Join us August 7 from 12-1 pm, where we will examine the CMS Notice Proposed Rule Making (NPRM) for Year 3 of the Quality Payment Program. We will discuss the major proposed changes, how they differ from Year 2 (2018 Program Year) requirements, and the possible effects of these changes on clinician practices.

In the proposed rule released July 12, CMS outlines numerous alterations for Year 3 (2019 Program Year) of QPP, including many changes to the Promoting Interoperability performance category and increased weighting for the Cost performance category. Along with extensive category restructuring, CMS has also proposed an increase in the performance threshold and added an additional factor for clinician eligibility.

Webinar August 7th – NPRM: Year 3 Proposed Rule Review

Tuesday August 7th 12-1 p.m. ET

With the adoption of EMR technology, transformative steps in healthcare have improved the safety, effectiveness, efficiency, education, responsiveness, and overall care of patients. A subsequent step in the evolution of EMR is to increase access to health information, offer functionality for providers for ordering tests, checking results, and ease the burden of sharing information to aid in patient care. The next step forward is integrating patients into their medical record via Patient Portals. A Patient Portal allows the patient to interact and communicate with their healthcare providers 24/7 through the internet. Portals can be applications on stand-alone websites, or applications integrated into the provider’s existing website, while others are modules added on to EMR systems.

CMS initially required providers and facilities to provide electronic access to patient health records through incentive/penalty programs, such as the EHR Incentive Program known as Meaningful Use. This was in order to encourage patient access to and utilization of EMRs and Patient Portals. This has now evolved into the View, Download and Transmit (or VDT) requirements and is continuing to stair step up the integration even further in 2019 with the requirements around Patient-Generated Health Data. This data can range from fitness tracker logs, daily blood pressure or glucose monitoring logs, to food diaries and beyond. Patients self-track and upload their data into the Patient Portal for their providers to review and act upon when necessary.

Individuals who are tracking their health data, uploading it to a portal, engaging providers with questions about their care through direct messaging, are all signs of Patient Activation. This concept describes the knowledge, skills and confidence a person has in managing their own well-being and health care. Activation is more than compliance. Compliance is about persuading a patient to follow recommended medical advice. Activation encourages willingness of the patient to take independent actions to manage their health and care. Developing a partnership between provider and patient that shifts daily decision-making and health ownership back to the patient to manage their health conditions encourages buy-in and engagement. Studies have shown links between highly activated patients and positive care experiences, better health outcomes, and lower costs.

Join Kentucky REC for our webinar “Patient Portals: Getting The Most Out Of Your Portals” on July 26, 2018. We will have an in depth discussion of the need for patient portals, how to promote patient activation and experience, and how maximizing your portal capabilities can positively impact your results in the Quality Payment Program and other Quality Programs, such as the Kentucky Medicaid EHR Program (Promoting Interoperability Program) for 2018.

Webinar – QPP: Patient Portals – Getting the Most Out of Your Portals

Thursday July 26th 12-1 p.m. ET

Contact the experts at Kentucky REC for all your QPP and MIPS questions. We’re here to help. Call us at 859-323-3090.

CMS raised the bar for Year 2 of the Quality Payment Program. In order to avoid a negative payment adjustment, you must now have a minimum score of 15 points (up from last year’s 3 points). In an effort to reduce the burden for small practices across the country, CMS has also raised the eligibility threshold. If you find yourself or your practice on the list of Eligible Clinicians for Year 2, you will have to do more than just submit a test this year to avoid the penalty.

If your practice is without certified electronic health record technology (CEHRT), don’t give up! There are still things you can do to avoid a negative payment adjustment. While use of CEHRT is required to participate in the Promoting Interoperability performance category, this is only one of the four performance categories. The Quality and Improvement Activities categories can both be reported on without an EHR and the fourth category, Cost, does not require submission, and therefore will also count toward your score.

Join us for our upcoming webinar where we will discuss approaches you can take to participate in QPP without a certified EHR.

Webinar – QPP: How You Can Participate Without an EHR

Thursday July 12th 12-1 p.m. ET

The CMS Quality Payment Program is comprised of four categories for Year 2: Cost, Quality, Promoting Interoperability, and Improvement Activities. Over half of your MIPS final score is made of Cost and Quality, which is a change for Year 2. While the Cost category does not require a submission, reviewing the feedback reports from CMS is essential to understanding your practice’s historical cost performance. This allows you to target strategic interventions for improvement in both cost and quality categories.

One method to gain a better understanding of the patients attributed to your practice is through identifying the Hierarchical Condition Category or HCC used for risk adjustment. A CMS Hierarchical Condition Categories (CMS-HCC) model generates a risk score for each beneficiary. CMS uses these CMS-HCC risk scores in the risk adjustment methodology for Medicare Advantage. This score summarizes each beneficiary’s expected cost of care relative to other beneficiaries using a mixture of demographics and diagnoses. Separate CMS-HCC models exist for new enrollees and continuing enrollees. The new enrollee CMS-HCC model accounts for each beneficiary’s age, sex, and disability status, and is used when a beneficiary has less than twelve months of medical history. The continuing enrollee CMS-HCC model accounts for each beneficiary’s age, sex, original reason for Medicare enrollment (age or disability), Medicaid enrollment, and clinical conditions as measured by CMS-HCCs.

Join us on our upcoming webinar as we take a closer look into the approach and factors CMS uses to determine a patient’s HCC score and how you can use this information to select clinical and process interventions to improve patient outcomes.

QPP Year 2 Webinar – What is a HCC Score and What Does it Tell You About Your Patients?

Thursday June 21st 12-1 p.m. ET