With new quality care models come new reporting burdens, and that’s forcing a sea change in the way physicians run their offices. Lori E. Rousche, M.D., says once providers array their clinical staff members to deal with the new reporting measures, improved care will follow.
In a blog post written for Medical Economics, Rousche, a family physician and hospice medical director for Grand View Health in Sellersville, Pennsylvania, describes the efforts her practice has made in response to the Comprehensive Primary Care Plus (CPC+) program.
Providers in areas covered by the program, which is administered by the CMS, often anticipate a financial boost and better access to care for patients. But the administrative burdens required by methodologies that seek to change physicians’ incentives from volume to value have generated resistance among physicians, who have called for better balance and a more visible connection between reporting metrics and positive care outcomes.
CPC+ has already generated improved outreach to clients with complex conditions, according to Rousche, who writes that she remains hopeful that improved outcomes will follow. She reports that staff members currently track 14 electronic Clinical Quality Measures for the program, nine of which they must report in their first reporting year, including two of three outcome-related measures and two of four complex care measures.
Managing this process has meant an increased administrative burden. Among the clinical staff's new duties:
- Staff members prepare for each patient, noting both the chief complaint and any additional preventive care for which a patient might be due.
- In addition to the usual tasks involved in preparing a patient for a physician visit, nurses take detailed EHR documentation, including a social history and information on any behavioral counseling given.
- Nursing staff screen patients for a variety of issues, allowing the practice to flag patients who represent a fall risk, for example. For patients with conditions requiring ongoing management, such as depression or dementia, screenings capture their current status using the appropriate questionnaires.