evident that PROMs reporting plays a critical role in healthcare as it provides a pathway for healthcare providers to improve patient-centered care and receive incentives through various programs.

To thrive in the ever-changing healthcare industry, it is crucial to implement actionable strategies that help effectively analyze data for PROMs reporting.

Monitoring PROMs using Clinical Insights

With HealthAsyst’s digital solutions, you can:

• Track patients screened for Annual Wellness Visits (AWV), HIPAA & Financial Responsibility Consents, and other assessments.
• Gather insights into performance trends for Ortho measures like Osteoporosis Management in Women, Functional Status after Lumbar Fusion, and Screening for future fall risk.
• Receive forecasts on performance measures tailored to your practice, covering pediatric and behavioral/mental health measures such as depressive disorders, suicide risk assessments, and screening for types of depression.

Explore the opportunities of Clinical Insights to establish a sophisticated, data-driven approach to maximizing incentives using PROMs.