Alteon Health Case Study
Alteon Achieves Year-Over-Year Exceptional Performance with MIPSpro
Services Provided by Alteon
Alteon Health is one of the largest physician-owned and physician-led acute care medical groups in the United States. Founded in 1971, Alteon has nearly 50 years of experience building custom solutions for many of the country’s most prestigious and well-respected healthcare systems. In 2017, Alteon brought together two industry leaders: Emergency Medicine Associates, a physician-owned practice that has been a leader in emergency medical services since 1971; and Island Medical Management, a physician-owned organization providing services in emergency medicine and hospitalist medicine for over 20 years. With common values and complementary strengths, these two organizations are uniquely suited to come together as Alteon Health, a name that signals a commitment to setting a higher standard in healthcare.
Alteon came to Healthmonix in 2019 to drive MIPS performance improvement across its entire organization. With over 1,400 providers in more than 40 TINs, Alteon faced the challenge of organizing and managing MIPS data in a manner that would enable proactive improvement in performance and scores. The solution also needed to integrate seamlessly with their EHR, athenahealth. Using Healthmonix’s MIPS reporting and tracking product, MIPSpro, in addition to Healthmonix’s consulting team, Alteon met their challenge and exceeded their expectations.
The Healthmonix team began by uploading data into MIPSpro via available HL7 files. Over time, that process evolved to utilizing more robust integrations. In 2021, working closely with Healthmonix’s data integration team, the data transfer process was even further enhanced by implementing a direct integration with athenahealth.
Next, the MIPSpro proprietary measure engine’s power was harnessed to enable Alteon to view performance for all 200+ Quality (eCQM and CQM) measures that are included in the MIPS program. The measure logic and dashboards of MIPSpro were further leveraged to provide snapshots, track performance, and identify opportunities at an organizational level. This provided Alteon with an overview of scores in all performance categories for all groups at once, as well at the ability to examine performance at the provider level. Ultimately, this delivered Alteon with a comprehensive view of which measures were performing best.
Utilizing the gaps in care reporting within MIPSpro, Alteon was able to identify patient visits that were eligible for measure inclusion, but missing numerator data or quality actions. Changes in data capture were instituted as needed. Areas for improvement within the clinicians’ workflow were identified and targeted.
That same year through a collaboration with Healthmonix, Alteon was able to license specialty-specific QCDR measures through the Emergency and Acute Clinical Care Registry (EACCR). Developed by Healthmonix, the EACCR addresses the specific needs of emergency medicine physicians and hospitalists, enabling them to better focus on Quality and Improvement Activities directly related to the best care management for their patients. The EACCR consists of an optimized set of measures from all the emergency medicine, acute care and hospitalist registries in the U.S., licensed by Healthmonix to provide clinicians the ability to report the most relevant measures and maximize MIPS scores. These measures were chosen based on 1) ability to influence performance (e.g. measures with reduced documentation burden), 2) clinical applicability and clinical pathway alignment, 3) ease of implementation for Alteon).
Through Healthmonix’s partnership and dedicated team working side-by-side with Alteon, the following outcomes were achieved:
Leveraging the measure performance dashboards and gaps in care reporting in MIPspro, Alteon drove their average MIPS score from 29 points in performance year 2018 to 81 points for performance year 2020. We anticipate continuing our improvement pathway, resulting in even higher performance for 2021.
Thirty-two of Alteon’s 45 TINs, representing 84% of reporting clinicians, achieved exceptional performance in 2020. Five providers were not MIPS-eligible. No providers received a penalty and five were not MIPS-eligible.
By partnering with Healthmonix, Alteon continues to achieve excellence by executing on the following:
- Selecting and reporting on more than 22 measures, tailoring the measure selection by organizational unit
- Including EACCR measures which are focused on clinicians’ specialties (Emergency Medicine, Hospitalist, Anesthesia, and Post-Acute Care). Leveraging the EACCR measures provides new opportunities for increased performance that can further drive the MIPS score:
- New measures for 2021 reporting will receive a 5-point score minimum.
- New measures for 2022 reporting will receive a 7-point score minimum.
- Using MIPSpro’s Quality Performance pages to monitor and improve compliance with reporting and completion thresholds
- Identifying clinicians and groups that show opportunities for improvement and driving that improvement
- Providing dashboards that enable the entire organization to view performance and compare results across operating units
"Alteon has been extremely pleased with the Healthmonix partnership. The ease of collaboration and strategic alignment with the Healthmonix team made it possible for Alteon to innovate and execute on a plan that transformed our MIPS performance. Healthmonix has been both extremely responsive to our needs and innovative on strategies that further enhanced our MIPS program. The partnership allowed us to jointly apply for and gain CMS approval to create a qualified clinical data registry that not only permits Alteon to further enhance MIPS performance, but also allows other health care organizations to join and do the same. We are committed to continuing our partnership with Healthmonix and see significant value in their services.
Wolfram Schynoll MD, FACEP
Chief Performance Officer
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