The challenge

Many hospitals and health systems have a siloed approach to CMS quality reportinggovernance due to the constant evolution of reporting requirements. In addition,internal factors like multiple electronic health records (EHRs) and staff turnover makeit challenging to coordinate quality reporting efforts across the Quality PaymentProgram (QPP), Promoting Interoperability (PI) program, and Alternative PaymentModels (APM). We profiled four organizations that have made significant progress inaddressing this challenge.

The organizations

• Intermountain Healthcare is a 24-hospital health system based in Idaho, Nevada, and Utah. They participate in an Medicare Shared Savings Program (MSSP) Track 1+ Accountable Care Organization (ACO) and have one EHR.
• Mass General Brigham is a 10-hospital health system in Massachusetts and New Hampshire. They participate in an MSSP Enhanced ACO and have one EHR.
• West Willow Hospital (a pseudonym) is a 5-hospital health system based in the Southeastern United States. They have 2 inpatient EHRs and 18 outpatient EHRs.
• Community Hospital Corporation (CHC) owns, manages, and consults with over 120 hospitals to guide, support, and enhance the mission of community hospitals and providers. Their hospitals operate on five EHRs.

The approach

All four organizations have evolved their governance structures over time to adaptto changing CMS requirements and take advantage of alignment between programrequirements.

The result

Breaking down silos between QPP and PI program management enables the healthsystems to coordinate efficiently between departments, make decisions quickly, andreduce redundant efforts.