how to succeed in the promoting interoperability …...2019/06/06 · how to succeed in the...

QUALITY PAYMENT PROGRAM SMALL UNDERSERVED RURAL SUPPORT (QPP SURS) WEBINARJUNE 18, 11:00 AM ET AND JUNE 20, 3:30 PM ET

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HOW TO SUCCEED IN THE PROMOTING INTEROPERABILITY CATEGORY FOR SOLO AND SMALGROUP PRACTICES

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HOW TO SUCCEED IN THE PROMOTING INTEROPERABILITY CATEGORY

HOUSEKEEPING ANNOUNCEMENTS

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If you are listening to this webinar through your phone, please remember to mute your computer speakers.

You can download the slides from the file pod on your screen.

For assistance, enter your issue in the chat box.

To ask a question, enter your inquiry in the chat box.

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POLLING QUESTIONWhat is your role?▸

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A clinician working in a practice with 15 or fewer clinicians

Non clinical staff from a practice with 15 or fewer clinicians

A clinician working in a practice with more than 15 clinicians

Non clinical staff in a practice with more than 15 clinicians

Quality Payment Program (QPP) contractor

Other person helping practices prepare for MIPS

Other

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POLLING QUESTIONHow familiar are you with the Promoting Interoperability (PI) category for 2019?▸

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Not familiar at all

Somewhat familiar

I understand it and think I’ll get a good score

I understand it and think I’ll get an average score

I understand it and think I’ll get a poor score

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POLLING QUESTIONWhat are your biggest challenges or concerns with receiving a good MIPS score in the PI category?

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CMS WELCOME

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HOW TO SUCCEED IN THE PROMOTING INTEROPERABILITY CATEGORY 7

Dominic DiMartini, Clinical Practice Advisor, HCQIP,

IPRO

Jeff Sobotka, MBA, PMP, CPHIT, CHP, Quality

Improvement and HIT Consultant, Comagine

Jennifer Anglin MS, CHES, PCMH CCE, Managing

Advisor, MIPS, Medicaid PI, PCMH

Bruce Spurlock, MDPresident & CEO,Cynosure Health


SETTING THE STAGE▸

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Focus: Understanding Promoting Interoperability (PI) scoring, what is needed to meet objectives and measures, and how to maximize your resources to improve the care of your patients.

Strategy: A panel of experts will discuss the PI objectives and measures, how this category can benefit your patients and offer advice on how to earn a great score in the PI category.

Topic Overview:

Understanding the importance of interoperabilityUnderstanding objectives and measures and how to calculate them How PI can benefit your patientsTips for Succeeding in the PI category

Using the Chat Box

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FIND YOUR LOCAL TECHNICAL ASSISTANCE ORGANIZATION FOR FREE ASSISTANCE

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Location of Practice Technical Assistance Organization

Contact Information

FL, GA, NC, SC Alliant GMCF [email protected], IN, KY, MI, MN, OH, WI Altarum [email protected], WA Comagine Health [email protected], MA, ME, NH, RI, VT Healthcentric Advisors [email protected]

AZ, CA, HI, NM, VI HSAG [email protected], MD, NY, VA IPRO [email protected], MT, NV, OR, UT, WY NRHI NV, OR, UT: [email protected]

AK, MT, WY: [email protected]

AL, TN QSource [email protected], NJ, PA, WV Quality Insights [email protected], ND, NE, SD Telligen [email protected], CO, KS, LA, MO, MS, OK, PR, TX

TMF [email protected]

Find your local technical assistance contractor here: https://qpp.cms.gov/about/small-underserved-rural-practices

mailto:[email protected]












https://qpp.cms.gov/about/small-underserved-rural-practices

PANELIST INTRODUCTIONS

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Introductions

Initial experiences and practice concerns with the Promoting Interoperability category

10HOW TO SUCCEED IN THE PROMOTING INTEROPERABILITY CATEGORY

PANELIST INTRODUCTIONS11HOW TO SUCCEED IN THE PROMOTING INTEROPERABILITY CATEGORY


Jeff Sobotka, MBA, PMP, CPHIT, CHP, Quality

Improvement and HIT Consultant, Comagine

QUESTION:

Why does CMS care about this category and why is it included in the MIPS program?



IMPORTANCE OF INTEROPERABILITY▸

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In 2011 CMS established the EHR Incentive Program to encourage clinicians to adopt, implement, upgrade, and demonstrate meaningful use of Certified Electronic Health Record Technology (CEHRT).

In 2017, it became part of the MIPS program as Advancing Care Information (ACI).

In 2018, ACI was renamed Promoting Interoperability to show CMS’s commitment to promoting and prioritizing interoperability of health care data.

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PI—OBJECTIVES▸

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Promoting interoperability is necessary to ensure patient access to high-quality care and better health outcomes and a healthcare systems that put patients first

Four main objectives:

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E-Prescribing

Health Information Exchange

Provider to Patient Exchange

Public Health and Clinical Data Exchange

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QUESTION:

What are the basics I need to understand about the PI category?



OVERVIEW OF 2019 PI CATEGORY ▸

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25% of your MIPS Final score

Must use 2015 Edition Certified EHR Technology (CEHRT)

Minimum performance period of any continuous 90- day period within the calendar year

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2015 EDITION CEHRT▸CMS and the Office of the National Coordinator for Health Information

Technology (ONC) have established standard certification criteria for EHRs

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Promotes improving patients’ access to health information and interoperability

Offers data storage format requirements

Provides benchmarks to improve care

Supplies fully functional and secure software

Not sure what Edition your EHR is? https://chpl.healthit.gov/#/search

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https://www.healthit.gov/

https://chpl.healthit.gov/#/search


PRACTICAL ADVICE FOR GETTING STARTED WITH YOUR EHR OR SWITCHING EHRS▸

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Prioritize measures for your practice based on requirements and perceived value

Ensure any new vendor has 2015 CEHRT

Explore all reporting capabilities

Ask for demonstrations or trainings to have a better understanding of the functionality of the EHR

Talk to your vendor

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PRACTICAL ADVICE FOR GETTING STARTED WITH YOUR EHR OR SWITCHING EHRS▸

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Understand your patient portal—EHRs without a patient portal may have different sets of reports

Make sure you plan for the HIE connectivity

If you have the opportunity to use HIE, do it!

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QUESTION:

The PI category has four objectives. How do I meet them?



2019 OBJECTIVES AND MEASURES

2019 Promoting Interoperability Measure Specifications

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https://qpp-cm-prod-content.s3.amazonaws.com/uploads/343/2019%20Promoting%20Interoperability%20Measure%20Specifications.zip


PI REPORTING BASICS▸To earn a score for the PI performance category, you must

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Use 2015 Edition CEHRT

Submit a “yes” to the Prevention of Information Blocking Attestation

Submit a “yes” to the ONC Direct Review Attestation

Submit a “yes” for the Security Risk Analysis measure

Report the required measures under each objective or claim any applicable exclusions

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PI —GROUP REPORTING▸

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The group should combine all of their MIPS eligible clinicians’ data under one Taxpayer Identification Number (TIN)

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This includes the data of MIPS eligible clinicians who may qualify for a reweighting of the PI performance category as individuals

If these MIPS eligible clinicians report as a group, and have data in CEHRT, their data must be included, and they will be scored on the PI performance category like all other MIPS eligible clinicians

If the entire group qualifies for reweighting, the group is not required to report for the PI performance category, but can choose to report

Clinicians choosing to report as a group and using multiple CEHRT vendors within their practice/system will need to aggregate patient data across all platforms and submit one file for scoring

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PI—IMPLICATIONS FOR REWEIGHTING▸ Clinicians who qualify for reweighting will have the 25% weight reallocated to the Quality

performance category (i.e., Quality would be worth 70%; Promoting Interoperability 0%).

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If you’re in a group, all of the clinicians associated with the group’s TIN must qualify for reweighting.

If all of the MIPS-eligible clinicians within a group do not qualify for an automatic reweighting or do not submit an application for and receive a hardship exception, the group will not qualify for an automatic reweighting and will have to report.

PI—IMPLICATIONS FOR REWEIGHTING27

• Be mindful of your quality score. Ask yourself: Is my quality score high enough that if I reweight, I will be ok?

• Just because you are eligible for reweighting doesn’t mean you should.

• If you can submit for PI, it’s an easy way to earn points.

QUESTION:

It seems like there are a lot of measures, do I need to report on them all?



PUBLIC HEALTH AND CLINICAL DATA EXCHANGEYou may choose from the following five measures:

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If you report using multiple registries, you can report on all of those measures.

If an exclusion is claimed for one measure, but you submit a “yes” response for another measure, you can still earn the full 10 points for the Public Health and Clinical Data Exchange objective.

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▸For 2019, you can earn bonus points by submitting data for either or both of thesetwo optional measures:

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Query of Prescription Drug Monitoring Program (PDMP) (e-Prescribing)

Verify Opioid Treatment Agreement (e-Prescribing)

BONUS POINTS30


SCORING31


EXCLUSIONS32

Objectives Measures Maximum Points

Redistributed Points New Weighting Scenario

E-Prescribing E-Prescribing* 10 points 5 Points to Sending HIE5 points to Receiving and Incorporating HIE

Health Information Exchange

Sending HIE* 20 points TBD • Exclude from e-Rx = 25 points• Exclude from

Receiving/Incorporating HIE = 40 points

• Exclude from e-Rx and Receiving/Incorporating = 45 points

Receiving/ Incorporating HIE*

20 points 20 Points to Sending HIE Exclude from e-Rx = 25 points

Provider to Patient Exchange

40 points Exclude from Public Health/Clinical Data Exchange = 50 points

Public Health and Clinical Data Exchange

Report to 2 Registries*

10 points 10 Points to Provider to Patient Exchange (Patient Portal)

*indicates exclusion availability


SCORING33

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CMS calculates the performance rate and translates it into points using the numerators and denominators you submitted for measures

There is one scored objective where CMS uses “yes” or “no” as the answer submitted for its measures

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Once all of the measure scores are added together, the total sum will be divided by the total possible points (100). The total sum cannot exceed the total possible points.

It is then multiplied by the 25% PI performance category weight, and then added to the MIPS final score.


SCORING EXAMPLE34

QUESTION:

How can Promoting Interoperability help my patients?



BENEFITS TO YOUR PATIENTS 36

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Preventive measures

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Value in sending and receiving referrals, accessing data, and sending data to other providers and specialists

▸Spans other MIPS categories

Completing the referral loop

▸HIE in particular yields results that are apparent to practices

Provider to patient exchange—promotes quality of care and care coordination

QUESTION:

What practical strategies will help us succeed in the PI category?



TIPS TO SUCCEED38

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Understand why you are doing it

If you can, invest the time and technology—it will benefit your MIPS score and your patients.

If you have the option of direct messaging in your CEHRT, do it!

Run your reports and run them often

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Look for changes or different percentages

Catch issues early

Work with your vendor to see if there are workflow changes


TIPS TO SUCCEED39

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Don’t do it alone, get help, contact your TAC

It takes a village – get your staff involved

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▸This includes Front Desk staff, Medical Assistants, Billers, and even non-participating clinicians!

Get on the phone with your EHR vendor to make sure you have the right functionalities

Don’t just meet the measures, integrate processes into your workflows

QUESTION:

If I still need help, where can I go?


FREE RESOURCES FOR ASSISTANCE FROM CMS▸

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QPP website: https://qpp.cms.gov/--includes information tailored for the needs of small practices

Contact the Quality Payment Program at: [email protected] or call 1-866-288-8292

Support and Available resources for Small, Underserved, and Rural Practices: https://qualitypaymentprogram.cms.gov/about/small-underserved-rural-practices

Small Underserved Rural Support Technical Assistance Organizations (see list on slide 9)

Contact information is available at: https://qpp.cms.gov/about/small-underserved-rural-practices

Available websites of each Technical Assistance Organization

Types of help: needs assessments, webinars, technical support, links to peers you can talk with, assistance getting signed up to report through an approved channel that meets your practice’s needs

▸ FREE Technical Assistance funded by CMS is also available for larger group practices and for clinicians interested in participating in an Alternative Payment Model. More information on those programs is available at: https://qpp-cm-prod-content.s3.amazonaws.com/uploads/25/TA%20Resource%20Guide%202017%2004%2024_Remediated.pdf


https://qpp.cms.gov/


https://qualitypaymentprogram.cms.gov/about/small-underserved-rural-practices

https://qpp.cms.gov/about/small-underserved-rural-practices

https://qpp-cm-prod-content.s3.amazonaws.com/uploads/25/TA%20Resource%20Guide%202017%2004%2024_Remediated.pdf

FREE RESOURCES FOR ASSISTANCE FROM CMS▸

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2019 Final RuleResource Library2019 Promoting Interoperability Performance Category Fact Sheet2019 Promoting Interoperability Measure Specification2019 PI Information Blocking Factsheet2019 MIPS Data Validation 2019 Promoting Interoperability Performance Category Overview


https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-24170.pdf

https://qpp.cms.gov/about/resource-library

https://qpp-cm-prod-content.s3.amazonaws.com/uploads/487/2019%20MIPS%20Promoting%20Interoperability%20Fact%20Sheet.pdf

https://qpp-cm-prod-content.s3.amazonaws.com/uploads/343/2019%20Promoting%20Interoperability%20Measure%20Specifications.zip

https://qpp-cm-prod-content.s3.amazonaws.com/uploads/282/2019%20PI%20Information%20Blocking%20Fact%20Sheet%20.pdf

https://qpp-cm-prod-content.s3.amazonaws.com/uploads/436/2019%20MIPS%20Data%20Validation%20Criteria.zip

https://qpp-cm-prod-content.s3.amazonaws.com/uploads/522/2019%20PI%20Performance%20Category%20Overview_Slides.pdf

WRAP-UP ACTIVITIES▸

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Links to Q&A documents, transcripts, and recordings of the event are available here: www.qppsurs.comAugust: Maximizing Your Quality Score: Beyond the Basics for Solo and Small Group Practices▸

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Tuesday, August 20, 2019, 3:30 p.m. – 4:30 p.m. ETThursday, August 22, 2019, 11:00 a.m. – 12:00 p.m. ET

Please provide feedback on this event: Feedback Form


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REFERENCESSlide decks created by event panelists also provided information reflected in this presentation. The input from project panelists is gratefully acknowledged.Other documents on the https://qpp.cms.gov/ and https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/Resource-library.html website provide additional detail about the MIPS program.Disclaimer: This presentation was current at the time it was published or uploaded onto the web. Medicare policy changes periodically so links to the source documents have been provided within the document for your reference. This presentation was prepared as a service to the public and is not intended to grant rights or impose obligations. This presentation may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of their contents.


https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/Resource-library.html

APPENDIX: ACRONYMSAPM – Alternative Payment ModelACO – Accountable Care Organization ACI – Advancing Care InformationCERT—Certified EHR TechnologyCMS – Centers for Medicare & Medicaid ServicesMIPS – Merit-based Incentives Payment SystemPCMH— Patient Centered Medical HomePCP— Primary Care ProviderPI— Promoting Interoperability PQRS— Physician Quality Reporting System

IA – Improvement ActivitiesEHR – Electronic Health Records QCDR—Qualified Clinical Data RegistryQPP – Quality Payment ProgramQRDA – Quality Reporting Data ArchitectureQRUR— Quality and Resource Use ReportsSURS - Small Underserved Rural Support TIN—Tax Identification Number


how to succeed in the promoting interoperability …...2019/06/06 · how to succeed in the...

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