Kentucky REC News

Organized Approaches to Improve Colon Cancer Outcomes

The Kentucky Regional Extension Center was proud to partner with the Kentucky Department for Public Health and other key partners on a five year Center for Disease Control and Prevention grant: Organized Approaches to Improve Colon Cancer Outcomes. As health information technology advisors we worked with grantee practices (seven federally qualified health centers) to use their certified electronic health records to implement evidence based interventions and make significant improvement in their colon cancer screening rates. The Kentucky Cancer Consortium Partner Spotlight from September 16, 2020, provides an overview of the project.

Kentucky Department for Public Health: Organized Approaches to Improve Colon Cancer Outcomes

In 2015, the Kentucky Department for Public Health (KDPH) was selected to participate in a five year grant from the Centers for Disease Control and Prevention (CDC) focused on improving Colorectal Cancer outcomes. In the course of this work, a team of colon cancer and health system experts assisted seven Federally Qualified Health Centers in reviewing baseline screening rate data, assessing current screening practices, and identifying opportunities for improvement in various clinics across the state. The health systems then implemented evidence based interventions, and addressed workflow gaps found during the assessment process.

These Evidence Based Interventions (EBI’s) included:

Provider assessment and feedback – generating reports on provider performance in delivering or offering screening to clients (assessment) and presenting providers with information about their performance in providing screening performance (feedback).

Provider reminders – inform healthcare providers that it is time for a client’s cancer screening test (called “a reminder”) or that the client is overdue for screening (called “a recall”). The reminders can be provided in different ways, such as in client charts or by email.

Client reminders – written (letter, postcard, or email) or telephone messages (including automated messages) advising people that they are due for screening or to complete a scheduled screening

Reducing structural barriers – addressing non-economic burdens or obstacles that make it difficult for people to access cancer screening. Interventions designed to reduce these barriers may facilitate access to cancer screening services.

Patient Navigation – providing coaching to patients on the process for CRC screening and providing support to address barriers such as transportation

From baseline to May 2020, CRC screening rates between all 7 participating health systems improved between 2-29.6% (with an average of 16.1%)! Each health system made different workflow changes to improve their CRC screening workflows to increase their screening rate. The common thread was improving use of stool based testing (FIT or Cologuard) for average risk patients, supported by improving patient education on the process of completing and returning stool based tests, using provider assessment and feedback reports to track progress and making use of patient navigators to support patients in the screening process.

The Kentucky Department for Public Health has received funding for a new five year cycle of funding from CDC and will begin working with 5 new health systems later this year. Key partners in the work include the Kentucky Regional Extension Center, the American Cancer Society, the Kentucky Primary Care Association, the Kentucky Cancer Programs at both UK and UL, and the Kentucky Cancer Consortium.

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


So far, 2020 has been anything but normal. With the unprecedented Public Health Emergency, we know that the burden of keeping up with reporting programs is yet another layer of tasks on your plate, and we want to help you. There is still time to achieve success in the remaining months! As we approach the final 90 days of 2020, we will refresh your minds and lead you on a strong path to finish out Year 4 of the Quality Payment Program successfully.

We will guide you through the process of creating an Action Plan for the final 90 days of QPP Year 4. We will discuss some key areas to concentrate on to strengthen your standing in the performance categories.


Thursday, SEPT 17, 2020 12:30 PM ET


*This webinar is for Kentucky REC contracted QPP clients only. If you are interested in this topic and would like to learn more about becoming a client, please contact us at (859) 323-3090 or Kentucky REC. We aim to be your trusted healthcare advisor!

Future dates subject to change

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


CMS released the Notice for Proposed Rule Making (NPRM) for the Quality Payment Program’s 5th year, 2021, on August 3rd. This proposed rule puts forth a number of significant changes in the Quality Payment Program (QPP) for the short term, as well as the future of the program.

Join our team of Kentucky REC advisors as we break down the most important changes being proposed and give you an opportunity to ask questions. We will detail how to give your input on this proposed legislation before the Final Rule is released later this year. Please contact us with any questions before the webinar and we will address them during our presentation.

Webinar – QPP Year 5: CMS NPRM

Thursday, AUGUST 27, 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.

PRACTICE SPOTLIGHT: U of L Pediatrics and Their Patient-Centered Medical Home Journey

University of Louisville Physicians – Pediatrics, which recently combined with Norton Healthcare and the University of Louisville School of Medicine in order to strengthen and enhance medical care for children in the region, has made the Patient-Centered Medical Home recognition program a high priority for a number of years. We interviewed Dr. Melissa Hancock and Amanda Cagle about their journey to discuss why they decided this quality improvement recognition program with NCQA (the National Committee for Quality Assurance) is the right path to take for their organization.

From the NCQA Website: The patient-centered medical home is a model of care that puts patients at the forefront of care. PCMHs build better relationships between patients and their clinical care teams. Research shows that PCMHs improve quality and the patient experience, and increase staff satisfaction—while reducing health care costs. Practices that earn recognition have made a commitment to continuous quality improvement and a patient-centered approach to care.

With the help of Kentucky REC PCMH/PCSP senior advisor Vance Drakeford, a NCQA Certified Content Expert, they achieved NCQA certification for their three sites in 2018 and 2019, and recently renewed their certification on their own. Dr. Hancock found out about PCMH from a conference she attended in 2014, and immediately became enthused about the program and what it could mean for their providers, support staff, and patients. However, at that time program and the standards were very paper driven and they struggled with implementing and tracking everything. In 2017, the program changed to an electronic platform, which was a better fit for them. And, when Amanda joined the practice, they created a team to help move them through the process. They sought the help of Vance at the Kentucky REC, who was able to guide them through the process and maximize their efforts to achieve recognition. They were able to change many processes in their offices that had a direct impact on their patients.

What is the most rewarding part of your PCMH journey so far? Amanda mentioned multiple results:

Standardization – “We were able to standardize actions across our locations, and improved practice administration and patient care. We had immediate benefits with improvements in health outcomes.”
Employee Engagement – “Employee engagement and satisfaction is better, with improved communication. Our staff huddles and team communication are much more effective. We beefed up care coordination and chronic care management improved greatly. It really ramped up during this process, and continues to improve.”
Patient Care – “We were able to change many of the processes in each of the offices that had a direct impact on our patients, such as how we return phone calls, follow-ups on overdue labs and x-rays, how we schedule, and improvements in continuity. Our chronic care management improved greatly. And we have fewer patients heading to the ED.”

What was the hardest part of the process? Dr Hancock shared the issues they faced:
Quality Improvement – “We really struggled with the QI piece. Vance helped us so much. He made sense of it and pushed us through to complete the process. IT was the best for us in the long run, as we raised immunization rates, did better screenings for lead levels, and more.”
IT – “This was a huge barrier to get over,” Amanda said. “We recommend getting IT people involved early and setting expectations for reporting needs and frequency.”
Team – “We didn’t do well until we had an engaged team. Once Amanda joined us, and we had Vance to advise us, we were able to get together and complete the project.”

Was there anything easy?
Dr. Hancock answered, “The standards, figuring out the things we were already doing, but weren’t documenting. We realized we just needed to write them down as a policy or procedure, and refine them in order to get credit for them. ”

How did Kentucky REC help?
“We found out about Kentucky REC through an email, and then we participated in a webinar,” Dr. Hancock answered. “We had really hit a wall. We had done everything we could.Vance is so organized, with check ins and calls. He walked us through the difficult parts. It’s great having that different set of eyes. He knows what NCQA is looking for, where we didn’t know what we were doing. We had no frame of reference to discern what we needed to do to gain recognition. Once we started with the REC, we would send things to Vance, and he would send feedback with recommendations, and give us encouragement. We wouldn’t have gotten to the finish line without him. He’s personable, trustworthy, and super professional, super organized so we could get it done.”

How does this help your long term goals? Has anything worked for you with interventions?
“We have more QI efforts we’re working on right now, to improve for next year. We’re working on HIV screening rates in adolescents, HPV vaccine, BMI and healthy weight for children. We can now track and improve on interventions, like in HIV screening, we have reminders up in charting areas, and videos for providers to watch with reminders. The downtown office had a 5-10% bump. We now have a process to document why parents or kids refuse, along with the multiple charting reminders. The Stone Street office hasn’t seen an increase. Before, this would have fallen through the cracks, because we wouldn’t know how to do Quality Improvement tracking.

Do you have any advice for other organizations?
Amanda said, “Get IT people involved early and set expectations on reporting needs and frequency. It was a huge barrier to get over at first, and then it got better.” Dr. Hancock replied, “Vance helped us immensely. We had done everything that we could do on our own. We had no money, but we scraped it together to have the Kentucky REC advise us and get through the process. We needed the Quality Improvement piece, IT and technology abilities. Vance really pushed us through to get the project completed. We really recommend having advisors from your organization.”

Does your practice have Quality Improvement goals that PCMH/PCSP recognition might fit? Contact us at Kentucky REC to discuss how this program can help you achieve them. Our team of experts is here to help: 859-323-3090.


In light of the continued need for social distancing to lower risk, the Kentucky REC team and our partners at KHIE have decided to go virtual with our planned August conferences. As much as we want to bring everyone together, guaranteeing your safety is more important.

Therefore we are announcing WoW: Week of Webinars August 10 – 14!

The WoW is a full week of FREE virtual learning and interactive sessions welcoming clinicians, administrators,
clinic staff and all healthcare professional to remotely connect and discuss the following subjects and more:

  • Quality Improvement
  • Telehealth
  • Promoting Interoperability for EHs
  • Patient-centered Medical Home & Specialty Practice
  • KHIE Services
  • The Quality Payment Program
  • Promoting Interoperability for EPs

Participants can choose individual sessions on a variety of useful topics to help you
address the challenges of today’s healthcare landscape.

Questions? Interested? Contact us: or 859-323-3090


One of the most challenging performance categories in the Quality Payment Program (QPP) is the Cost Category.

The number of potential Cost measures and the category weight has so far increased each year of the QPP. As Cost continues to rise in significance, it is increasingly important that clinicians consider how their performance on Cost measures will affect their overall performance scores. Clinicians and their organizations will want to grow their ability to avoid the program’s escalating penalties for not meeting performance thresholds.

Eligible Clinicians do not need to submit data for this category, but there are still some ways in which you can prepare for and improve your Cost scores.

Here are a few suggestions as you work on the Cost category:
1. Review the Measure Information Sheet
2. Become familiar with each measure’s Attribution Methodology
3. Analyze your past Cost performance in the annual QPP Feedback Reports
4. Confirm all Coding/Billing practices
5. Consider implementing relevant QI (Quality Improvement) processes

If you are interested in this topic and would like to learn more, or have other questions, contact us at (859) 323-3090 or email us at Our experts are here to help!


Performance Year 4, 2020, of the Quality Payment Program (QPP) is just about halfway over! During our July 30th webinar, Kentucky REC experts will discuss the details of the Promoting Interoperability (PI) and Improvement Activities (IA) Performance Categories to help you make informed decisions for improvement. This webinar will be the third and final in our series of performance category deep dives for QPP Y4.

The Promoting Interoperability (PI) Performance Category has maintained its 25% weight of the MIPS final score. Also much of the category remains the same after it went through a substantial overhaul for Y3. One change to note is the reduction to only one bonus opportunity for Y4 of the program. CMS also refined the reweighting flexibilities that allow you to shift some of the raw category points around several objectives and measures.

Additionally, the Improvement Activities (IA) Performance Category aligns very well with processes we are already doing to improve our practices. With the new changes to IA requiring more preparation and planning, we will discuss what you should keep in mind as we move into the second half of the Performance Year, ranging from best practices, to documenting as a large organization, and how to find the right activities for your organization. Let us know if you would like more information on becoming a Kentucky REC client.

Webinar – QPP Categories Year 4: Promoting Interoperability & Improvement Activities
Thursday, July 30, 2020 12:30 PM ET


Next QPP Webinar:

August 27 – Year 5 NPRM (Notice of Proposed Rule Making)

This webinar date and subject might change if CMS delays release of Year 5 NPRM

All QPP Webinars start at 12:30 PM ET

*This webinar is for Kentucky REC contracted QPP clients only. If you are interested in this topic and would like to learn more about becoming a client, please contact us at (859) 323-3090 or Kentucky REC. We aim to be your trusted healthcare advisor!

Future dates subject to change

This exclusive content is for contracted QPP clients only. If you are interested in this topic and would like to learn more about becoming a client, please contact us at (859) 323-3090 or email us at We want to be your trusted healthcare advisor!


There are so many changes in healthcare due to COVID-19 it can be overwhelming to keep track. Kentucky REC quality experts point out a few of these changes from CMS to help providers stay on top of the most important information.

Updated Questions and Answers on COVID-19

Review CMS’ updated FAQs (PDF) to equip the American health care system with maximum flexibility to respond to the 2019 Novel Coronavirus (COVID-19) pandemic. Check this resource often as CMS updates it on a regular basis – they insert the date at the end of each FAQ when it is new or updated.

Using CS Modifier When Cost-Sharing is Waived

This clarifies a prior message that appeared in CMS’ April 7, 2020 Special Edition of their Medicare Learning Network Newsletter.

CMS now waives cost-sharing (coinsurance and deductible amounts) under Medicare Part B for Medicare patients for certain COVID-19 testing-related services. Previously, CMS made available the CS modifier for the gulf oil spill in 2010; however, CMS recently repurposed the CS modifier for COVID-19 purposes. Now, for services furnished on March 18, 2020, and through the end of the Public Health Emergency, outpatient providers, physicians, and other providers and suppliers that bill Medicare for Part B services under specific payment systems outlined in the April 7 message should use the CS modifier on applicable claim lines to identify the service as subject to the cost-sharing wavier for COVID-19 testing-related services and to get 100% of the Medicare-approved amount. Additionally, they should NOT charge Medicare patients any co-insurance and/or deductible amounts for those services.

Medicare FFS Claims: 2% Payment Adjustment Suspended (Sequestration)

Section 3709 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act temporarily suspends the 2% payment adjustment currently applied to all Medicare Fee-For-Service (FFS) claims due to sequestration. The suspension is effective for claims with dates of service from May 1 through December 31, 2020.

You can subscribe to CMS’ MLN Connects here.


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


Webinar – Virtual SRA 2020: The Social Distancing Option for Staying HIPAA Compliant
Thursday, July 9, 2020 12:00 PM ET


The Kentucky REC is here to assist you with completing your Security Risk Analysis and ensure organizations stay compliant under the HIPAA Security Rule. Since the COVID 19 crisis demands a new level of caution, Kentucky REC experts have developed an innovative SRA via a virtual platform. Join us on July 9 to learn more about the details and logistics of a virtual SRA, and learn the best options for HIPAA Compliance in 2020.

We’ll also discuss the state of healthcare security in 2020 and important steps to take to remain HIPAA compliant in this rapidly changing environment.

Call 859-323-3090 or email Kentucky REC HIPAA Privacy and Security experts with your questions, or if you want to talk to an advisor to schedule to schedule a Security Risk Analysis with us this year.


As your organization works through the 2020 Quality Payment Program year, Kentucky REC Quality Experts want to share insights on how we can help your eligible clinicians in both the MIPS and APM (Alternative Payment Models) tracks. The Kentucky REC has a proven record with 10 years of advice and guidance to help Kentucky providers, small and large, comply with federal and state regulations, avoid penalties, and earn incentives when available.

We are committed to helping Kentucky clinicians with our patient-centered approach and Quality Improvement methodologies to improve quality, patient care, and health outcomes in the Commonwealth. We look forwarding to sharing with you how our team of experts can help your organization achieve your goals.

Webinar – QPP Year 4: Kentucky REC Can Help You Improve Your QPP Performance

Thursday, JUNE 18, 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.