Tips in Selecting Quality Measures

Transcription

1 Learning Forum Fridays Countdown to Merit-based Incentive Payment System (MIPS) Data Submission Webinar Series Tips in Selecting Quality Measures Ohio Physician Office Team Health Services Advisory Group (HSAG) July 21, 2017

2 To connect to the audio portion of the Webinar, dial the following tollfree telephone number: for Noon event, dial for 3 p.m. event, dial (This is not for speakers/panelists.)

3 HSAG Ohio Physician Office Team Kimberly Harris- Salamone, PhD, MPA Vice President, Health Information Technology Carol Saavedra, BA Health Informatics Specialist Chris Fechner, BS Health Informatics Specialist Carly Hogan, BS Health Informatics Specialist 3

4 Learning Forum Friday Objectives After attending the webinar, the attendee will be able to: Recognize steps to take in preparing for the MIPS data submission. Adopt successful strategies to meet the Quality Payment Program (QPP) reporting requirements. Identify solutions to avoid the negative payment adjustment. 4

5 How Are MIPS Performance Categories Weighted? Weights assigned to each category are based on a 1 to 100 point scale. Transition Year Weights Quality Cost Improvement activities Advancing care Information 60% 0% 15% 25% Note: These are defaults weights; the weights can be adjusted in certain circumstances 5

6 Quality Replaces Physician Quality Reporting System (PQRS) Providers must select 6 measures total out of about 300 quality measures. 1 of these quality measures must be an outcome or intermediate outcome measure. If no outcome or intermediate outcome measure is available, a high priority measure can be chosen instead. 6 Source: The Centers for Medicare & Medicaid Services

7 MIPS Scoring For Quality (60 Percent of Final Score 2017) Select 6 of the approximately 300 available quality measures (minimum of 90 days) Or a specialty set Or CMS Web Interface measures (needed to register by 6/30/17) Clinicians receive 3 to 10 points on each quality measure based on performance against benchmarks. Clinicians will receive 3 points minimum on any measure submitted, no matter the numerator or benchmark Quick Tip: Easier for a clinician that participates longer to meet case volume criteria needed to receive more than three points. Bonus points are available Failure to submit performance data for a measure = 0 points. 7 Source: The Centers for Medicare & Medicaid Services

8 How To Choose Which Measures To Report The majority of quality measures available in 2017 were previously available for PQRS. If you as a physician performed well on PQRS in previous years, try to continue using the same measures. Be sure to know which submission method you will be using, because measures vary depending on your choice. Use the QPP website qpp.cms.gov to explore all measure choices by specialty and data submission method. 8

9 Submission Methods 9 Source: The Centers for Medicare & Medicaid Services

10 Selecting Measures qpp.cms.gov/mips/quality-measures 10 Source: The Centers for Medicare & Medicaid Services

11 Scoring Q: Now that you have chosen your measures, how will they be scored? A: In 2017, participants will automatically receive 3 points for completing and submitting each measure. However, participants can earn higher than 3 points depending on the measures benchmarks. 11

12 Benchmarks If a measure can reliably be scored against a benchmark, then the clinician can receive 3 10 points. Reliable score means the following: Benchmarks exist (see next slide for rules) Sufficient case volume ( 20 cases for most measures; 200 cases for readmissions) Data completeness met (at least 50 percent of possible data is submitted) If a measure cannot reliably be scored against a benchmark, then the clinician receives 3 points. Easier for a clinician who participates longer to meet case volume criteria needed to receive more than 3 points 12

13 Benchmarks (cont.) There are separate benchmarks for different reporting mechanisms EHR 1, QCDR 2 /registries, claims, CMS 3 Web Interface, administrative claim measures, and CAHPS 4 for MIPS Reminder: Not all measures will have a benchmark. If there is no benchmark, then a clinician only receives 3 points for that measure! Electronic Health Record (EHR) 2. Qualified Clinical Data Registry (QCDR) 3. Centers for Medicare & Medicaid Services (CMS) 4. Consumer Assessment of Healthcare Providers and Systems (CAHPS)

14 Bonus Points Clinicians receive bonus points for either of the following: Submitting an additional high priority measure 2 bonus points for each additional outcome measure (after required outcome measure) 1 bonus point for each additional high-priority measure Using CEHRT 1 to submit measures to registry or CMS 1 bonus point per measure for submitting electronically end-to-end Certified Electronic Health Record Technology (CEHRT)

15 Final Quality Score Total Quality Performance Category Score Points earned on required 6 quality measures + 60 Any bonus points Quick Tip: Maximum score cannot exceed 100 percent. *Maximum number of points = # of required measures x Source: The Centers for Medicare & Medicaid Services

16 To Submit Questions Via Chat Box To submit a Question, click on the Chat option at the top right of the presentation. 2. The Chat panel will open. 3. Indicate that you want to send a question to the Host & Presenter. 4. Type your question in the box at the bottom of the panel. 5. Click on Send.

17 Webinar Materials To obtain the webinar slides and the web recording, visit

18 This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for Arizona, California, Florida, Ohio, and the U.S. Virgin Islands, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. QN-11SOW-D