KENTUCKY REGIONAL EXTENSION CENTER

Even though the Quality Payment Program (QPP) impacts all Eligible Clinicians, we often hear that specialists think it is directed toward primary care providers. There are currently five types of providers (Physicians, PAs, NPs, CNS, & CRNAs) that can be Eligible Clinicians, and this list is expected to expand in coming years. The NPRM for 2019 proposes to include: Physical and Occupational Therapists, Clinical Social Workers, and Clinical Psychologists. This expansion, if included in the upcoming Final Rule, could include more specialists than ever before in a CMS program. While the Improvement Activities and Promoting Interoperability performance categories have significant flexibility to allow for the best fit regardless of practice type, Quality is an area that many specialists tend to struggle with as they work to choose the best approach.

While the majority of quality measures are highlighted as being primary care specific, there are measures and objectives for specialists. In fact, there are subset measures that are designed specifically for different specialties. The challenge is in identifying the correct quality measures, and the best approach for capturing the required information and submission.

Join us for our upcoming webinar where we will discuss how measure availability and subsequent benchmarks can affect scores for specialists. We will present crucial steps to take as a specialty practice to ensure ongoing success in the Quality Payment Program.

Webinar September 20 – QPP for Specialty Practices

Thursday September 20th 12-1 p.m. ET

I am sure many of you have heard talk about Virtual Groups, and may have even looked into joining one. If you have only heard in passing about the third level of submission available for participation in the Quality Payment Program, we will shed some light for you on Virtual Groups. We’ll explain what they are, and how to decide if a Virtual Group would be a good fit for your practice. If you have considered or are planning to join a Virtual Group, we will also outline the necessary steps to establish one and participate at this level.

CMS defines a Virtual Group as “a combination of two or more TINs consisting of the following: Solo practitioners who are MIPS eligible (a solo practitioner is defined as the only clinician in a practice); and/or groups that have 10 or fewer clinicians (at least one clinician within the group must be MIPS eligible). A group is considered to be an entire single TIN”. This allows smaller practices (10 or less EC’s) to join together with other like practices to form one reporting entity for QPP. Doing so allows for the potential to maximize overall performance and positive payment adjustments under this program.

Webinar September 6 – Whats the Big Deal About Virtual Groups?

Thursday September 6th 12-1 p.m. ET

Join us on July 30th for an in depth look at the new Quality Payment Program feedback report. We will explore how you can use these reports to shape your practice action plan to maximize your Year 2 QPP performance. We will also take a look at the targeted review request process and how to use this form to correct any errors. Please note: the targeted review application must be submitted no later than September 30th of 2018. However, CMS recommends submitting before the end of July.

CMS released Year 1 QPP feedback reports Friday, June 29th on the QPP.CMS.GOV Portal. Providers who participated in Year 1 of the QPP under either the Merit Based Incentive Payment System (MIPS) or the Alternative Payment Models (APMS) can log in to their QPP Portal to review their final performance score and the associated payment adjustment factor. The new feedback report replaces the Quality Resource and Utilization Report (QRUR), and provides feedback across Quality (reported measures), Cost (claims based evaluation), Advancing Care Information (now known as Promoting Interoperability), and Improvement Activities. The report provides feedback on performance across these four categories and illustrates ranking across the country and each measure(s) respectively. We suggest that you look at your feedback reports as soon as possible to initially check for accuracy, as time is short for a potential appeal. While you are in the QPP Portal, we also recommend you verify that your connected clinicians are accurate, in the event someone is tied to your TIN who is not part of your organization. If this is the case, you will also want to clean up PECOS and work with CMS to remove any errors.

You can gain access to your feedback reports by logging in to the Portal at www.qpp.cms.gov using your EIDM login and password. If you do not have a login/password, or the appropriate level of access, you can request or modify it here.

Webinar July 30th – QPP Year 2: 2017 Feedback Reports

Monday July 30th 12-1 p.m. ET

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.