Guest Blog: Improving Quality through Patient and Provider Outreach

Providers can become true managers of quality—and earn bonuses as part of value-based contracts—by making full use of data to close gaps in care as well as data transparency to benchmark their performance against their provider group and national peers. At Lumeris, our powerful technology solutions provide market differentiation for health systems and payers, especially in equipping their network of providers with the ability to stratify patients and populations for improved quality performance.

Deploying Tools and Information

Health systems and payers utilize Lumeris’ Quality Management Solution to enable performance on quality measures and perform successful outreach to improve outcomes. Lumeris supports more than 150 national standard quality-related measures in the Accountable Delivery System Platform (ADSP)®, including HEDIS, Star, ACO, PCMH, and Physician Quality Reporting System (PQRS) measures.

My team guides clients in deploying Lumeris’ technology and services to advance their quality management initiatives by providing:

  • Qualitative and quantitative analyses to develop an overarching strategy to address quality opportunities
  • Proven methodologies for effective value-based physician contract design
  • Proprietary and unique predictive modeling tools and simulators
  • Technology tools that provide actionable insight
  • Training programs to increase physician engagement and satisfaction
  • Expertise in benefit design to enhance access to care
  • Best practices for patient outreach campaigns to close gaps in care and improve contact and intervention rates

Motivating Patients

Alignment of patient incentives is essential to managing and improving quality. Successful programs incorporate these three components to improve the effectiveness and experience of care:

  • Remove financial barriers to care: Make it easier for patients to access care. Improve availability of care by removing financial, transportation and other barriers, such as offering zero dollar co-pays for lab visits that support achievement of key clinical metrics.
  • Educate patients: Make health content about the importance of primary care and prevention accessible to patients, such as through patient portals.
  • Motivate patients: Align benefits with cost-effective care; incentivize in-network, better coordinated care; and focus on wellness, prevention and chronic disease.

Equipping Providers for Successful Outreach

Founded by physicians, Lumeris helps health systems, payers and providers optimize performance on quality measures and deliver on the goals of the Triple Aim Plus One: better health outcomes, lower costs and improved patient plus physician satisfaction.

With the ADSP’s tools—including the Patient Worklist, Patient Care Profile, Measure Summary Table, and Content Library—combined with reports and dashboards (such as Members/Patients Not Seen), payers and providers can manage their populations, as well as address gaps in care with each individual patient. In addition, our consulting and delivery services within the solution offer health systems, payers and providers analysis of historic quality performance and help identify target measures for improvement.

Read the Lumeris Quality Management Point of View today.