Top 6 Questions to Drive Clinician Engagement

June 4th, 2019 by

Getting physicians engaged in your organization-wide initiatives while developing a MIPS strategy can be overwhelming. I recently had the opportunity to attend a forum where Dr. William Faber, Director of Navigant Consulting, discussed how to get physicians more engaged in quality initiatives.  Dr. Faber treated patients for 27 years, transitioned to a Chief Medical Officer, and now is a thought leader in Physician Engagement.

Based on Dr. Faber’s recommendations, I’ve identified the top six questions that you may consider asking your organization to help get your clinicians more involved in the MIPS program (or other quality initiatives).  These questions will help you have high-value conversations within your organization.

Physician Engagement in MIPS

Step one to getting your clinicians engaged is to make them feel very invested in the program.  I always recommend having a Physician Champion on your Steering Committee to provide insightful advice from a clinical perspective.  Burnout is a huge concern and allowing a Physician to have a seat at the table can help them feel more engaged in the decisions being made.  Hear Dr. Faber discuss getting them involved in committees and decision making here on a recent Voices in Value-Based Care:

 

  1. What’s in it for the clinicians?
    • To get a clinician on board they need to understand the value for taking on additional work. What is in it for them?  How are you rewarding them for what you want them to do?  If you are planning on incorporating incentives into their compensation model, can you involve clinicians in the contract negotiations, so they have a say in what’s being developed?  Financial incentives are great, but you can get creative – it doesn’t have to be monetary. Clinicians are naturally competitive and displaying scorecards for bragging rights can go a long way.  I think Dr. Faber summarizes this very well on the podcast (listen at 11:45-15:06).  “No good doctor wants to be number 20 on a list of 20.  If you give them a level playing field and feedback about their performance, it’s been my experience for many, many years that they will try to improve.  It’s a matter of pride for them.”
  2. Are there certain clinicians you feel may never get on board?
    • Try starting a conversation with them about why they feel this way and see if there are ways you can mitigate some of those concerns. Your first instinct may be to avoid those clinicians, but I would encourage the opposite.  Seek them out and try to see from their perspective.  You may be surprised that you can find some mutually agreeable compromises.  At the very least, allowing those clinicians to vent ensures that their voices are heard by the Steering Committee and considered during decision making.
  3. Is the data valid?
    • Have regular meetings with your clinicians to ensure that the data is valid and accurate. Without valid data, a clinician will not be interested in reading inaccurate reports. As soon as the data is proven inaccurate, it may take time to recover from the lack of trust in the data.

Physician Engagement in Measure Selection

The first step to getting clinicians engaged in MIPS, is to make sure they understand the value of the program as a whole.  The next step is to have them invested in monitoring and improving performance throughout the year.  When your organization is trying to select relevant Quality measures to focus on, you might ask your team the following questions to help drive decision making around measure selection.

  1. Are there local (or regional) population health issues relevant to your area?
    • We recently heard a success story from one of our customers. In their area, over 30% of high school aged kids had thought about suicide. To combat this, they began displaying statistics regarding depression to their clinicians. This resonated with the clinicians, who agreed it was important to monitor the depression screening measure. What other issues are affecting your organization – Opioid addiction? Obesity?  Diabetes?  Find what local issues may be important for your organization to address, and the clinicians will see how they are making an impact by prioritizing these measures.
  2. Is the measure amenable to change?
    • Do your clinicians have the ability to move the needle on this measure? Is this measure relevant to your clinician’s specialties?  Outcome measures require you to improve the result for a patient, so these are harder to improve on than process measures.  Is there any low hanging fruit? Are there simple workflow changes, clinician education, more utilization of mid-levels, or any other low resource initiatives you can implement to improve this measure?  Having a conversation with your team about the measure specifics is a great starting point.
  3. What organizational initiatives may align with your CQMs?
    • Do you have any other programs that may align with CQMs you can select? Medicare is likely one of many payers that your organization gets reimbursement from.  What measures are a priority for other payers? Do you have any other VBC programs you are involved in that overlap with CQMs you can choose from?  If you have an opportunity to utilize a CQM across programs, you will dramatically reduce the overall number of objectives your team is trying to monitor and enforce, and any improvements will be recognized twofold.  Trying to find common ground across these programs/initiatives can help reduce data overload and focus your clinicians where you need them the most.

I hope these questions will support you in having those high-value conversations within your organization and really help you engage your clinicians in the MIPS program.  Government programs aren’t going away no matter how many times the name of the game may change.  At the end of the day, the goal is to improve patient care, and I think we can agree that is a priority for all of us.

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