CASE STUDY

Mabel helps ACO REACH capture
>90% of PY23 HEDR data within 2 weeks

THE CHALLENGE

Under Health Equity Data Reporting (HEDR), CMS is incentivizing ACO REACHs to collect beneficiary-reported demographic data (PY23) and SDOH data (PY24) on aligned beneficiaries. As part of this initiative, ACO REACHs can earn up to 0.2% of the ACO Benchmark—representing a significant financial opportunity in the hundreds of thousands to millions.

However, collecting, aggregating, and standardizing this data for CMS submission can be challenging for a number of reasons.

  1. EMR Fragmentation: Many ACOs consist of a network of providers on disparate EMRs. The majority of providers cannot extract this data out of their EMR, even if it’s been collected.

  2. Data Standardization: Even when this data can be extracted from an EMR, cross-walking or mapping these values into the CMS submission template and aggregating across several providers can be a manual and tedious process.

  3. PY24 SDoH Data: Unlike demographic data (PY23), most practices have not collected SDoH data (PY24). Additionally, CMS only accepts three SDoH screeners with no hybrid responses allowed.

Given the dollars at stake and the complexity involved, several ACO REACHs have turned to Mabel to support their PY23 and PY24 HEDR efforts.

THE SOLUTION

Mabel’s HEDR product supports ACOs REACHs and their participating providers in meeting this requirement in a compliant way. This includes:

  • Aggregating HEDR data through EMR exports

  • Generating practice-specific and patient-specific online HEDR surveys as a practical alternative to EMR exports

  • Tracking real-time progress across the ACO network via the Mabel Dashboard

  • Crosswalking responses across different EMR formats to meet CMS's submission file requirements

Within just 2 weeks of kicking off with Mabel, ACO REACHs have captured a majority of their PY23 HEDR data—and on track to earn back the full amount of their HEDR adjustment (>$100K).

Mabel HEDR Case Study #1

CONTEXT

  • High Needs ACO with ~1000 aligned lives

  • >20 providers all on different EMRs

  • Only 2 practices could extract relevant data from their EMR; the remaining used Mabel’s practice-specific and patient-specific online HEDR surveys

RESULTS

  • >90% completion within 2 weeks of deploying Mabel solution

  • On schedule to capture full $100K of HEDR Adjustment

Data aggregation and mapping

Mabel ingests the data from different EMRs, and standardizes the data so it can be mapped back to the CMS submission template. By using an aggregating tool like Mabel, Mabel can provide real-time visibility into any gaps for HEDR collection — both at the individual practice and patient level.

Practice-specific patient rosters

For each individual practice, Mabel creates patient-specific links that providers can use to fill in the demographic data for each aligned patient. This provides an easy interface that providers can use to share the data they’ve collected for their patients back with the ACO REACH in a structured format.

Dashboard tracking & submission

The Mabel Dashboard provides real-time visibility into the completion rates of PY23 data by provider across all channels, allowing the ACO REACH team to focus their efforts on providers that need more support

Click below to learn more about Mabel’s suite of ACO REACH solutions.

With more than 20 providers on several different EMRs, we were having difficulty collecting and consolidating demographic data across our network. Mabel had a unique approach that allowed us to aggregate this data from our providers. We were able to collect most of our data in 10 days for the PY23 submission, and we’re already working with Mabel on PY24 data collection.

— High Needs ACO REACH

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