Pop Health Projects 2021

The way to get started is to quit talking and begin doing – Walt Disney

Quality MIPS performance, financial risk score/benchmark metrics and virtual care revenue will be paramount in 2021 and require strategic action to be successful.   We launched PopHealthproject.com to assist your team in staying on track with tasks critical to your organization's value-based care success.

Quality management in business process a

Quality Payment Program (QPP) 2021 Performance

MIPS positive payment adjustments are in the budget now – keep it that way.


ACO Claims Data Modeled for Direct Contracting Entity (DCE) Program

  • Book an Appointment with Kris Gates to review your ACO claims data modeled for DCE program.  

  • Benchmark, Capitation Payments and PQEM analysis 

Prescription Not Picked Up and COVID-19 Vaccine


A healthcare provider at the point of care is now able to see if a patient fails to pick up a prescribed medication and implement the important next steps of medication adherence with the patient much more quickly and effectively.  In addition, COVID-19 Vaccine and prior diagnosis information will be populated. 

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What is up with FHIR?

Fast Healthcare Interoperability Resources (FHIR) provides a platform for enhanced interoperability such as:

  • Pull data from EHR for quality reporting

  • Add diagnosis to EHR from claims data

  • Feed 4-year health history to EHR from claims data

Rural Village

Community Health Access and Rural Transformation (CHART) Model



Medicare ACO 

Medicare DPC FHIR

Medicare Blue Button FHIR 

Medicare Advantage

Primary Care First (PCF)

Direct Contracting Entity (DCE)


•Quality Reporting Document Architecture (QRDA)

•Fast Healthcare Interoperability Resources (FHIR)

•HL7 Lab

Other Payer



•Self-Insured Employer TPA

Patient-Generated Engagement

•Events-Based Interventions

•RPM Device Data

•Online Health Screenings

•Text Notifications

•Interactive Health History