STAR RATINGS & QUALITY GAP CLOSURE FOR ACOs
Support Stronger Quality Performance With In-Home Diagnostics
Principle Health Systems helps ACOs and value-based care organizations address open quality measures by bringing diagnostic services directly to attributed patients. From patient outreach and scheduling to in-home testing, result delivery, and reporting, we help remove barriers to care and support quality gap closure at no cost to the patient.
Call – (832) 932-5968
Where We Go
- Texas
- Oklahoma
- Kansas
- Indiana
- Missouri
Who We Work With
We support IPAs, MSOs, physician groups with delegated Medicare Advantage risk, MSSP ACOs, value-based care organizations, and health systems participating in risk-based and quality incentive arrangements.
What Your Patients Pay
No cost to the patient, with no copay, transportation, time off work, or appointment to drive to.
Some Quality Gaps Are Harder to Close
Reaching every attributed patient takes more than traditional outreach.
Quality performance reflects your entire attributed population, including patients who may not have received the care they needed during the performance year. Some may have limited mobility or transportation, live in a skilled nursing or assisted living facility, or simply be difficult for participating practices to reach.
For practices already managing full patient panels, repeated outreach, scheduling, and coordinating diagnostic services can require time and resources they may not have available.
Those unresolved gaps can ultimately affect Star Ratings, quality scores, and value-based reimbursement. Principle Health Systems helps address the diagnostic side of the equation by extending care beyond the traditional clinical setting.
When patients can’t easily get to the diagnostic services they need, we bring those services to them.
QUALITY GAP CLOSURE FOR CRITICAL DIAGNOSTICS
Bringing Diagnostic Services Directly to Your Patients
1. Patient Outreach
Our full-service call center schedules approximately 100,000 visits annually. We connect with patients using customized talk tracks, text campaigns, text-based scheduling, AI-enabled phone systems, and follow-up outreach to help coordinate needed diagnostic services.
2. Mobile Diagnostics
Our phlebotomists and clinical staff bring diagnostic services directly to patients at home, in skilled nursing or assisted living facilities, and in other community settings. Services may include blood draws, urine collection, blood pressure readings, FIT kits, and imaging, with applicable testing processed through our laboratories. All at no cost to the patient.
3. Patient Support
We help patients understand what to expect before and during their visit, answer questions, and coordinate the delivery of results back to the attributed practice. Your practices maintain the patient relationship while we help complete the diagnostic services needed to support quality gap closure.
Diagnostic Support Across Quality Programs
The quality measures that matter depend on your program. Delegated Medicare Advantage organizations work against Star Ratings, while MSSP ACOs are measured through APP Plus. PHS supports diagnostic services across both, as well as commercial, Medicaid, and other value-based programs.
How It Works
The Data Path
A Result That Never Reaches the Record
Never Reaches the Measure
Quality reporting increasingly relies on electronic clinical quality measures, making it essential for completed diagnostic results to reach the appropriate patient record. That’s why we establish the return path with your quality team and participating practices before services begin.
Results are routed back to the attributed practice through the interface, portal, or transfer method established with your team, helping ensure the information reaches the patient record used in your quality reporting.
Through Principle Insights, your quality team also gains customized reporting into who has been contacted, scheduled, completed services, and more. Combined with structured result files and supporting documentation, this provides greater visibility into program progress while helping ensure completed diagnostic services reach the appropriate reporting workflow.
The Results
Closing outstanding diagnostic gaps can help strengthen performance across the quality measures that matter to your organization. For delegated Medicare Advantage arrangements, that includes measures contributing to Star Ratings. For shared-savings organizations, completed care and documented results can support performance across applicable quality measures.
Our services can also help reduce the administrative burden on participating practices. We manage patient outreach, scheduling, mobile diagnostic services, and result delivery so practices can focus their resources on patient care. Principle Insights provides customized reporting throughout the process, giving your team visibility into who has been contacted, scheduled, completed services, and more.
Why PHS?
Your organization already has a quality strategy supported by analytics, care management, and participating practices. Principle Health Systems complements those efforts with the outreach, mobile diagnostic services, and patient support needed to reach patients outside traditional care settings.
Our capabilities bring together a full-service call center, field clinicians, laboratory testing, mobile imaging, logistics, and customized reporting through Principle Insights. By coordinating these services through one partner, we help create a more streamlined path from patient outreach and scheduling to completed diagnostic services, results, and reporting.
Frequently Asked Questions
We help reach patients with open diagnostic needs through outreach, scheduling, mobile diagnostic services, and result delivery. Our goal is to help complete eligible services and return the results to your existing quality workflow.
Our services can support measures related to blood pressure control, glycemic status, kidney health, colorectal cancer screening, and other diagnostic needs depending on your program and available services.
Yes. We support organizations with delegated Medicare Advantage risk as well as MSSP ACOs. The applicable measures and reporting requirements differ, so we work with your team to determine where our diagnostic services can support your program.
Principle Insights provides customized reporting that gives your team visibility into patient outreach, scheduling, completed services, and other program activity. Reporting can be tailored to help your team monitor progress and identify where additional follow-up may be needed.
No. MSSP ACOs are evaluated through the APP Plus quality measure set rather than Medicare Advantage Star Ratings. PHS can support applicable diagnostic measures within both frameworks.
Our primary service area includes Texas, Oklahoma, Kansas, Indiana, and Missouri. Additional market coverage may also be available upon request. Contact our team to discuss coverage for your attributed patient population.
We coordinate the data pathway with your team before services begin. Results can be routed to the attributed practice and quality team using the established reporting workflow so completed services are reflected in the appropriate patient record.
There is no cost to the patient. Services are provided through the participating organization’s program, with billing arrangements established during contracting.
Contact our team with the measures you’re focused on, approximate patient volume, and geographic needs. We’ll review your program and determine how Principle Health Systems can support your quality gap closure efforts.
Tell us which measures you’re focused on, your attributed patient volume, and where your patients are located. We’ll help identify where our diagnostic services can support your efforts to close quality gaps.
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