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 Payment Program (QPP) 2021 Performance

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

  • GET the QPP 2021 Handout

  • Join Quality Payment Program - Mandatory Monthly User Group to start seamless quality data imports from claims CPT II codes, FHIR, and QRDAs.  January 21, 2021

  • Register Mandatory Medicare ACO QPP 2021 Onboarding Course January 28, 2021

Medication Reconciliation - healthhistory.com

Medication Reconciliation and Adherence

With this widely available data source, medication reconciliations will now take a fraction of the time as all data from all providers will be instantly presented at the point of care in the EHR. Healthcare providers will no longer need to rely solely on a patient's recollection of their medication names and related diagnoses. In addition, patients will not have to deal with frustrating paper forms.  A reduction in medication errors is also anticipated as a view of a comprehensive history will be available to all providers involved in a patient's care.

In addition, a healthcare provider will be 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.

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

Did you know?

Rural Village

Community Health Access and Rural Transformation (CHART) Model


  • Join Medicare Chart ACO Webinar

  • The CHART Model is offering two track options for participation: the Community Transformation Track and the Accountable Care Organization (ACO) Transformation Track. CMS announced the Notice of Funding Opportunity (NOFO) for the CHART Model’s Community Transformation Track in September 2020. Applications for the Community Transformation Track are due by March 16, 2021. The Request for Application (RFA) for the ACO Transformation Track will be available in early 2021.



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

Health Endeavors

P.O. Box 27290

Scottsdale AZ  85255

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2021 Health Endeavors