Are you a Medicare ACO with an annual GPRO Quality Audit coming up?
Do you understand how PQRS Quality Reporting to CMS truly works?
ACOs and Healthcare organizations are turning to Hexplora to provide insight and user-friendly technical solutions that automate the process. Our full service IT analytics capabilities enable us to offer cost-effective solutions that help achieve your goals in an efficient and expeditious manner, may they be GPRO Quality Reporting, or your greater objective of achieving Shared Savings.
Hexplora can help:
Our Hexplora PQRS Reporting Tool allows you to efficiently automate the GPRO process and quickly upload your vast data to CMS directly. Your Providers can personally login and input quality compliance details into the system. Alternatively, Providers can extract quality data from their EHRs for direct importing into Hexplora and can any choose either or both options.
During and after the PQRS submission process, we provide comprehensive reports and analytics at the Organization and Provider Level with option to drilldown to the individual members and quality measures. ACOs can monitor the progress of the data collection process and take action to ensure there is no delay in submission. Our solution makes the process hassle free
We understand the process:
We understand the importance of GPRO Data Submission Process to CMS and potential Shared Savings associated with it whether it is Pay for Reporting or Pay for Performance. We also understand the need of providing a state of the art tool which can facilitate data collection and submission process for providers.
The CMS Quality Collection Process:
In the absence of a database and a user interface, the process can get extremely tedious because:
  • GPRO sends an approximate total of 17 files, 1 for rank data and 16 for measure data. Each measure file contains a list of patients for all providers
  • Each of these files has to be split as per the number of providers. They are then distributed to the corresponding providers.
  • Data will have to be reconciled from those distributed files into one master file. This makes the process very cumbersome.
  • CMS has defined stringent business rules for the structure of data that it receives at the end of data collection. And since users don’t have a common platform to enter data; the format of data entered is highly inconsistent.
  • Manual intervention for making the data comply with the rules does not guarantee accuracy and makes the task of submitting data inefficient and time consuming.
Why Chose Hexplora?
Our Hexplora PQRS Tool simplifies GPRO Data Collection and Submission by eliminating majority of the manual tasks:
  • PQRS Sample Data files are instantly loaded in the Database once they are received.
  • Users can start using the tool right after data is loaded.
  • It offers secured and private access to every provider associated with the ACO. This enables each of them to look at only those patients assigned to them.
  • It has standardized the format for entering data whether it be dates or results of lab tests.
  • Data entry is guided by business rules which ensures 100% accuracy and eliminates the need to structure the data for XML creation and submission.
  • Performance of ACO can be analyzed by generating Provider Quality Reports from the data.
  • Actionable insights can be gained from the data collected to improve the performance of the providers.
The Hexplora PQRS GPRO solution tool will also:
Continuously Track Quality Metrics across Your Entire ACO Population: GPRO is available only during submission period (Jan 15th to March 15th) and only allows for the data collection for the 611 assigned beneficiaries that are sampled for each measure. The Hexplora platform allows for data collection throughout the year and provides your Participating ACO Providers with regular reports, continuously tracking the quality performance of ALL assigned beneficiaries.
Help ACOs Improve Quality Performance Scores: By allowing for the real-time analysis of quality data throughout the year, the Hexplora platform can easily identify those patients with gaps in care and ensure that improvement initiatives to address these gaps are followed DURING the performance year. Waiting to collect data through the GPRO system eliminates the ACO's ability to improve its quality scores during the performance year, while it still counts.
Empower ACO Participating Providers: The GPRO system is a data collection tool with limited access to administrators who have been assigned by the ACO to manage the ACO's GPRO account during the reporting period. The only analysis provided by the GPRO system consists of an overall assessment indicating whether or not the ACO has successfully reported sufficient data for each measure and some basic overall stats pertaining to the population sampled for reporting. Hexplora allows Participating ACO Providers to have real-time access to their practice-specific data and in-depth claims and quality data analysis. With easy access providers can instantly have an overview of their practice performance and how they compare to the overall ACO performance, alternatively, they can opt to drill-down to patient-specific data, to review trends in the patient's care.
Eliminate the GPRO Headaches: With Hexplora you will complete the annual GPRO Audit in a few days, instead of weeks and with significantly less human effort during 8-week GPRO Audit. Hexplora eliminates the need to navigate the cumbersome GRPO system by seamlessly mass uploading the necessary data for your sampled population.
Why our client, a NY based ACO chose Hexplora over the GPRO tool: “We needed each provider to give us their data. GPRO limits its access to 15 users per ACO so we needed to first capture the data in excel and then upload each spreadsheet onto the GPRO system. We also didn’t want the practices directly entering their data onto GPRO because we wanted to make sure to validate the data before it was officially submitted. It was also cumbersome to train multiple users on how to enter the data onto GPRO.” – COO of this ACO.
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