CMS released the highly anticipated Quality Payment Program Year 3 Final Rule for Calendar Year 2019 on November 1st. Numerous changes were made, including expanding the list of eligible clinicians to physical therapists, occupational therapists, speech-language pathologists, audiologists, clinical psychologists, registered dieticians, and nutrition professionals.
“The historic reforms CMS finalized today move us closer to a healthcare system that delivers better care for Americans at lower cost,” said Health and Human Services (HHS) Secretary Alex Azar. “Among other advances, improving how CMS pays for drugs and for physician visits will help deliver on two HHS priorities: bringing down the cost of prescription drugs and creating a value-based healthcare system that empowers patients and providers.”
This final rule will impact and shape the Quality Payment Program Calendar Year 2019 and beyond. Join the Kentucky Regional Extension Center on Thursday November 29th for our live webinar. We will explain the major changes to the Quality Payment Program and how they might impact your practice in Program Year 3. Prior to the webinar, consider sending us any questions you have for us to include in the webinar.
Webinar November 29 – QPP Year 3: Final Rule 2019
Thursday November 29 12-1 p.m. ET
PFS/MACRA/Quality Payment Program 2019 Final Rule.
The Year 3 final rule overview fact sheet and executive summary produced by CMS can be found here.
Contact the experts at the Kentucky REC for all your QPP, MIPS, and APM questions. We are here to help. Call us at 859-323-3090.
It is essential for representatives of Eligible Hospitals and Critical Access Hospitals to know the steps to take for the Medicare Promoting Interoperability Program (formerly Meaningful Use) for Program Year 2018 and beyond. You will want to stay on top of monitoring your reports and progress to ensure that your hospital avoids a negative Medicare payment adjustment.
The Centers for Medicare and Medicaid Services (CMS) recently published the Fiscal Year 2019 Medicare Hospital Inpatient Prospective Payment System (IPPS) Final Rule. In this ruling, CMS adopted policies to continue the advancement of CEHRT utilization, focusing on burden reduction, interoperability, and patient access to their health information. We’ll outline the Stage 3 changes contained within the final rule and provide a review of the Modified Stage 2 requirements during our informative webinar on Monday, November 19th.
Register now and let us help you succeed in meeting your Promoting Interoperability goals.
The Medicare Promoting Interoperability Program for Hospitals
Monday, November 19, 2 – 3 PM ET
Contact us at Kentucky REC with your questions. Our team of experts is always here to help: 859-323-3090.
In the second episode of The PILL Podcast, we interview Dr. Chris Yost, Medical Director for Ambulatory Quality at UK HealthCare, Assistant Professor in the Department of Internal Medicine, and Co-Chair of the UK HealthCare MACRA steering committee. Dr. Yost brings a unique perspective as he leads the initiatives to improve quality and value in a large academic medical center. He not only plays a key role in UK HealthCare’s preparation for value-based payment and quality improvement, but he is also a practicing physician. This makes him better able to handle the key issues of physician buy-in and engagement, which are required for true organizational transformation. He also discusses the journey of leading the charge for Patient-Centered Medical Home recognition and discusses how this designation helps lay a strong foundation for the larger quality improvement infrastructure.
Episode 2: Dr. Chris Yost – A Physician’s Perspective
In case you missed them, visit this blog post about our previous episodes.
Contact Kentucky REC with your questions regarding the Quality Payment Program. Our team of experts is here to help. Phone 859-323-3090. For specific Quality Payment Program assistance for small practices, visit our online resource center.
This past summer, on August 1st-3rd, two representatives of Methodist Physicians Group, Sue Ginn, RN and Quality Improvement Specialist & Analyst, and Tiffany Smith, RN and Population Health Coordinator, accompanied Trudi Matthews, Robin Huffman, and Kelly Fountain to the Transforming Clinical Practice Initiative (TCPI) National Expert Panel (NEP) conference in Columbia, Maryland. They represented the CMS sponsored Great Lakes Practice Transformation Network (GLPTN) as one of the designated Exemplary Practices within the GLPTN consortium of four states. As a designated Exemplary Practice, an organization must currently be in Phase 4 out of 5 phases of practice transformation, as defined by CMS. They must also have an improvement in least one outcome Quality measure, and be identified an Exemplary Practice by CMS. Methodist has seen improvement in their diabetic measure, and are currently in Phase 4; they are nearing completion of Phase 5.
Methodist has locations in Webster, Henderson, and Union counties in Western Kentucky. They see nearly 10,000 patients per month at two hospitals, 18 clinics, and an urgent care clinic. Ms. Ginn spoke at the conference and shared their experiences with attendees, as they have made significant improvements and changes in their organization. After the conference Sue said, “the highlight for me was listening to the comments and strategies of other practices to get provider buy in, patient compliance, and in general how they achieved the CMS Exemplar Practice Goals. I came back with some great ideas to try with our providers and staff. Listening to the patient stories was motivating, to understand their thoughts on the different processes within the practices and how to make things better for them.”
They have seen significant successes in the reduction of hospital readmissions and ER visits. Methodist also improved their diabetic quality measures, with a decrease of 10% in their A1C numbers from 2017 to 2018. Many of their successes have been due to the addition of hiring a Quality Improvement Specialist, along with adding five Care Coordinators to their QI team. They have also tied Quality Performance standards to provider contracts, and Sue meets often with each individual provider at their organization to review Quality metrics and requirements in order to achieve the required standards. Regarding their quality journey, Sue states that she was surprised by “the overall improvement on the individual measures from 2016 to 2017.” She said, “Our providers and clinical staff have accepted the changes, for the most part, that have been put into place to meet the measures. Our administration has been very supportive of the quality program and emphasized to the providers the importance of meeting the thresholds.”
Methodist has achieved this during a time when they faced significant hurdles, as they switched EHRs and had, “two systems that housed the necessary data”, and had to do “manual extraction of all the data for reporting via web interface.” Sue said, “I think 2018 data collection will be easier. The majority of the information will be in our new EHR but some of it may still be in the previous EHR, such as colon cancer screening or pneumonia vaccines.” Not all will be solved right away, as Sue remarked, “We are still struggling to find a way to track the patients with a new diagnosis of depression so we can meet the depression remission at 12 months. Our new EHR doesn’t have a mechanism for alerting the provider or staff that a new PHQ9 is needed at a specific date. If we could run a report to collect the data, if no office visit, we could call the patient and complete the PHQ9 via phone.” They are still working on how to build a report that will help them with this measure.
The Methodist team is wonderful for Kentucky REC Quality Improvement Advisors to work with, and they are willing to work on suggestions to improve their efforts and make the lives of their patients better. They have gone from a negative payment adjustment in previous years to a positive payment adjustment for 2017, with a nearly perfect MIPS score. Besides speaking at the conference, they shared their tips during a live Q-Source webinar in July for practices seeking ideas and help with improvement in MIPS and Quality performance.
Many practice representatives from across the nation at the National Expert Panel were able to speak with Sue and Tiffany during the conference. They were able to learn from their presentation, and gain valuable lessons, ideas and solutions for their own improvement endeavors. Our team at Kentucky REC has now made new long term friends from this quality improvement journey, culminating in the trip to Maryland. We are proud to share Methodist’s achievements on a national level.
Does your practice have questions on how to succeed in the Quality Payment Program? Contact our experts at Kentucky REC or by calling us at 859-323-3090. We are here to help?
Don’t forget! Monday October 15, 2018 at 8 p.m. ET is the final deadline to submit a targeted review request to CMS for your 2017 Quality Payment Program performance and associated payment adjustment. We recommend that you log in into the QPP portal and verify your feedback and associated adjustment. This feedback and associated adjustment factor is set to take place beginning January 1, 2019 and will be applied to your Medicare Part B claims.
Have questions? Not sure of how to submit a targeted review request? The experts at Kentucky REC can help! Feel free to call 859-323-3090 or email Kentucky REC. We are happy to help answer your questions.