Quality Programs & Initiatives 

 

Bridges to Excellence (BTE)

Bridges to Excellence (BTE) is a not-for-profit organization developed by employers, clinicians, health care services, researchers, and other industry experts with a mission to create significant leaps in the quality of care by recognizing and rewarding health care providers who demonstrate that they have implemented comprehensive solutions in the management of patients and deliver safe, timely, effective, and patient-centered care. Bridges to Excellence will work with payers and employers to provide a incentive to physicians who are Bridges to Excellence Recognized.  

The national Choosing Wisely campaign was launched in April 2012 as an initiative of the American Board of Internal Medicine (ABIM). In the current consumer driven climate, physicians often report feeling compelled to accommodate patients’ requests for interventions they know are unnecessary. Therefore, the goal of Choosing Wisely is to start a conversation among physicians and patients about whether, when and why these test are appropriate, and to help patients choose treatment that are evidence based, not harmful, not duplicative, and truly necessary.  

 

MACRA and the Medicare Quality Payment Program (QPP)
On Nov. 4, 2016 CMS implemented several critical provisions of The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) by creating a new Medicare quality reporting program, entitled the Quality Payment Program (QPP). The QPP is the umbrella program for two separate participation pathways, The Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). 

 

  • Merit-Based Incentive Payment System (MIPS) – In the law that repealed the Medicare Sustainable Growth Rate (SGR) physician payment methodology, a new payment framework was established consisting of stable fee schedule updates, a new Merit-Based Incentive Payment System (MIPS), and incentives for participation in qualifying alternative payment models (APMs). (Updated January 2018)   
  • 2018 MIPS Guide – 2018 MIPS step-by-step guides are under development and will be published soon. These guides provide information on how each category is scored along with detailed steps on how to report each MIPS category for the 2018 performance year. 
  • Alternative Payment Models (APMs) – MACRA, practices can propose alternative payment models (APMs) to the Centers for Medicare & Medicaid Services (CMS) that accept two-sided financial risk and use electronic health records and quality measures. “Qualifying APM participants” will not be subject to MIPS adjustments and will receive a lump sum incentive payment equal to five percent of the prior year’s estimated aggregate expenditures under the fee schedule. The five percent incentive payment is available from 2019 to 2024, but beginning in 2026, the fee schedule growth rate will be higher for qualifying APM participants than for other practitioners. Accountable Care Organizations (ACOs), Patient Centered Medical Homes, and bundled payment models are some examples of APMs. Eligible APMs will be defined by CMS. Proposed rules should be released in Spring 2016. 

Medical Cultural Awareness and Health Literacy
The ability to effectively and clearly communicate with patients can dramatically improve clinical outcomes. Clear communication encompass a knowledge of the spoken language as well as medical cultural awareness. For physicians practicing in Houston and Harris County, more than 90 languages are spoken throughout the Houston area. A recent report from the Rice University Kinder Institute for Urban Research indicates Houston has become the most racially and ethnically diverse metropolitan area in the nation, surpassing New York metropolitan area.

 

Patient Experience
Providing great patient experience can help a physician grow his/her practice by cultivating patient loyalty and retention. Patient experience encompasses a wide range of issues including cultural competency, health disparities, health literacy, patient satisfaction. In addition, in today’s consumer-driven health care environment, payment may soon be dependent on measuring patient satisfaction.  

 

Physician's Hospital Survey
HCMS is committed to serving the needs of our physician members as they care for their patients and improve the health of our community. Since much of that care is delivered in area hospitals, HCMS conducts an annual survey to determine physicians' perspective and satisfaction with local hospitals' delivery of quality patient care. In 2017, almost 4,000 physician surveys were received that provided statistically valid results for 26 hospitals. The results generated dialogue between physicians and hospital administration and are meant to improve the overall quality of care across all Houston hospitals. 

2018 Survey: The 2018 survey will be launched on Sunday, September 9 via email and fax and will close on October 15. The survey will include 36 hospitals. Please complete the survey as soon as you receive it to avoid receiving reminders. To promote the survey at your hospital, click here for the survey flyer.

2017 Results: The 2017 survey was launched on September 18 and closed November 20. The survey included 36 hospitalsClick here for the details.

2016 Results: Click here to read more about the purpose of the survey, from 2016 HCMS President, Dr. Kimberly Monday. To request a copy of the survey for a hospital(s) of your choice, email kerry_hardwick@hcms.org.