June 26, 2018
2 min read

‘Data wrangling’ essential for small nephrology clinics to survive, adapt

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WASHINGTON – Data analyzation, among other strategies, is key for small nephrology practices to survive and adapt in the value-based world, according to two panelists at the Renal Physicians Association’s Nephrology Coverage Advocacy Program in Washington. The panelists spoke about the different ways small practices are evaluated for the Quality Payment Program.

Jeffrey Perlmutter

Jeffrey Perlmutter, MD, the president-elect of the Renal Physicians Association (RPA), and Gary Singer, MD, the founding partner of Midwest Nephrology Associates, spoke before the attendees about Merit-based Incentive Payment Systems (MIPS) quality measures and advancing care information as they relate to small practices. According to the RPA’s website, under the Advancing Care Information (ACI) category, practices of 15 or fewer nephrologists are considered small.

Perlmutter identified some realistic strategies such as getting into an advanced payment model, watching the MIPS YouTube videos, and monitoring your data. Singer said that key points in his practice include investing in a practice manager, having a physician champion and buy-in from other nephrologists in the group.

“We tracked our data through our [electronic health record], there’s a quality score card, and we keep an eye on it as we go on so we can see where we were not doing quite what we needed to do both in advancing care information and on the quality of care side so we could modify things,” Perlmutter said.

Gary Singer

He also said he would spend about an hour a day working on the data. Singer said he works on the data a couple hours per day, although working in such a small clinic allowed for days where he did not work on it as long. The biggest challenges that were presented were the lack of safety nets, time management and constantly changing regulation and targets.

Both speakers noted that RPA meetings, and the association itself, is a huge resource that small nephrology clinics can use.

“You really need to use resources. This is sort of a new and evolving field. A major resource – again giving a plug to the RPA – go to the meetings, watch the webinars, my office manager has been involved in user groups,” Singer said. He also said that meaningful use can be achieved through use of RPA, PQRS and MIPS wizards.

When being evaluated, there are many quality measures that are considered. The top six presented were pneumococcal vaccination status, attention to diabetic nephropathy, blood pressure management (which Perlmutter said should be under 140 over 90 for patients with CKD), medication documentation, tobacco use, and use of high risk medications. – by Jake Scott