MACRA’s Quality Payment Program (QPP) is intended to provide new tools and resources to give patients the best possible, highest-value of care. The initial intent is to transform the Medicare payment structure while moving towards a larger scope to eventually include the entire healthcare continuum and broader payer system.

In this engagement, RoundTable’s Executive Consultant will conduct a MACRA / MIPS Quality Reporting and Gap assessment focusing on four key measures including Quality, Resource Use, Clinical Practice Improvement Activities and Meaningful Use of Certified EHR.

“We will summarize the Value-Based Payment Risks and assist the organization with making changes to provider workflow and ensure it’s Practice Management and EMR application are being utilized efficiently to capture the key discrete data elements for reporting,” said Kyle Swarts, Senior Vice President.

“Working in lock-step with the Senior Vice President of Revenue Cycle Management, the RoundTable consultant will serve as the Interim System Director, Coding and Charge Capture for a multi-state IDN to develop a go forward strategy to standardize and centralize the Coding and Charge Capture function while developing a high performing team and structure“, said Art Lopez, Regional Vice President.

The Interim System Director will have the following responsibilities.

1. Responsible for providing leadership and oversight of operational and financial decisions and performance pertaining to Coding and Charge Capture for Physician and Ambulatory Services Organization.
2. Manage operational coding and charge capture leaders across three regional business offices serving six divisions.  Functional areas include:  abstract coding, charge review work queue (CRWQ) edits, manual charge entry, charge reconciliation, coding denial follow-up, physician feedback and education, HCC coding, Epic template review and development (in conjunction with EpicCare team), and collaboration and coordination with Corporate Responsibility (aka compliance) program.
3. Provide strategic vision to Coding and Charge Capture operations across the Physician and Ambulatory Service Organization and challenge assumptions and standards of business in an effort to improve overall operational effectiveness and service to customers.

“Healthcare organizations from across the country are engaging RoundTable to provide interim management, strategic consulting services and IT implementation support due to our ability to present high-quality candidates that can execute on deliverables and drive ROI” said Kyle Swarts, Senior Vice President.