HUman INtelligence Consulting

The Center of Medicare and Medicaid Services (CMS) and The Joint Commission continue to expect more from clinicians and healthcare institutions while raising the bar relative to the number and scope of annual measures as well as the complexity of these measures.

CMS continues to shift Medicare and Medicaid reimbursements from pay-for-reporting to pay-for-performance which is based on a sum-zero strategy. Meaning those clinicians and/or institutions that perform/score higher in these measures are counter balanced against those clinicians and/or institutions that perform/score lower. The higher performance the higher the reimbursements within the highest cap of the scale for all; the lower the performance the lower the reimbursements with the lowest cap of the scale for all.

It takes an enormous amount of administrative staff time to:

1. read, digest and understand CMS’s annual proposed rules;
2. prepare and submit to CMS appropriate comments relative to the proposed rules;
3. and then also read the associated final rule
4. for each of the federal regulatory programs. It takes even more time to ensure your operational workflows align with these quality measures that often change annually.

I can augment your pre-existing quality focused staff by providing consulting services in the healthcare regulatory reporting arena which encompasses inpatient, outpatient and ambulatory patient care in the following specific areas of scope:

• CMS Eligible Clinician Regulatory Reporting (ACO, MIPS, MVPs)
• CMS Eligible Hospital Regulatory Reporting (promoting interoperability, inpatient and outpatient)
• The Joint Commission Hospital Regulatory Reporting

Other topics of interest you would like consulting services with?

CEO and owner, Trudie Pearcy, has 25 years of information technology (IT) data management experience across many industries such as healthcare, education, non-profit fund raising, finance and manufacturing. Early in her career, she worked as a database architect, reporting team lead, computer programmer, unix administrator, database administrator, SQL expert and teacher/trainer.

The last 10 years of Trudie's career have been in healthcare regulatory reporting; specifically in quality measure reporting in both eligible hospital (inpatient and outpatient) and eligible clinician (ACO and MIPS) areas of patient care in the form of eCQMs, SDOH, hybrid measures and attestations. During this time, Trudie has built a strong working relationship with several groups within the federal government’s governing body - the Center of Medicare and Medicaid Services (CMS).

Trudie has a unique talent in that she has honed skills in keeping up with the complexities of healthcare regulatory programs that CMS constructs. She is highly disciplined in that she reads and digests CMS’s annual proposed and final rules for inpatient, outpatient and ambulatory clinical regulatory governance. This entails a disciplined approach of tracking the publications of the applicable proposed rulings, the comment period for each ruling and the resulting final rules. Trudie is then prepared to provide guidance to her customers who may not have the staffing band width to perform this disciplined tracking and reading or her customers may simply want someone else’s perspective on their own readings and interpretations. She even provides guidance to individual clinicians who would like to participate in improving their individual quality measures.

Contact me: trudie.pearcy@huin-iowa.com