Clinical Insights

VALUE-BASED CARE AND POPULATION HEALTH MANAGEMENT

NEQCA has a proven track record of successfully delivering value-based care by helping the practices in its Network more efficiently capture performance-based incentive payments. NEQCA’s practice operations support – including electronic health record optimization and clinical documentation improvement – have measurably helped the Network improve contract performance.

NEQCA’s population health management initiatives – such as pharmaceutical cost management and care management support for high-risk patients – have delivered quantifiable benefits for both patients and providers since 2009. NEQCA recently made a significant investment in its population health capabilities to even more effectively aggregate, analyze and act on data at the point-of-care in ways that will positively impact patients and drive contract value.

More information about NEQCA’s value-based care and population health performance will be posted here in the months to come.

Performance Call To Action: The Importance of Caring For Chronically Ill Patients

All Network providers are asked to participate in a focused effort from now through December 31, 2020 to prioritize the care of chronically ill patients and, in the process, appropriately code for their chronic conditions.

Because of COVID-19, NEQCA practices have fallen behind in seeing (and risk-coding) chronically ill patients, which could put these individuals at risk of developing additional health complications - and also could impact our Network's ability to achieve 2021 Efficiency goals. In simple terms, if patients appear to be healthier than they actually are because of missing or inaccurate risk-coding, our payer-derived budgets will be accordingly, and wrongly, lowered.

NEQCA practices must spend the rest of 2020 prioritizing the care of these patients and, in the process, appropriately coding for their chronic conditions. Visits may take place in-office or by video telehealth. Clinical need must always drive the priority of who is seen and the type of visit, and it is essential to code accurately when seeing patients in person or online. NEQCA is working with your Local Care Organization (LCO) to provide High Priority Patient Outreach lists that should be used to identify patients who must be seen by year-end.

You can learn more about our Network-wide patient prioritization initiative in our Network Briefing and in this presentation. You also are encouraged to contact your practice manager, Local Care Organization (LCO) administrator, or NEQCA Central's Senior Medical Directors Ben Kruskal, MD or Pratiksha Patel, MD for additional information or support.

Thank you for engaging in this important and time-sensitive focus on your chronically ill patients.