Patient Outcomes

Patient Outcomes

A positive patient experience results in improved financial and patient outcomes. As competition between healthcare providers for patients increases, patients may select their healthcare provider based not only on clinical outcomes, but also on whether their healthcare provider delivers compassionate patient-centered care.

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QPI’s aim is to monitor and report findings to healthcare providers and payers that contribute to overall population health. Our Chief of Patient Outcomes will develop a heat map based on your organization’s performance to identify and assist in the implementation of overall improvements as applicable

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Quality Measures

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High quality health care is a priority not only demanded by payers, but also by the US Department of Health and Human Services. Quality initiatives are determined by payers to assure quality health care for their members through accountability and public disclosures. The data collected data in 12-month terms, and the weights of their measures, can be submitted to the following Merit-based Incentive Payment Systems (MIPS):

It is QPI’s goal to work with healthcare providers to select applicable measures, for pre– and post– care, and begin collecting data for report to your organization’s selected MIPS Program. After all, high quality care is equitable care.

HEDIS Management

As we identify Quality Measures, we may work with payers or insurance carriers for HEDIS Management. The Health Effectiveness Data and Information Set (HEDIS) Tool was developed so that payers and insurance carriers can gauge how their patients or members are being cared for.

The premise behind HEDIS is simple. HEDIS rewards healthcare providers for preventive care—a major focus for federal and state healthcare programs. The concept is that by increasing preventive care, the excessive number of in-office visits and hospital readmissions for one patient decreases as that patient begins to experience better health outcomes.

At QPI, our in-house HEDIS Director works with healthcare providers to identify and close gaps in care, based on patient demographic and diagnosis, and to improve overall health outcomes. By closing care gaps, healthcare providers are incentivized by payers or insurance carriers. QPI’s HEDIS Team is dedicated to reduce Medical Record Audit requests from reoccurring due to habitual open care gaps. Additionally, QPI identifies claims that are not coded to the highest specificity per HCC (Hierarchal Condition Category) based on patient diagnosis.

QPI collects HEDIS reportable measures by utilizing HARP Light Technology. Our system of weights and measures include:

Patient Experience

Promoting interoperability combines quality data and timely, secure access to care that proves optimization for positive patient outcomes. How do patients perceive their care from their trusted healthcare providers? Should surveys solely rank “satisfaction?” In truly achieving patient-centered care, gauging the patient’s overall experience will allow healthcare providers to further educate their patients on care, treatment or services; focus on addressing dissatisfaction; and showcase positive patient outcomes.

Creating a Patient Centric Environment

There is no “I” in “team.” Patient experience is not measured solely by the patient’s experience with the physician, but rather by the patient’s experience with all staff in any healthcare setting.

At QPI, we strongly encourage healthcare providers and their team to seek exemplary patient outcomes by utilizing AIDET.

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Patient Experience Surveys

There is no “I” in “team.” Patient experience is not measured solely by the patient’s experience with the physician, but rather by the patient’s experience with all staff in any healthcare setting.

At QPI, we strongly encourage healthcare providers and their team to seek exemplary patient outcomes by utilizing AIDET.QPI follows the CMS-approved CAHPS (Consumer Assessment of Healthcare Providers & Systems) Surveys. Implementing the leading healthcare payor source’s approved survey and achieving positive patient outcomes allows healthcare providers to increase revenue. By providing patient experience reports to Merit-based Incentive Payment Systems (MIPS), healthcare providers are eligible to receive additional revenue from inside payor sources like Medicare, Medicaid and Commercial Insurance Carriers.

CAHPS (Consumer Assessment of Healthcare Providers and Systems)

QPI will conduct surveys for you as an unbiased third-party. Raw data is collected, communicated and analyzed with you, and distributed to MIPS and requesting payor sources. Ultimately, aggregated data will be added to Physician Compare, available to Medicare patients.

QPI will conduct surveys for you as an unbiased third-party. Raw data is collected, communicated and analyzed with you, and distributed to MIPS and requesting payor sources. Ultimately, aggregated data will be added to Physician Compare, available to Medicare patients.

Let’s face it though… word of mouth is the best way to get the message out there. Patients have the option to post their experience on HealthGrades, Google and more. QPI will post positive findings to these sources.

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HOS (Health and Outcomes Surveys)

Another random sampling of surveys may be collected and assessed for healthcare providers. HOS Surveys are established to hold healthcare providers accountable in managed care.

Patient Resolution Reporting

As QPI conducts Patient Experience Surveys for healthcare providers, all adverse findings are communicated with your organization for immediate intervention both daily and weekly.

Complaint and Grievance Reporting

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Reality: Not everyone is happy. Not every patient will provide a positive patient experience.

Patients may complain or formally submit a grievance. QPI strives to obtain resolution with healthcare providers and provide written notification to the patient. Complaint response and resolution due dates are auto-configured in Lavear and will populate as a daily task for Risk Management until the task is complete.

When responding to a complaint/ grievance is necessary, our Risk Management team will work you for immediate resolution. Once resolution is achieved QPI will notify the patient, in writing, of the resolution. This is done case-by-case. Continued or habitual complaints/ grievances of the same nature will be discussed one-on-one with your leadership team.

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