{"id":11521,"date":"2018-12-19T14:13:24","date_gmt":"2018-12-19T19:13:24","guid":{"rendered":"https:\/\/www.bumc.bu.edu\/medicine\/?p=11521"},"modified":"2019-01-03T10:30:12","modified_gmt":"2019-01-03T15:30:12","slug":"2018-baco-masshealth-pc-group-quality-bonus-program","status":"publish","type":"post","link":"https:\/\/www.bumc.bu.edu\/medicine\/2018\/12\/19\/2018-baco-masshealth-pc-group-quality-bonus-program\/","title":{"rendered":"2018 BACO MassHealth PC Group Quality Bonus Program"},"content":{"rendered":"

\"\"<\/p>\n

Starting in 2018, MA Executive Office for Health and Human Services will generate a Quality Score for each ACO participating in the new MassHealth ACO program.\u00a0 This Quality Score will determine our ACOs share of any surplus or deficit accrued.\u00a0 The amount of surplus or deficit will be based on the difference between our ACO\u2019s state-assigned spending budget and the actual total cost of care for the patients attributed to BACO.<\/p>\n

The state\u2019s Quality Score will be based on both claims-based data and our submission to MassHealth of chart-based information.\u00a0 In Performance Year 1 (2018), to receive a quality score of 100%, our ACO is only required to submit all requested data (referred to as \u201cpay for reporting\u201d).\u00a0 Beginning in 2019, our score will be based on our performance on the various metrics, making it essential that BACO begins to build infrastructure across the ACO to enable optimal metric performance.<\/p>\n

The amount of the Primary Care Group Quality Bonus, tied to $2 per member per month, awarded to each group will be determined by the group\u2019s performance in three distinct areas:<\/p>\n

    \n
  1. Complete submission of requested MassHealth beneficiary clinical data to BACO to enable successful BACO pay for reporting in 2018.<\/li>\n
  2. Performance by the group on a BACO-created Ambulatory Visit Quality Metric, which is success in maximizing the number of BACO patients seen in the ambulatory setting<\/b>. Only 60% of BACO patients were seen between 3\/1\/17 and 12\/31\/17.<\/li>\n
  3. Performance by the group in the BACO-created Diagnosis Identification Program Screening for homelessness <\/b>and depression <\/b>which can be performed by any office staff. Based upon historical performance, that screening rates of 80% are feasible for both homelessness and depression.\u00a0 The bonus, however, will be based upon each group\u2019s performance normalized to the BACK mean performance rate.\u00a0 Screening for homelessness should be done as part of a larger social determinants of health screen using a screening tool such as THRIVE.\u00a0 Screening for depression should be done with a screening tool such as PHQ2 or 9.\u00a0 Groups should make every effort to capture an appropriate diagnosis code with appropriate documentation in the medical record whenever a screen yields a diagnosis (e.g. homeless or major depressive disorder).\u00a0 Groups should also ensure that positive screens are addressed by clinical providers during the encounter to ensure appropriate care of patients.<\/li>\n<\/ol>\n

    If you would like more details about the BACO MassHealth Primary Care Group Quality Bonus or any of the metrics, please contact Dr. Brian Jacobson at brian.jacobson@bmc.org<\/b><\/a>.<\/p>\n

     <\/p>\n","protected":false},"excerpt":{"rendered":"

    Starting in 2018, MA Executive Office for Health and Human Services will generate a Quality Score for each ACO participating in the new MassHealth ACO program.\u00a0 This Quality Score will determine our ACOs share of any surplus or deficit accrued.\u00a0 The amount of surplus or deficit will be based on the difference between our ACO\u2019s […]<\/p>\n","protected":false},"author":14042,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[3146],"tags":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/medicine\/wp-json\/wp\/v2\/posts\/11521"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/medicine\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/medicine\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/medicine\/wp-json\/wp\/v2\/users\/14042"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/medicine\/wp-json\/wp\/v2\/comments?post=11521"}],"version-history":[{"count":2,"href":"https:\/\/www.bumc.bu.edu\/medicine\/wp-json\/wp\/v2\/posts\/11521\/revisions"}],"predecessor-version":[{"id":11578,"href":"https:\/\/www.bumc.bu.edu\/medicine\/wp-json\/wp\/v2\/posts\/11521\/revisions\/11578"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/medicine\/wp-json\/wp\/v2\/media?parent=11521"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/medicine\/wp-json\/wp\/v2\/categories?post=11521"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/medicine\/wp-json\/wp\/v2\/tags?post=11521"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}