Getting a handle on quality and value-based analytics in your medical group practice

Having the right data helps medical group practices make better decisions, which can pay off as more reimbursement shifts into value-based arrangements.

While the pace of adding quality performance metrics as a component to physician compensation plans has been slow in recent years, its importance continues to grow: A May 24, 2022, MGMA Stat poll found more than 4 in 10 medical practices make quality a component in compensation methodologies for their doctors.

To better understand how healthcare leaders are approaching the task of measuring what they hope to manage, a June 7, 2022, MGMA Stat poll asked medical groups how they handle quality and value-based analytics. The majority (45%) reported they use both in-house analysts and vendors/software to get the job done, while 40% said they only use in-house analysts and 15% noted they only use vendors or third-party software. The poll had 354 applicable responses.

A recent discussion group during the 2022 Medical Practice Excellence: Pathways Conference DX brought together several practice leaders to discuss their work in healthcare data. Among those who participated, many suggested that they have looked to move beyond pre-built reports within their practice management (PM) systems or EHRs to tools such as Power BI to pair with their existing reporting done in Microsoft Excel®.

Previous joint research by MGMA and Humana on value-based care in the primary care environment has found that care collaboration and integration of data represent two of the most important aspects of being successful in value-based arrangements. In primary care, this often entails dashboards, upgraded software and/or increases in staffing as part of participation in an accountable care organization (ACO).

That research found that:

• More than half (55%) of primary care practices added data analytics staff to accommodate the shift into value-based care.
• Among practices that added new technology to enable their value-based care efforts, 90% said they added data analytics/reporting platforms; 60% added a system for population health management; and 42% upgraded their EHR.

As noted in the research report, “investments in upgraded EHR systems, which can enable data collection for additional analytics, were very common and seen as an essential part of adoption” of value-based care models.

Why analytics matter

As more medical groups take on responsibility and risk for costs of delivery within ACOs, aligning financial and clinical outcomes requires a close eye on the data underpinning value-based arrangements.

According to Ashok Roy, MD, MPH, MBA, chief medical officer, Caravan Health, during his session at the 2021 Medical Practice Excellence: Leaders Conference, one of the main hurdles to group practices’ embrace of value-based arrangements has been the continued performance of volume-based care in many areas of the nation.

With continued promotion of value-based contracts by government payers and commercial insurers, there are specific areas of focus for practices in FFS-dominant workflows to prepare for a population health model that has a heavy emphasis on avoiding emergency department (ED) visits and inpatient stays, Roy said.

“Either you can choose to participate in value-based care, or eventually it may be forced on you by some payer,” Roy said, underscoring that it’s valuable if medical groups take initiative toward value to help set their own timelines for implementation.

Aligning incentives with new value-based metrics and engaging your physicians and providers is crucial, too, and underneath that work is an analytical foundation of easily accessible and frequently updated data on how the organization is doing, Roy said.

• To read more about the economics of population health in an ACO and how data influences governance, read the recent MGMA Connection magazine article, “Leveraging value-based care data analytics to improve outcomes.”

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