Premier, Inc. has introduced a comprehensive system that predicts the financial impact of federal payment programs to health systems based on clinical outcomes.
Premier Quality Cycle Management provides automated software-as-a-service (SaaS) analytics powered by Premier’s performance improvement platform PremierConnect. These analytics enable health system leaders to identify, in real-time, which facilities, clinicians and clinical outcomes are impacting reimbursement opportunities, as well as benchmark performance with peers both at the health system and facility level. It also includes Premier advisory services to accelerate strategic improvements in clinical integration and care quality optimization. By combining these services, health systems can leverage actionable intelligence to generate meaningful performance improvements across the continuum of care.
“Under the multiple federal payment programs that measure healthcare provider performance, integrated health systems are challenged with fully understanding the financial impact and drivers of clinical outcomes across all of their acute care facilities, physician groups and post-acute care facilities,” said Liz Martin, VP of quality, at Riverside Health System, which recently began using Premier Quality Cycle Management. “Health system leadership need visibility to their outcomes across the continuum so they can target and prioritize the areas with the greatest opportunities.”
Premier Quality Cycle Management is unique in that it seamlessly integrates clinical outcomes data from multiple sources and performance periods to predict health system reimbursement by year, based on the policy measures for that year. Specifically, it measures reimbursement for the Centers for Medicare & Medicaid Services’ (CMS’) Hospital Value-Based Purchasing (VBP) program, and it is currently adding capabilities to measure for the CMS Hospital Readmissions and Hospital-Acquired Condition (HAC) Reduction Programs. All three reimbursement programs will be integrated so health system leaders can quickly and easily understand the financial impact of their HAC, readmissions and VBP outcomes, all in one place.
“In today’s environment, health systems cannot afford to leave to chance the link between quality performance and financial performance,” said Richard Bankowitz, MD, chief medical officer, Premier. “We believe Premier Quality Cycle Management is the industry’s first system that allows leadership to view outcomes across their organization, identify and predict the impact of those outcomes on reimbursements, and more efficiently mitigate and potentially reverse negative consequences.”
With a multi-stakeholder view of financial and clinical performance, Premier Quality Cycle Management empowers all areas of health system leadership to generate change through a focused approach to improving outcomes. An effective quality cycle management strategy integrates a clear cadence, metrics with targets, a firm culture of accountability and deep executive engagement.
Premier provides a variety of other SaaS solutions to support quality cycle management practices by helping health systems stay ahead of reform and engaged on the changes impacting clinical and financial health across the continuum, including:
- PremierConnect Quality analytics to drill deeper into outcomes data and identify opportunities to improve resource utilization and eliminate unjustified variation.
- PremierConnect Safety clinical surveillance analytics to monitor patients and protect them from infections, harmful drug interactions and other adverse events.