NewWave Plays a Pivotal Role

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Designing and building a data and reporting infrastructure that determines the flow of one out of every five dollars spent on health care in the U.S. requires a multidisciplinary team with broad technical capacity and process improvement skills.

That’s exactly what NewWave has provided for the federal government since it was awarded the Physician Quality Programs Management and Implementation (PQPMI) contract to support the Physician Quality Reporting System (PQRS). A pay-for-reporting program, PQRS was designed to ensure doctors are paid by Medicare based on the quality of care they provide.

Efficient Complexity

Making such a complex system work efficiently while properly benefiting all stakeholders — and holding each participant accountable for the quality of care — entails a huge data reporting and collection challenge, as well as extensive education and outreach.

NewWave brings all the capabilities necessary, including proficiency in the “Lean Kaizen” approach to process improvement, to this complex task.

PQRS is a program that affects almost 1.4 million physicians and other providers, all of whom are impacted by value-based care policies which have fundamentally changed the way doctors and other healthcare providers are paid.

On the provider side, PQRS involves a highly sophisticated group of stakeholders and a multitude of complex data collection and reporting processes associated with the delivery of healthcare to about 57 million consumers across America.

The sweeping changes to healthcare delivery underway in America today, designed to incentivize providers to achieve optimal outcomes for their patients, includes a set of 281 separate quality metrics or ‘measures’ — each of which represents a critical set of data points.

This type of comprehensive change in reporting requirements naturally creates a substantial amount of questions and initial confusion, and a need for clear communication to and from health care providers, to make the system user-friendly and technically valid.

It’s the type of challenge where NewWave excels.

 

Not only does NewWave support the complex infrastructure required to ensure collection of quality data from PQRS stakeholders, we also assist with implementation of four intersecting programs, including education and communications outreach.

For care providers, NewWave conducted several webcasts a month to educate and clarify issues around how to properly report their performance data under the new value-based payment metrics, with an average of 600 participants attending each session. NewWave also conducted national conference calls for providers every quarter, with anywhere between 1,000 and 4,000 individuals participating in each.

NewWave also operates the PQRS help desk, where providers can reach out for guidance on specific issues they might have about best practices in terms of reporting their performance data and adjusting their internal processes to meet the new national quality standards for value-based care.

On the consumer side of the value-based healthcare equation, NewWave supports quality control reviews for the Physician Compare website, which helps users find and compare physicians and other clinicians enrolled in Medicare. That way consumers can make more informed decisions about which providers are most suitable to their needs.

Physician Compare is designed to encourage providers to deliver the best care they can, by providing consumers with as much comparative data as possible. It’s a key component to the major goal of making the entire health care system more transparent, so consumers can make more informed decisions about their own care. NewWave helps ensure the program achieves its purpose.

Ultimately, the value of data is not measured by its variety or size, but rather how well it enables better outcomes. In the case of PQRS and patient outcomes, NewWave is playing a pivotal role in solving for the greater good.

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