Letter from the BWPO Chairman
Dear Colleagues:
Our pay-for-performance targets now are outcomes-based measures, which means using the technologies and processes we now have in place to document and quantify the quality of Brigham care. We face new challenges in maximizing the return on our withhold dollars this year, and we expect these P4P measures to become more challenging in years to come.
We have had some latitude and flexibility in recent years to develop our own systems so our physicians would not have the burden of securing prior authorization for radiology exams. In Percipio and our peer-to-peer support program, we have the tools in place to ensure that we perform the right exams for the right patients without the need for the ordering physicians to obtain prior authorization. However, it’s imperative that ordering physicians use Percipio to take advantage to the built-in decision support and use peer-to-peer communications as a back-up for anomalous neurology and cardiovascular orders.
In Pharmacy utilization trends, we must continue to use LMR and ePrescribing especially in outpatient settings. Prescribing generics must be our first choice, as we continue to push, “write it right the first time.” With tiered co-pays, more and more patients are asking for generics to begin with. E-Prescribing has built-in defaults to lowest-cost options and an automatic check for adverse drug interactions and allergic restrictions, making it not only cost-efficient but also safe for our patients.
We have a number of programs in place to support PO members in meeting medical management P4P targets, with many resources in place to help manage the care of diabetes patients. We have outreach coordinators to manage out-of-compliance lists for all managed care patients. Staff are reviewing all charts of patients who are not at target and sending follow-up e-mails to PCPs suggesting further follow-up and offering to arrange referrals and additional services and schedule eye exams.
With the support of Partners and BWH leadership, we are committed to improving the quality of our care and measuring that quality. As part of Partners Community HealthCare, Inc., we have pushed for these quality and efficiency targets to be included in our contracts because achieving these targets means we are delivering quality care to our patients.
Sincerely,
Steven Seltzer, MD
Chairman, BWPO