Kentucky REC News


With the start of 2020, we have a new set of rules and guidelines to implement for the Quality Payment Program Year 4! At the same time, we are now in the submission period for 2019.

Kentucky REC experts will present the biggest impacts of the Final Rule for the Merit Based Incentive Payment System’s (MIPS) four performance categories, highlighting what could affect you and your practice the most. We will also explore the changes to the Alternative Payment Model (APMs) track of the QPP, and what you can expect to see with the future of the program.

MIPS is becoming progressively more difficult to achieve a positive payment incentive as thresholds increase, and as more clinicians aim to better their own performance to avoid the penalties associated with the program. Don’t fall behind in your performance!


Thursday, February 20, 2020 12:30 PM ET


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


Do you have questions about the benefits of PCMH/PCSP?

Are you wondering how to sustain your recognition?

Join us for an in-depth conversation about recent PCMH and PCSP updates, along with ways to sustain a patient-centered care model through Recognition and Annual Reporting.

Topics include:

  • recognition sustainability
  • quality improvement
  • financial benefits
  • increase staff engagement
  • improve patient satisfaction

Patient-Centered Medical Home (PCMH) and Patient-Centered Specialty Practice (PCSP) are excellent practice transformation models for organizations committed to improving access, communication, and care coordination. NCQA recognized practices succeed in cutting costs, increasing both quality outcomes and patient satisfaction. Now is the perfect time to pursue recognition since your organization can also receive full points in the Improvement Activities category of the Quality Payment Program (QPP) Merit-Based Incentive Payment System (MIPS) under the Medicare Access and CHIP Reauthorization Act (MACRA).

Thursday March 5, 12-1 p.m. ET

Contact us at Kentucky REC with your questions about PCMH and PCSP. Our team of experts is here to help: 859-323-3090.


Focus on Care Coordination – Improving Patient Outcomes, Reducing ER Visits & Hospital Readmissions

The Methodist Physician Group (MPG) is a hospital-based organization with locations in three counties in Western Kentucky. MPG is comprised of acute and ambulatory services that include various multi-specialties. They see nearly 10,000 patients per month at 18 clinics, plus a same day clinic.

Sue Ginn, RN, is the Quality Improvement Specialist and Analyst, and heads their Quality Improvement team. The team members are comprised of clinical, IT, and administrative staff. Team members include: Amy Scales, Tiffany Smith, Jenny Phillips, Chanda Smock, Christy Stone, Scott Lutz, Janet Burnett, and Todd Duckworth. Vance Drakeford of Kentucky REC serves as the Quality Improvement Advisor for the practice. They have concentrated their efforts on building a Quality Improvement team and engaging clinicians and staff in quality improvement activities. This has been the intervention responsible for much of their success. MPG brings value to their patients through improved outcomes, care coordination, patient experience, and reduction of costs associated with care. This driving force places Methodist Physician Group in a position to be highly successful in various value-based payment models.

Performance Area Highlights

Beginning in November 2015, a pilot Care Coordination role was added to the MPG team at one of their primary care locations, and soon after another location was added to their responsibility. The goal for the Care Coordination role was to help reduce risk of readmissions, ER visits and facilitate follow-up care with patients’ primary care providers. This has led patients to improved understanding of their conditions, comorbidities, treatment and health goals.

Their high level of care coordination has resulted in a decrease of their 30 day Hospital Readmissions, showing a 0.80% improvement from 2017 to 2018. Specific patient populations have seen even higher reductions in the 30 day Hospital Readmission rates: Acute Myocardial Infarction = 1.5%, and COPD = 4.50%. Total Knee and Hip Arthroplasty had a 2% increase; however, they were 1% below the Expected All Cause Readmit rate. This is a 1.2% improvement on being below the Expected All Cause Readmit rate from 2017.

Additionally, their care coordination has led to a reduction in ER visits from 2017 to 2018. ER visit reduction has led to an estimated cost savings of $983,180.00 based off adjustment of total patient population, and CMS’s average cost of $902.00 per ER visit.

These reductions are credited to MPGs dedication to comprehensive, patient-centered care that has proven to decrease hospital readmissions and ER visits.

The MPG Care Coordinators review the daily hospital and ER discharge lists, and then call discharged patients to discuss the following:

    • Check on their current conditions
    • Confirm follow-up appointments
    • Verify appropriate medication has been received
    • Verify medication education understood


These actions have proven to be the most effective factors for the 30 day hospital readmission reduction and decreased number of ER visits.

Key Success Factors

Not only has the team seen reductions in 30 day hospital readmissions and ER visits, but the staff has gained satisfaction in the “little things” by helping patients with such things as: transportation assistance to appointments; diagnosis education; self-management with their diagnoses; coordination with various local agencies; and coordination with case management companies for other medical referrals to ensure patients receive the best care available.

MPG has added a total of five Care Coordination roles to their team since they began in late 2015 due to the success of this effort. These roles now include Medicare Gap and Medicare Wellness Appointments. This has helped improve the health of their patients, and helped catch abnormalities early by encouraging patients to have preventive screenings completed. Their work has not only helped keep patients out of the hospital, but it has also integrated an entire patient focus, improving the overall wellness of and care for their community and patient population.

We asked members of the MPG team questions regarding their experience with practice transformation. Here are some of their answers.

What’s the #1 thing you’ve gotten from your four years of practice transformation work?

Sue answered, “After the first conference I came back thinking ‘OMG what have I gotten into, it’s the tiger by the tail and the tiger has me!’ With the help of KYREC, it was still hairy scary, with a lot of work, but less intimidating because we could go to (Kentucky REC Quality Advisors) Vance, Robin, and Kelly for help.”

“I knew cost was always important, but thought of it in regard to patient affordability until working with KYREC. Now I understand the impact of cost on the healthcare organization, and the payers.”

How did you choose to focus on care transitions, particularly your hospital readmission rates?

Sue answered, “In 2015 the hospital was taking a hit with 30 day readmission rates, it’s bad for the bottom line and staying in the black. We had a restructuring in MPG – to add a care coordinator under a trial basis; we saw the advantage of it with just a couple providers, decided to move forward with other practices. We had a high number of readmits and avoidables at the beginning. Then we hired a care coordinator, and it just turned into more.”

“It was definitely worth it! The goal for the nurses is the outcome of the patient. The administration is looking at the financial bottom line, for us patient care is absolutely #1. We see clinical outcomes. With these changes, all sides benefit.”

“We saw the benefit it would make to our patients and in the community. Healthier patients, better community!”

Contact our Quality Improvement Advisors at Kentucky REC for all your quality improvement questions. We’re here to help: 859-323-3090.


The QPP Resource Center for CMS designated small practices (fewer than 15 clinicians) now offers a Qualified Registry to users of the Resource Center Portal. Eligible clinicians can use MIPScast® Qualified Registry to submit their data to CMS.

Read through the 2019 Participation Guide for an overview, explanation, and reasons to consider using MIPScast® as a Qualified Registry for reporting to CMS. It also includes registration steps, how to access the necessary consent forms through the portal, and important dates to keep in mind.

Reasons to Consider Using MIPScast® QR for Reporting to CMS:
You may want to use the MIPScast® QR reporting option simply for the convenience of having a trusted partner do the submission work for you, and skip HARP account access requests and connecting to providers to submit data. Perhaps you want the confidence of knowing your data has been reviewed to check for completeness, catch potential validation issues earlier, and that it includes any available reporting options/bonuses that can boost your total score.

Many clinicians are still without the functionality and updated reports from their EHR technology to get the performance data they need for eCQMs and Promoting Interoperability measures. Some will need an alternative to reporting eCQMs from the EHR due to vendor issues including:

  • Vendor having difficulty attaining 2015 certification or using de-certified EHR technology
  • Unable to upgrade and implement 2015 technology in a timely manner due to vendor issues or delays
  • Reporting/data issues (e.g. limited eCQM availability, invalid QRDA 3 reports, inability to produce group-level aggregated reports)
  • Having to acquire and implement additional 3rd party technology to support your functional needs and reporting requirements
  • Cost barriers (e.g. additional costs for eCQM report access, eCQM access bundled with costly data submission services)
  • Difficult eCQM workflows, system configuration, and clinical documentation requirements leading to low performance results

Claims-based reporting for the Quality Performance Category is one alternative, but you have to submit Quality Data Codes (aka “G-codes”) on your Medicare claims throughout the 12-month performance period to get credit. Another alternative is to report through a QR such as MIPScast® , which provides the option to report MIPS CQMs (formerly referred to as “Registry measures”) which can only be collected and submitted by QRs and QCDRs.

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



In our second episode of the PILL podcast focused on diabetes prevention and treatment, Trudi speaks with Dr. Tamea Evans, a 2003 graduate of the University of Kentucky College of Medicine. Dr Evans is an Internal Medicine physician and diabetologist who is passionate about helping patients with long term illness get the tools and knowledge they need in order to get and stay well. Listen as she shares what it means to be “blessed by bad” and how doctors can be rewarded for doing a good job.

This episode includes a focus on diabetes self-management education and support (DSMES), a fundamental but underutilized element of diabetes care. Kentucky has around 95 recognized or accredited DSMES programs and branches serving 88 counties across the Commonwealth. To find locations, click here and search for “Nationally Recognized or Accredited Diabetes Self-Management Education and Support Classes”.

Listen to our podcast on Buzzsprout, or Spotify and Apple Podcasts. All previous episodes are available.

If you need assistance with quality improvement and/or the QPP, contact the Kentucky REC at 859-323-3090 or by email. For specific Quality Payment Program assistance for small practices, visit the online resource center.


The start of a new year brings many additions to your to-do list. Between wrapping up the 2019 program year and preparing to attest, and beginning the 2020 performance period with all of its changes, it can seem like too much to keep up with.

To help kick off the year, and a new decade, our first webinar will help you sort and manage your QPP to-do list for 2020. This will help ensure you are making progress toward meeting goals and not letting anything slip between the cracks.

We will guide you through:

  • creating an Action Plan for the 2020 Program Year
  • key areas to concentrate on in 2020
  • preparing for the 2019 QPP attestation
  • identifying areas of focus for Quality
  • month by month break down

Join us as we discuss the four performance categories and how to create a plan to set you and your practice up for success!

QPP Year 4: Planning for Success

Thursday, January 16, 2020 12:30 PM ET


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


Program Year 2019 is almost over for the KY Medicaid Promoting Interoperability Program. Be sure you have ALL of your documentation compiled and ready to submit. The Kentucky Medicaid EHR Incentive Program (Promoting Interoperability) is accepting program year 2019 attestations until 11:59 p.m. March 31, 2020. Any attestation not submitted will be closed out and ineligible for participation for the program year.



1. Individual Provider NPI and EHR Incentive Program Registration Tracking ID (assigned upon registration with CMS) used to log into website to submit attestation (Not required for upload, just need for log-in)
2. Public Health or Clinical Data Registries – Required uploads will vary based on providers’ level of engagement with KHIE or other public health or clinical data registries; see below:

  • Option 1: Completed Registration to Submit Data to KHIE: Participation Agreement and all signed addendums required (upload required), and registration documentation should be kept for audit purposes
  • Option 2: Testing and Validation to KHIE: Testing and Validation Confirmation (upload required) Other Registries: Documentation of completed testing should be kept for audit purposes
  • Option 3: Production to KHIE: Go-Live Approval Form (upload required) Other Registries: Confirmation of production data should be kept for audit purposes

3. Promoting Interoperability reports must be uploaded for the qualifying 90 day period for each individual EP attesting
4. Electronic Clinical Quality Measure (eCQM) report should be generated for the applicable reporting period as a QRDA-III file for each EP attesting. If a QRDA-III file is unavailable, eCQM report should be saved as a PDF for upload.
5. Payment Reassignment document: Documentation is required for all EPs that attest for incentive payments through the Kentucky Medicaid Promoting Interoperability Program. This is required for all providers that reassign payment to an entity other than themselves.
6. Documentation must be uploaded to the attestation in the form of a signed agreement indicating EP is permitting their monies to be reassigned. The agreement shall be on the entities clinic or group letterhead, renewed each payment year and to include all information below:

  • Name and NPI of EP participating in the incentive program
  • Program Year and Payment Year EP agrees to reassign incentive monies
  • Name, NPI & TIN of clinic or group payment will be reassigned to
  • Signed and dated by EP
  • Signed and dated by authorized representative of entity receiving incentive payment on behalf of the EP

7. Patient Volume Report for a 90 day period, during or prior to the calendar year of the reporting period for attestation. A patient volume report form is available here.
8. When requesting a KCHIP report, if applicable, allow adequate time for receipt before attesting as this report can take up to 3 hours to complete.
9. Signed vendor contract, invoice or purchase order (documentation must be a legally binding contract) with current software version number listed to support the 2015 version CEHRT ID. Any other documentation supporting Yes/No attestation responses, testing with other entities, etc.
10. EHR Certification ID for current version (2015) from the CHPL website.

Contact your Health IT Advisor at the Kentucky Regional Extension Center to assist you with reviewing your Stage 3 reports, or with any questions you may have regarding the attestation process or suggested documents to retain. Also, be certain to schedule a time with your Health IT Advisor to submit your attestation. Kentucky Medicaid provides a manual for Eligible Provider Meaningful Users here.

Contact us at Kentucky REC with your questions about the Promoting Interoperability Program. Our team of experts is here to help: 859-323-3090.


With the calendar year drawing to a close, it’s time to develop your plans for submission to Year 3 of the Quality Payment Program. A great deal of hard work goes into a successful QPP submission. Much of your information gathering and documentation can actually be done now, or at least lined up for quick collection at the close of 2019.

Both Improvement Activities and Promoting Interoperability performance categories allow some flexibility in data reporting timeframes. You can select 90-continuous days for reporting for either category throughout the calendar year. This flexibility allows you to work ahead of the submission deadlines by gathering reports or other required documentation for the associated measures.

While Quality and Cost have a full year reporting requirement, you can implement strategies now for a strong finish to the 2019 performance year. Keep in mind that Cost is based upon Medicare Part B claims submitted to CMS during the performance year, so there is no additional information that to be submitted for attestation.

We’ll discuss how to put your practice in the best position for submission success. Don’t miss this opportunity to engage with your experts at Kentucky REC and have your QPP questions answered by our team of Quality Improvement Advisors!

QPP Year 3: Attestation Prep

Thursday, December 5, 2019 12:30 PM ET


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


On November 1st CMS released the highly anticipated Quality Payment Program Year 4 Final Rule. This Final Rule will impact and shape the Quality Payment Program for Program Year 4, calendar year 2020, and beyond.

We would like to answer your specific questions during the webinar. Therefore, please submit any questions or contact us in advance here.


QPP Year 4 Webinar: Final Rule 2020
Tuesday Nov 26 12:30 – 1:30 PM ET


Download the 2020 PFS/MACRA/Quality Payment Program Final Rule from the Federal Register here.
Read the Year 4 Final Rule Overview Fact Sheet and Executive Summary produced by CMS here.

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