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The Quadruple Aim
Quadruple Aim

A Conceptual Framework

Improving the U.S. health care system requires four aims: improving the experience of care, improving the health of populations, reducing per capita costs and improving care team well-being. HITEQ Center resources seek to provide content and direction aligned with the goals of the Quadruple Aim

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Accessing Data for QI

As adoption of EHRs has increased, so have the concerns about ability to access the data needed to drill down into quality improvement efforts or even reporting requirements. Depending on the type of system being used, data may be cloud based, on a remote server, or on a local server. Further, data may be accessible through preprogrammed, ad hoc, or custom reports, but there may be greater challenges to accessing raw data or data that can be analyzed for quality improvement purposes. Resources in this section address these challenges and provide actionable information for accessing the data needed.

Accessing your Data
Payer Mix Analysis Tool
Payer Mix Analysis Tool

Payer Mix Analysis Tool

This Excel tool helps health centers conduct a strategic review of their health plan contracts - across all product lines including Medicaid, Medicare, and Private/Commercial - to ensure their organization's financial sustainability and capacity to expand services to meet community needs.

Value Based Care Basics Module 3
Value Based Care Basics Module 3

Value Based Care Basics Module 3

The Value Based Care Basics training is a three-module series. All three modules can be completed by health center leaders to gain a working knowledge of value based care and how to successfully implement it at your health center. This third module includes a video and companion resource related to utilizing payer data.

 

Value Based Care Basics Module 2
Value Based Care Basics Module 2

Value Based Care Basics Module 2

The Value Based Care Basics training is a three-module series. All three modules can be completed by health center leaders to gain a working knowledge of value based care and how to successfully implement it at your health center. This second module includes a video and companion resource related to Managed Care data. 

 

Value Based Care Basics Module 1
Value Based Care Basics Module 1

Value Based Care Basics Module 1

The Value Based Care Basics training is a three-module series. All three modules can be completed by health center leaders to gain a working knowledge of value based care and how to successfully implement it at your health center. This first module, including the video and companion checklist, uses the Health Care Payment Learning & Action Network (HCP-LAN) Alternative Payment Model (APM) Framework as its basis.

 

[Video] The Managed Care Data Set
[Video] The Managed Care Data Set

[Video] The Managed Care Data Set

This video module helps health centers to understand how payers use data to evaluate their performance, to learn how to incorporate data into practice to improve value-based payment opportunities, and to prepare with best practices around organizing managed care data.
Clinical Quality Measures for Eligible Professionals: 2023 Update
Clinical Quality Measures for Eligible Professionals: 2023 Update

Clinical Quality Measures for Eligible Professionals: 2023 Update

This spreadsheet developed by the HITEQ Center provides a crosswalk of Clinical Quality Measures and their electronic specifications as defined in the 2023 update for Eligible Professionals (Clinicians). Fields include the crosswalk of measures with related information about CMS, NQF, and MIPS ID, and Telehealth Eligiblity, as well as inclusion in HRSA BPHC Uniform Data System (UDS) CY2023, Million Hearts, CMS Quality Payment Program (QPP) -  APM Performance Pathway (APP) Measures, Medicare Shared Savings Program (MSSP)/ CMS ACO Shared Savings Program, CMS Core Set (Child Core Set Medicaid / CHIP): HEDIS Specified, CMS Core Set (Adult  Core Set Medicaid): HEDIS Specified, Core Quality Measures Collaborative (ACO / Primary Care). Links are included throughout.

Managed Care Glossary for Health Centers
Managed Care Glossary for Health Centers

Managed Care Glossary for Health Centers

Glossary of managed care and value based payment terms that may be useful to health centers and health center stakeholders beginning to explore this topic.

Managed Care Data Checklist for FQHCs
Managed Care Data Checklist for FQHCs

Managed Care Data Checklist for FQHCs

This checklist will walk you, the health center, through a series of common considerations for contracts you may receive from payers with a specific focus on contracts that include value-based payment components. This document assists organizations in understanding the necessary data and data-related tools for managing population health within a managed care environment. It is a primer on the types of best-practices that are necessary to maximize care delivery models that are responsive to value-based payment programs. Follow this checklist to further your understanding of these considerations and to help flag any outstanding issues for legal and/or consultant review prior to execution.

Value Based Payment Contract Review Checklist for FQHCs
Value Based Payment Contract Review Checklist for FQHCs

Value Based Payment Contract Review Checklist for FQHCs

This checklist will walk you through a series of common considerations for contracts you may receive from payers, with a specific focus on contracts that include value-based payment components. Work through this checklist to be sure you understand these considerations and to help you flag any outstanding issues for legal and/or consultant review prior to execution of the contract.
[Video] FQHC Value Based Payment Basics
[Video] FQHC Value Based Payment Basics

[Video] FQHC Value Based Payment Basics

In this 25 minute video we cover the basic mechanics of how FQHCs are paid, the prospective payment system, and how it is evolving over time. We also review the spectrum of value-based payment arrangements using the HCP-LAN framework as a guide. We also discuss the capacity needed to be successful in each of those payment categories. Patient attribution process, including why that data is so critical in value-based payment arrangements, and what questions to ask payer partners about attribution processes are also reviewed. Lastly, a real value-based payment arrangement and related considerations are reviewed.

Strategies for Supporting Health Center Patients Experiencing Food Insecurity
Strategies for Supporting Health Center Patients Experiencing Food Insecurity

Strategies for Supporting Health Center Patients Experiencing Food Insecurity

Food insecurity has doubled since the onset of the COVID-19 pandemic in March 2020, and has tripled among families with children. Not having enough access to food is a key contributor to negative health outcomes for adults and children alike, and it is important now more than ever for health centers to identify and support patients who are experiencing food insecurity.
This resource is designed to support health center efforts to identify and assist patients who are experiencing food insecurity. It outlines key considerations around integrating social determinants of health (SDoH)-related screening and intervention into the electronic health record (EHR) workflow, highlights standardized screening tools and data elements to monitor the prevalence of food insecurity among patients, and describes several strategies to meet food-related needs. 

Panel Management in the Age of Value-Based Care
Panel Management in the Age of Value-Based Care

Panel Management in the Age of Value-Based Care

Panel management is an essential function of a health center. When done well, it smooths the scheduling and operations of the health center; when done poorly it creates challenges with productivity, patient continuity, Quality Improvement reporting, and more. This resource offers guidance on improving panel management activities, including real-life examples from two health centers of the challenges and successes in managing panels.

Telehealth and Chronic Care Management
Telehealth and Chronic Care Management

Telehealth and Chronic Care Management

Learn how to get started. We’ll review what you need to consider when developing your telehealth program, from selecting equipment to policy issues you need to consider. Hear from a FQHC success story on how they did it.

ICD-10 Z Codes for Social Determinants of Health
ICD-10 Z Codes for Social Determinants of Health

ICD-10 Z Codes for Social Determinants of Health

This resource will equip health center stakeholders with the understanding of how standardized social determinants of health (SDoH) data can be used and which ICD 10 Z codes can be used to document a patient's social needs, and are therefore pertinent to a standardized SDoH data set.

Coding Social Determinants of Health (SDH) for Optimizing Value
Coding Social Determinants of Health (SDH) for Optimizing Value

Coding Social Determinants of Health (SDH) for Optimizing Value

The purpose of the infographic is to describe how SDH data would be used for a variety of goals that would have traction with the clinic staff audience who may likely need to modify workflows and behavior in order to collect such data.  The visual case could be used in presentations or hung on a provider break room wall.

Acknowledgements

This resource collection was compiled by the HITEQ Center staff with guidance from HITEQ Advisory Committee members and collaborators of the HITEQ Center.