In Ohio, Value-Based Care Takes Center Stage

When the Cincinnati-based Mercy Health—the largest  health  system  in  Ohio  and one of  the largest in the U.S.—partnered  with the Cleveland-based  Explorys in 2011 for its cloud-based  platform, the idea was to manage  populations,  engage  patients,  and  meet  patient-centered medical home (PCMH) and accountable care organization (ACO) goals. 

At the time, no one could deny the need for this type of IT platform, considering Mercy’s wide-reaching span of facilities, and all of the value-based contracting programs that the health system was in: the Medicare Shared Savings Program (MSSP) ACO in its southwest Ohio market; several commercial ACOs, Medicare Advantage programs, the employee health plan, and HealthSpan integrated care (HealthSpan serves most of Ohio’s major metro areas, with health plans for individuals and families, companies, and Medicare and Medicaid members).

Since then, Mercy has deployed the company’s cloud-based, big data analytics platform to all of its markets, including more than 50 care coordinators, to identify and close gaps in care for the populations it serves. According to the health system’s officials, the Explorys platform has helped support Mercy Health’s PCMH accreditation process and rapid-cycle improvement in PCMH practices, as well as enabling population management and performance measurement for its MSSP program, including supporting a successful submission of the MSSP performance results through the group practice reporting option (GPRO) reporting process in 2012 and 2013.

To that end, Mercy Health’s first and most time-sensitive challenge was to transition its primary care practices to a PCMH model. As a part of this initiative, it was vital that Mercy Health develop an efficient way to manage its clinical quality measures to meet certification requirements defined by the National Committee for Quality Assurance (NCQA) within a 15-month timeline. Within this aggressive timeframe, Mercy had to implement an electronic health record (EHR), develop ambulatory quality measures, and show significant improvements in outcomes. Full system integration was key to Mercy Health’s goals, says Rebecca Sykes, Mercy’s senior vice president, resource management, and CIO. Today, 27 of Mercy’s physician offices are Level 3 PCMH certified.