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Clinical Quality

Drawing on clinical experience and data analytics expertise, BRG’s quality improvement team works with hospitals to identify potential opportunities.

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Overview

The Centers for Medicare and Medicaid Services has placed up to 6 percent of inpatient Medicare revenue at risk under its three major quality reporting programs: Value-Based Purchasing, Hospital Readmissions Reduction Program, and Hospital-Acquired Conditions. Organizations must review both their data quality and clinical quality related to these programs and analyze trends to provide the opportunity for change. Drawing on clinical experience and data analytics expertise, BRG’s quality improvement team works with hospitals to identify potential opportunities. Our experts advise hospitals, hospital associations, regulatory agencies, rate regulators, and other healthcare facilities on an approach that may include:

  • Expertise in national healthcare quality data-submission requirements and pay-for-performance initiatives
  • Expertise in identifying impact of documentation and coding on quality performance scores and financial rewards or penalties
  • Medical record review to identify opportunities for coding and documentation improvement for more accurate reflection of the patient experience
  • Education to all levels, from boards of trustees to medical staff to front-line staff, on the impact of quality performance scores
  • Strategic assistance for prioritization and implementation of quality improvement activities

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