- On average, only 38 percent of providers are satisfied with their EHR systems’ ability to meet the requirements of the CMS Quality Payment Program (QPP), according to the State of QPP Preparedness Industry Report.
Conducted by Porter Research and SA Ignite, the study found that 64 percent of surveyed healthcare providers hope to maximize payment incentives associated with QPP. However, most respondents reported low satisfaction rates with the EHR and population health management solutions they plan to use to meet program requirements.
Researchers surveyed nearly 120 medical, quality, and operations executives and directors from large health systems and integrated delivery networks about their experiences using EHR and population health management solutions.
Eighty-three percent of respondents reported they intend to use their EHR solution as the primary method for managing QPP performance. Seventy-two percent reported either that their EHR vendor does not offer a specific solution tailored to the Merit-Based Incentive Payment System (MIPS), or that they do not know whether their vendor offers a MIPS solution.
Furthermore, only 4.7 percent of respondents reported being very satisfied with their EHR system’s ability to display overall MIPS scores and estimate financial impact.
“The significant gaps between what is important and what EHR and population health management vendors are providing should be no surprise,” stated report authors. “These systems are not intended to manage clinician data and perform the type of program management and detailed analysis required to optimize performance in a value-based program.”
Overall, respondents most frequently cited lack of system preparedness, poor end user satisfaction, and limited focus on program complexities as the primary barriers to maximizing QPP incentives.
“In addition, respondents are unsatisfied with the level of guidance and exposure to regulatory experts that they have through their EHR vendors,” authors explained.
Seventy-eight percent of respondents that ranked regulatory guidance and expertise as important reported being unsatisfied with the guidance provided by their EHR system vendors. Knowing where to receive guidance during the program is imperative for providers still feeling underprepared and overwhelmed by reporting requirements as QPP heads into its second year.
“Maximizing performance in value-based programs goes way beyond submitting the required data to CMS or other organizations,” the researchers wrote. “It requires the ability to dive into performance data by entity and clinician, look at trends over time, understand financial impact, and ultimately communicate effectively with clinicians who are bearing the brunt of this new way of working.”
As part of the report, researchers offered several recommendations to assist in mending the gap between provider objectives and EHR system capabilities.
Researchers first recommended providers maintain a working knowledge of eligibility changes in the coming years.
“Having the ability to scope out scenarios or compare results at an individual and group level is one way healthcare organizations can optimize performance,” the research team advised.
Next, researchers suggested healthcare organizations implement tools to assist in identifying hidden opportunities, predicting scores, proactively addressing shortcomings, and choosing optimal reporting methods.
The research team also recommended practices find a purpose-built solution for value-based program management to reduce regulatory complexity and provide clarity about which activities are most meaningful. Additionally, providers should set realistic goals for their practices based on their system capabilities.
Lastly, researchers recommended provider organizations draw up a multi-year plan.
“Having a multi-year plan supported by predictive analytics tools specialized in regulatory compliance will give healthcare leaders fact-based insights to achieve their goals and better chart their own financial outcomes,” the team advised.
Providers should design plans that anticipate and account for potential change because regulations are subject to frequent modification.
While many providers still feel underprepared for the second year of QPP, stakeholders – including the National Committee for Quality Assurance (NCQA) and the American College of Physicians (ACP) – have voiced support for recent efforts by CMS to reduce regulatory burden in 2018.
Portions of the QPP 2018 final rule were informed by the new CMS Patients Over Paperwork initiative. The initiative was designed to reduce unnecessary regulatory burden and increase clinical efficiency so providers can focus on patient care over fulfilling federal requirements.