I sat down with Crossing Healthcare CEO, Tanya Andricks, and CMO, Dana Ray MD, to discuss how they improved their UDS measures while growing their patient population by 65% and reducing cost by 15%. In 2015, Crossing implemented a physician incentive program to improve measure performance and improve the quality of data in their EHR. They have seen double-digit improvements on preventative care measures and wanted to share advice from their learnings.
1. Keep your goals focused
Crossing's leadership had two primary goals for implementing an incentive program:
- Develop a system to monitor and achieve goals for performance measures
- Foster a culture of continuous improvement
The leadership team chose to benchmark their goals against Healthy People 2020 and the lllinois Primary Health Care Association's goals. Ms. Andricks and Dr. Ray chose to focus on 5 measures where they wanted to focus improvement. To demonstrate leadership's commitment to the initiative, the program is personally overseen by Dr. Ray who incorporates quality improvement into her monthly provider meetings.
2. Decide on program logistics
Early on, Ms. Andricks and Dr. Ray knew that they wanted a program with frequent payments to keep providers engaged. The first challenge was finding an easy way to accurately measure the current performanc of their providers. Their EHR's reporting functionality was limited and unreliable so they started exploring other options. They decided to proceed with a reporting tool called MediQuire. With MediQuire, clinical adminstrative staff could collaborate with the finance team to pay incentives on a quarterly basis.
3. Communicate early and often
Ms. Andricks and Dr. Ray started explicitly communicating the goals and expectations of the program to their staff 6 months prior to launching. During this time, the clinical staff was trained on how to use MediQuire. Providers were individually responsible for auditing their data to increase buy-in and accountabiity. Having a platform where providers and administrative staff can see provider performance in real-time allows clinical staff to efficiently prioritize improvement efforts.
4. Remember providers are people tooThe leadership at Crossing recognized that the incentive payouts were not huge, but they framed it to their providers as extra money for doing extra work. Crossing implemented a leaderboard that encourage friendly competition between care teams taking advantage of the competitive nature of providers. Some providers even began sharing their incentive payments with their teams. Providers often choose their career as a way to help people, so it is important not to treat the incentive program like a sales commission.
Ms. Andricks and Dr. Ray emphasize that consistency and patience are essential for a successful incentive program. Due to the success of the program, Crossing plans to expand the program to include support and ancillary staff in the future as well. If you have any questions, post in the comments!