Medicare and private payers are demanding health care delivery accountability from providers. WRA believes that Rheumatology needs to take the lead in developing an accountable model like Oncology (Oncology Medical Home) and Cardiology (Clinical Outcomes Assessment Program) that also justifies appropriate treatment. Without this, the landscape of rheumatologic care will continue to condense, will become more fragmented, and patients will face less accessible and more expensive care, which also will be borne by patients and payers.
While we have a lofty goal in mind, our objectives this year will continue our focus on action steps and objectives that will demonstrate quality improvement for our specialty by:
Building a network of State Societies and CSRO working together within rheumatology practices to establish a national Rheumatology Specialty Medical Home Demonstration Project under the Medicare program for the purpose of changing the Medicare payment for rheumatic disease care in order to enhance the quality of care and to improve cost efficiency, and other purposes.
Develop different payment models and contracts with Medicare (Noridian) and payers to make the Rheumatology Medical Home Demonstration Project a viable model for Rheumatology
Identify measures, and conduct initial data quality review
Identify and Engage Physician and State Healthcare Leaders and Stakeholders to lead our QI committee, comprised of a rheumatologist, private payers, practice administrators, PharmD, a patient, Industry, community group representation, (CRSO, NORM, ACR) Establish a forum of information exchange for practices to continually improve processes and outcomes
Partner with all EHR vendor to help connect EHR Data Quality Improvement Activities (practices can participate without connection as well)
Establish Process to Continuously Monitor EHR Data Quality and Resolve Data Quality Issue