Contexture helps healthcare organizations navigate new regulations and succeed in
value-based payment models.
We can help your organization:
- Earn incentives and avoid payment adjustments with quality reporting
- Relieve stress and resource constraints by getting hands-on support from experts
- Reduce the administrative burden of participating in value-based incentive programs
- Improve office productivity by optimizing EHR use
- Improve reimbursements and the integrity of data
CMS Qualified Registry
Contexture is approved by the Centers for Medicare and Medicaid Services (CMS) as a Qualified Registry (QR). This designation allows the health information exchange to collect and submit clinical quality data for eligible healthcare practices. As a qualified registry, our Quality Improvement team can aggregate, calculate, validate and submit measures on your organization’s behalf.
Our Services & Programs
Since 2010, the Quality Improvement Team has provided practice transformation, coaching, and clinical advising to primary care offices to help implement changes and become examples of excellence in advanced patient-centered care and transform clinical practices to meet the quadruple aim: better care outcomes, improved patient experience, lower costs, and improved clinician satisfaction. Practice transformation includes implementation of continuous quality improvement, engaged leadership, empanelment, team based care, care coordination, enhanced access, and more.
Current initiatives include:
- Behavioral Health Integration Practice Transformation
- Differential Adjusted Payment Program (DAP)
- Incentives and Support for Medication Assisted Treatment for Opioid Disorder (ISM)
- Innovation Support Project (ISP)
- CDPHE Diabetes & Cardiovascular Disease Project (D/CVD)
Our Quality Improvement team can assist you with reviewing, selecting and reporting your clinical quality measures to avoid negative payment adjustments.
We provide assistance with:
- Training staff on how to document quality measures accurately to ensure best quality scores possible
- Reviewing, selecting and reporting clinical quality measures to earn incentives and avoid negative payment adjustments
- Assessing your patient volume and determining the amount of incentives you can earn and/or penalties you may incur
- Reviewing your EHR reports and measures to optimize for quality reporting
- Optimizing health information exchange for improved provider communications and referrals, clinical decision-making and participation in reimbursement programs
Colorado’s Health Care Practice Transformation Act
Colorado’s Health Care Practice Transformation Act (HB 22-1302) allocates roughly $30 million to create a primary care and behavioral health statewide integration grant program in the Department of Health Care Policy & Financing.
Contexture’s Quality Improvement team can assist your organization in providing practice facilitation for behavioral health integration and transformation.
Differential Adjusted Payment Program
The Arizona Health Care Cost Containment (AHCCCS) Differential Adjusted Payment (DAP) program aims to distinguish providers that have committed to supporting designated actions that improve patients’ care experiences, improve members’ health and reduce cost of care growth. An integral part of the DAP program includes participation in and meeting milestones related to a qualifying HIE organization such as Contexture.
Technical Assistance for Data Quality
HIE participants access and input a wealth of data, but the quality and usefulness of the data is only as good as what you and other participants provide. Contexture’s Quality Improvement team offers technical assistance to help participants put their HIE and EHR to optimal use. Technical assistance services include training and feedback to help users properly report and analyze Hierarchical Condition Category risk coding and Electronic Clinical Quality Measures coding, assistance in improving data entry so other HIE participants can access reliable information and helping you use data for patient follow-up and direct outreach.
Hierarchical Condition Category Risk Coding
Current payment models are underscoring the importance of risk adjustment and offering compensation for practices able to make up for the extra costs associated with high-risk enrollees. Hierarchical Condition Category coding is a risk-adjusted model originally designed to estimate future healthcare costs for patients. Risk adjustment could positively impact your overall cost measure score. Contexture can help you code correctly to increase reimbursements and ensure adequate documentation to support coding.
Process Improvement Coaching Services
Contexture offers Process Improvement Coaching Services to optimize the benefits of value-based models, such as CMS’s Primary Care First (PCF) program, which offers an innovative payment structure to support the delivery of advanced primary care by rewarding value and quality. A PCF practice must meet certain standards to be eligible for a positive performance-based adjustment to their primary care model payments.
Quality Payment Program Reporting Support
The Quality Payment Program (QPP) is one of several programs that intends to change the way Medicare reimburses healthcare providers by moving toward value over volume. Our QPP Reporting Support service is aimed at quality improvement support and guidance on reporting specifications. As a CMS-defined Qualified Registry for the QPP program, we can also aggregate, calculate, validate and submit measures on the client’s behalf.
Electronic Clinical Quality Measures Reporting
eCQMs help measure and track the quality of healthcare services that eligible professionals and hospitals provide — as generated by a provider’s electronic health record. Contexture can help practices meet the ever-changing criteria in eCQM reporting to improve reimbursements and patient care.