Pay for Performance (P4P) Initiatives

"Meaningful Use" reporting is NOT accomplished through anything currently in SOAPware such as the Health Maintenance or Data Explorer sections.

Performance Reporting is via either:

1. G-codes attached to billing claims
2. Registry Participation
   

Various payer initiatives, require that a practice be able to report measures that patients have received. This "report card" functionality is not the intent or function of the Health Maintenance section in SOAPware. HM is a tool for the practice to incorporate to manage the necessary workflows that ensure the data to report is collected. The Data Explorer workspace can assist with this, but...

• does NOT include the tools (often very complex, unique to each reporting entity, and expensive to develop) for the actual reporting of the data.
• will never be able to pull out that type of information very well due to the variations in how that information tends to be entered into the record (i.e. too much variation).

A practice intending to do performance reporting really needs to plan in advance and enter the information in a consistent format before reporting time comes around. See Message to Clinicians Regarding Reporting

The earliest and most common approach to this "performance" reporting has been via adding special codes to billing statements (i.e. G-codes or CPT Level II codes in the CPT sections). This has proven problematic in that there are several steps, and each step is an opportunity for information to be lost. The end result is often that practices are usually associated with less than an accurate level of performance. A registry system to bypass the claims method often solves this problem.

Registries come in many flavors, but there are 2 main types. The first type is where the practice periodically, manually reports the information to the registry. This is typically a lot of extra, duplicative work for the practice, but is often the only option for most without advanced electronic record systems linked to reporting registries. SOAPware->registry integration is underway in early 2010, Soon, we anticipate announcing our first, preferred registry partner.

The second registry type is one that is more automatic. In the automatic registries, the software regularly searches through the clinic's charts and creates reports from the normal documentation. This is more efficient. However, IF the practice has not implemented styles of documentation that contain the elements that can be identified and reported, the results still promise to be poor.

In mid 2009, a large collection of thousands of new SMARText items and lists are available to meet this need. These can be viewed in the SMARText Items Manager by searching with P4P as the search term (i.e. Press F10; Type P4P in the Find field; and Click the Search button). 

However, it is not too early to start the process of entering documentation that will be recognized when the registry combs through your charts later. For the first phase of this, once the appropriate Structured Dx items are entered into Assessments and Structured Rx are in Medications, focus on primarily entering appropriate SMARText items into the Plan fields.

The unstructured information converted from v4 is far less useful for reporting purposes. The sooner the transition to SMARText in 2010, the greater (and the sooner) the effectiveness of reporting occurs. The significance of this difference is likely to be financially significant in 2010. This means that starting in 2009 will be wise.

Workflows are being designed-suggested to facilitate the collection of data items for "quality" reporting initiatives. See - Quality Reporting Scenario - Example