IPRO and its Atlantic Quality Innovation Network (AQIN), commit to developing innovative approaches to evaluate healthcare cost and quality that permit payers and consumers to readily identify performance that is high-value, based on the three-part aim of better health, better healthcare and smarter spending.
IPRO believes that the work we’re doing—highlighting physician practices that meet stringent Advanced Primary Care criteria and promoting the cost and quality performance of ACO-served geographic areas, versus non-ACO areas—offers important educational support to value-based payment reform. By advancing the learning curve among consumers, patients and family care-givers, we will be building the case for Category 3 and 4 APMs as a value proposition. While IPRO doesn’t provide care, we have an important role to play in educating the lay public on the importance of recognizing and rewarding high-quality, cost effective healthcare.
Advanced Primary Care Scorecard
IPRO’s Managed Care Department is currently designing an Advanced Primary Care (APC), scorecard to evaluate cost and quality performance at the individual practice level and across payers. The initial scorecard will include a total of 13 cost and quality measures, including hospital utilization, preventive care and total cost per member per month. Under the auspices of the New York State Department of Health, IPRO will offer technical assistance to health plans to assure data accuracy and to evaluate attribution logic. Additionally, IPRO will aggregate performance across payers, producing reports at the regional and state-wide levels.
Success of the APC scorecard will be measured by whether the NYSDOH converts this effort from a pilot-study to a required, publicly-reported performance report for practices across New York.
Why Not the Best Website
Additionally, IPRO will use the freely-available WhyNotTheBest quality improvement website it created and manages to compare and contrast the performance of Accountable Care Organization (ACO)-participating providers against non-participating providers. By accessing ACO “quality footprint” information, visitors to the website will be able to contrast quality and cost performance across dozens of measures between regions that are and are not served by ACOs. IPRO will collect and publish comparative cost and value information on a range of quality and utilization measures, including procedures, visits and imaging.
Success of the ACO “quality footprint” data collection and analyses will be measured by surveys of users, who will be asked to rank the website for timeliness, ease-of-use and other user experience measures.