Pay for Quality Tools and Templates
In 2008 MGO partnered with Ohiohealth (as an employer) to implement the first phase of our value based contracting model. Primary care and OB/GYN physicians who care for OhioHealth insured patients received actionable information about their patients. The actionable information enabled physicians to identify patients who may be due to receive specific preventive health services. The program was very successful, and over 500 MGO physicians earned bonus payments for the services they provided to OhioHealth associates and family members.
In 2009 the PHO (MGO and OhioHealth facilities) expanded the program to include Aetna members who are cared for by MGO physicians and OhioHealth hospitals. The addition of Aetna meant more than 80,000 people were included in the program. It also enabled expansion of the program to include allergists and endocrinologist.
The Specialty Physician Care Coordination program was also added in 2009. This program assists patients who are receiving care from specialists and do not have an established relationship with a primary care physician to find one.
CIGNA patients were added to the pay for quality program in 2010, bringing the total number of patients in the program up to 95,000 and significantly increasing the bonus potential for MGO physicians. Also, in 2010 new metrics for the management of GERD and depression were added and the program was again expanded to more specialties. In 2010 specialties receiving actionable reports include allergy, endocrinology, family practice, gastroenterology, internal medicine, OB/GYN, pediatrics, psychiatry and psychology.
Please take some time to read the material provided below to learn more about the pay for quality program.
In an effort to assist practices with understanding the Pay for Quality program and maximizing the opportunities for enhanced revenue and improved patient care, MGO has worked with practice managers that are successfully using the Actionable Reports to identify and contact patients who are due for specific services. These practice managers have provided examples of their tools and templates that they have found to be useful.
Patient Preventive Service Recall Letter - This is a template letter that can be sent to your patients as a recall method for prevention services. Click here for a downloadable letter that you can customize to meet your practice needs.
Patient Diabetic Labs Recall Letter - This is a template letter that can be sent to your patients as a recall method for diabetic labs. Click here for a downloadable letter that you can customize to meet your practice needs.
Preventive Service Checklist for the Patient Chart - This form may be used in a patient chart to track the prevention services met and/or needed. Click here for downloadable form that you can customize to meet your practice needs.
Diabetes and Heart/Stroke Tools & Resources -- MGO has compiled a range of tools to assist you and your staff in providing documented, high quality care to your patients with diabetes and or peripheral vascular disease. Click here for more information.
Webinars - A series of webinars discussing Clinical Integration and Actionable Reports. Click here to view webinars.
