Medaxiom Blog

A common challenge in CV programs today is the cost/resource requirements of quality registry involvement such as NCDR-PCI and others. Due to several payer requirements for registry utilization, I’ve not yet been to a program that has not engaged with at least one registry in the CV program or service line. The challenge typically lies in the resource requirements for abstraction and registry data management. Although this is an important and real challenge, the bigger challenge I see is the utilization of the registry data in a meaningful way. Whether the registry is STS, NCDR-PCI, ICD, Action or others, there is a wealth of quality data that can provide feedback on patient outcomes, processes, clinical decision making and patient throughput. All of these can be tied to clinical outcomes, patient experience and the economics of your CV program. The key is using the data in a meaningful way to drive and support quality and process improvement within your organization. There are three areas that need to be managed in order to promote effective utilization of quality data - abstraction, data management, and program performance.

As the Advanced Practice Practitioner (APP) role evolves and the industry moves toward value-based care and alternative payment models, establishing a method for tracking and monitoring the productivity and performance of APPs is more important than ever. In fact, I would argue that more important than productivity is tracking/quantifying the value that they bring to the team. In addition, per Peter Drucker, “What gets measured gets managed,” continues to hold true.

A report published by the New England Healthcare Institute opened by stating that ‘Adults in the United States receive only about half of the health care they need when they need it.’[i] The report outlines the reasons why clinical care guidelines that improve health outcomes aren't being followed and proposes industry changes that would improve this.

Value-based care has been an area that I have found fascinating ever since I was first introduced to the concept in 2010. At the time, it made so much sense—creating an environment where the keys to effective patient care are incentivized and resources are available—yet it seemed elusive. Almost 10 years later, we have many different ‘value’ type models emerging both in public and private payer sectors, but I wonder if we are seeing the results that we were hoping to get.

In thinking about next week’s CV Transforum conference, a lot comes to mind on the need to re-engineer the way we do things. And from my work assisting groups who are thinking about the different alternative payment models, and helping programs develop their care team models, I have many stories that illustrate the need for change. Today, before I get into the problem areas, I want to start with a story that shows how things can go right.