McKesson Specialty Health’s Oncology-Specific EHR: A Model for Advancing Value-Based Care

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For the second consecutive year, McKesson Specialty Health has received approval from the Centers for Medicare & Medicaid Services (CMS) to participate in the Merit-Based Incentive Payment System (MIPS) program as a Qualified Clinical Data Registry (QCDR). Through their oncology-specific electronic health record (EHR), iKnowMedSM, McKesson can collect and report clinical data for both MIPS and non-MIPS quality measures that help drive improvements in quality and cost of care. McKesson’s QCDR will support the Quality, Advancing Care Information, and Improvement Activities categories of MIPS.

The QCDR designation allows iKnowMed users to relay data directly to CMS without having to utilize a separate registry vendor. Additionally, the EHR enables streamlining data submission and minimizes the need for additional administrative resources. McKesson’s reporting and analytics tool, Practice InsightsSM, will provide users with actionable insight from ongoing feedback and continuous data monitoring to help streamline and improve patient care.

Journal of Clinical Pathways spoke with Erin Crum, MPH, director of quality reporting, McKesson, about being granted approval again to participate in MIPS, what is new for 2018, and how the company is situated to support the three MIPS practice-reported categories. The ensuing discussion focused on data reporting solutions in today’s oncology climate.


What makes McKesson Specialty Health a quality candidate to participate in the MIPS 2018 program as a QCDR?

Beginning in 2007 with the launch of the Physician Quality Reporting System (PQRS), McKesson Specialty Health has prioritized technology development to ensure successful practice participation in quality programs. We support more than 3700 oncologists through a variety of services to best support community-based care. As both CMS and commercial health care quality programs continue to evolve, McKesson Specialty Health has maintained its commitment to help community-based practices remain independent. 

Through our Practice Insights QCDR, which provides continuous data monitoring and feedback, we are enabling practices to exceed the simple task of participating in quality programs and elevating their ability to actually perform, with the goal of improved patient care and reduced costs. Practice Insights not only supports successful participation in the MIPS program, but it also serves as a powerful reporting platform for practices pursuing other value-based care initiatives and alternative payment models (APMs), including the Oncology Care Model (OCM). McKesson Specialty Health supports more than 35 practices and over 1100 physicians who have been selected to participate in the OCM, representing approximately 35% of all physicians selected to participate in the OCM. McKesson Specialty Health understands the challenges that community-based oncology and multispecialty practices face with today’s evolving health care landscape, and we are committed to helping practices maintain their focus on the patient, in addition to meeting program requirements. 

How is McKesson equipped to support the 3 MIPS practice-reported categories (Quality, Advancing Care Information, and Improvement Activities)? What initiatives are in the works for meeting these categories?

In 2018, with McKesson Specialty Health’s Practice Insights QCDR, participating iKnowMed EHR users will have access to:

  • A comprehensive end-to-end solution for data capture through standard workflow, performance monitoring, and direct data submission to CMS.
  • Support for 16 MIPS quality measures; all measures calculated based on standard clinical documentation. No additional data entry required.
  • An additional 3 physician-driven custom quality measures specific to oncology developed in conjunction with clinicians in The US Oncology Network and other iKnowMed users.
  • Ongoing feedback and continuous data monitoring via Practice Insights, McKesson Specialty Health’s reporting and analytics tool, designed to help streamline and improve patient care.
  • Direct submission capabilities for all 3 MIPS practice-reported categories; no additional software or fees required.

As we continue to expand our QCDR capabilities, we will maintain a keen focus on the development of outcome-based quality measures that have clinical relevance for physicians and align across a number of value-based care initiatives.

This is the second consecutive year that McKesson has earned QCDR designation in the MIPS program. What data do you have available that supports iKnowMed’s ability to drive improvements in quality and cost of cancer care?

The Practice Insights reporting dashboards are critical to measuring success in the MIPS program. Practices have the ability to compare practice-level and provider-level results over time to track improvements or make comparisons against national benchmarks in real time. In addition, users can “drill down” to see the patient-level details to determine the root cause for lapse in appropriate or timely patient care. This level of reporting can help drive workflow changes and optimize patient care. 

As we just closed out the first year of the MIPS program, practices are reorienting their focus from participation to performance. The year of 2018 will be critical for practices to monitor their performance given that it will be the first year that MIPS quality measure data is required for the full calendar year. 

We also collaborate with practices in The US Oncology Network to review their results and identify areas of opportunity to continue to improve patient-centric care and minimize unnecessary costs. For example, one of our custom QCDR measures developed in partnership with the Steering Committee looks at reducing the utilization of white blood cell growth factors in metastatic colorectal cancer patients.   

Are there any new components of iKnowMed that will make data reporting of quality measures different in 2018 in comparison to last year?

For the 2018 program, Practice Insights has expanded to include data submission and attestation for all 3 practice-reported MIPS categories. In 2017, MIPS data submission was limited to Quality and Improvement Activities. 

Why are streamlined solutions to data reporting of quality measures such valuable resources in today’s oncology care climate?

The tenets of the CMS Quality Payment Program push clinicians into the next era of medicine, where more is not necessarily better. It is a paradigm shift of value over volume. 

I am cautiously optimistic about the current framework that has been proposed; however, in order for both MIPS and APMs to succeed, we must leverage technology to provide necessary insights that support clinicians to optimize patient care. Quality of care must be assessed based on key indicators that matter to the physician and the medicine that he or she practices. How physicians are fairly (or unfairly) assessed will be the crux of the success of MIPS and will influence physicians’ motivation to gravitate towards participating in APMs. 

McKesson Specialty Health is uniquely positioned to best support this movement of value over volume by harnessing the clinical and reimbursement data across a number of technologies to provide trends in quality care, patient outcomes, and cost without additional burden to the practice or provider. With a few simple clicks, practices can make their MIPS program reporting selections within the Practice Insights QCDR, and their data is automatically submitted to CMS on their behalf- no additional software, 3rd party vendors, data entry, or fees.