how to transform your practice workflow to …...2019/10/10 · quality payment program small...
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QUALITY PAYMENT PROGRAM SMALL UNDERSERVED RURAL SUPPORT (QPP SURS) WEBINAROCTOBER 15, 3:30 PM ET AND OCTOBER 17, 11:00 AM ET
HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS: ADVICE FOR SOLO AND SMALL GROUP PRACTICES
HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
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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HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
POLLING QUESTIONWhat is your role?▸
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A clinician working in a practice with 15 or fewer cliniciansNon clinical staff from a practice with 15 or fewer cliniciansA clinician working in a practice with more than 15 cliniciansNon clinical staff in a practice with more than 15 cliniciansQuality Payment Program (QPP) contractorOther person helping practices prepare for MIPSOther
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HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
POLLING QUESTIONHow would you describe your practice’s progress with MIPS participation? ▸
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We’re totally prepared and feel confident we will receive a good MIPS score
We are mostly prepared, but not expecting a high score
We are going to accept the penalty
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HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
POLLING QUESTIONWhat are your biggest expected challenges or concerns with receiving a high MIPS score?
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HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
CMS WELCOME
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Kathleen Johnson RN, BS
Health Insurance Specialist
Centers for Medicare and Medicaid Services (CMS)
Quality Improvement and Innovation Group (QIIG)
Division of ESRD, Population and Community Health (DEPCH)
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Courtnay Ryan, Sr. QI Facilitator, Telligen QIN-QIO
Bruce Spurlock, MDPresident & CEO,Cynosure Health
Bruce Maki, MA Regulatory Analyst and Project Manager
Michael Sacca, Managing Director, IMPAQ Health
Division, QPP SURS Central Support
HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
SETTING THE STAGE▸
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Focus: Understanding how to improve your MIPS score using care coordination techniques, EHR functionalities, collaborating with partners, and engaging your staff.
Strategy: A roundtable event where panelists share their insights and challenges related to succeeding in MIPS.
Topic Overview:
How workflow changes can help small practices What workflow changes can improve scores all of the Performance CategoriesEffectively engage with staffStrategies for improving workflow changes
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
Find your local technical assistance contractor here: https://qpp.cms.gov/about/small-underserved-rural-practices
PANELIST INTRODUCTIONS
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Introductions
Experience with Practice Workflow and Transformation
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PANELIST INTRODUCTIONS
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Bruce Maki, MA Regulatory Analyst and Project Manager
PANELIST INTRODUCTIONS
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Courtnay Ryan, Sr. QI Facilitator, Telligen QIN-QIO
PANELIST INTRODUCTIONS13HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
Bruce Spurlock, MDPresident & CEO,Cynosure Health
QUESTION:
How can workflow changes help small practices better serve their patients and earn higher MIPS scores?
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HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
BENEFITS OF IMPROVED WORKFLOW
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Alleviate clinician burden
Facilitate communication and staff engagement
Help when choosing the right quality measures for your practice
Improved care coordination
Improved patient education
Identify practice improvement areas
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QUESTION:
Why is healthcare moving away from rewarding me for what I do in the office?
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HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
CHANGES IN HEALTHCARE▸
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Patients don't always come into the office and there is strong evidence that effectively managing chronic diseases requires regular interactions
Healthcare is becoming more complex and it requires more sophisticated systems, like population health and HIT, to manage effectively
We know patients are falling through the cracks and better coordination outside of the office with other practitioners is crucial
The old system of peer review is not as effective at improving quality as the newer improvement activities and systems
Waste in the health system might be as high as 25% and we know how to reduce costs without harming patients
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QUESTION:
What workflow changes can improve our scores in the Quality Performance and Cost Categories?
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HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
QUALITY MEASURES—BASICS▸
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45% of your final MIPS score
Select 6 measures
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1 outcome OR
High Priority
Small practice bonus of 6 points, if you submit data on 1 quality measure
2019 Quality Measures
2019 Cross Cutting Quality Measures
2019 Clinical Quality Measure Specifications and Support Documents
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QUALITY MEASURES▸
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Identify potential issues by taking a deep dive into your data
Schedule time to review your data regularly
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Review data for possible configuration issues
Work through the calculations to ensure your EHR is calculating the measure correctly
Train staff on EHR use and functionalities
▸Ensure staff are using the data fields correctly
Set up clinical support around your measures
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QUALITY MEASURES▸
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Set time aside to review the measures with the team
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Discuss the goals of each measure
Plan out processes to meet these goals
Create a team environment
▸Appoint Quality Measure Champions who are responsible for certain measures, including:
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Documenting
Reporting
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COST—THE BASICS▸
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No reporting requirements
Based on 12 month performance period
Measures (10 total)
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Medicare Spending Per Beneficiary (MSPB)
Total Per Capita Cost
Episode- Based Measures:
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COST▸
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Align processes that could have an impact on other performance categories such as:
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Care coordination (Improvement Activities)
Referral loops (Promoting Interoperability)
Set up regular meetings to review HCC codes
Review your care coordination policies
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Do you have any policies?
Standardize your care coordination processes
Closely examine top 25 attributed patients to see where your costs are going
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COST▸Standardize entire process that goes into a patient appointment
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Before they arrive
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Gather information on previous clinicians
Understand their health story
During their visit
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When they leave
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Follow up with the patient
Follow up with specialists
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QUESTION:
What workflow changes can help us improve our scores in the Improvement Activities and Promoting Interoperability Performance Categories?
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HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
IMPROVEMENT ACTIVITIES—THE BASICS▸
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90 day continuous performance period
Small practice requirements:
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1 high-weighted OR
2 medium-weight activities
Over 115 activities divided into the following sub-categories
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2019 Improvement Activity Inventory
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Set aside time to review what activities you are already doing
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Document processes for each activity
Strategize to align activities with what you are already doing—make it easier to meet requirements!
▸Standardize these process
Engage patients through portal
Streamline as much as you can:
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Link your activities to your practice goals
Align with quality measures
IMPROVEMENT ACTIVITIES
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90 day continuous performance period
Must use 2015 Edition Certified EHR Technology (CEHRT)
▸Four main objectives:
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E-Prescribing
Health Information Exchange
Provider to Patient Exchange
Public Health and Clinical Data Exchange
PROMOTING INTEROPERABILITY—THE BASICS
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PROMOTING INTEROPERABILITY
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HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
PROMOTING INTEROPERABILITY
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Align resources with Health Information Exchange (HIE)
Make connections with local health systems
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Share addresses with providers
Stay engaged with larger community
QUESTION:
What are some strategies I can use to effectively engage with staff and other clinicians?
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HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
STRATEGIES TO ENGAGE WITH STAFF
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Make regularly meetings a priority
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Standardize the agenda items for each meeting
Create and follow up on action items
Appoint a lead for specific action items
Educate and train staff of MIPS goals and why it’s important
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Educate staff on MIPS requirements
Appoint a champion for each of the performance areas
Regularly share and post scores in a common area like a break room
HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
STRATEGIES TO ENGAGE WITH STAFF
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Medicine is increasingly a team sport, both in the office, the hospital, other care locations and in the community
▸Your life is easier and care is better if you engage them all
Data tells you what to do, stories tell you why
▸Develop regular storytelling about your patients
Work upstream to solve problems before they come to you
Celebrate the little and big victories
▸And continually be dissatisfied with the status quo
QUESTION:
Can you offer any strategies for improving workflow in small practices?
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HOW TO TRANSFORM YOUR PRACTICE WORKFLOW TO SUCCEED IN MIPS
OTHER STRATEGIES TO IMPROVE WORKFLOW
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You can’t focus on quality too much
Standardize as many processes as you can
Regular communication with your team is essential
Review data regularly…not a one a done
QUESTION:
If I still need help, where can I go?
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FREE RESOURCES FOR ASSISTANCE FROM CMS▸
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QPP website: https://qpp.cms.gov/--includes information tailored for the needs of small practicesContact the Quality Payment Program at: [email protected] or call 1-866-288-8292Support and Available resources for Small, Underserved, and Rural Practices: https://qualitypaymentprogram.cms.gov/about/small-underserved-rural-practicesSmall Underserved Rural Support Technical Assistance Organizations (see list on slide 9)
Contact information is available at: https://qpp.cms.gov/about/small-underserved-rural-practicesAvailable websites of each Technical Assistance OrganizationTypes 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
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Resource Library2019 MIPS Participation and Eligibility Fact Sheet
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FREE RESOURCES FOR ASSISTANCE FROM CMS▸
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QPP Participation Status Tool
2019 MIPS Quality User Guide
2019 Quality Performance Category Fact Sheet
2019 MIPS Cost User Guide
2019 Cost Performance Category Fact Sheet
2019 Improvement Activities Performance Category Fact Sheet
2019 Improvement Activities Inventory
2019 Promoting Interoperability Performance Category Fact Sheet
2019 MIPS Promoting Interoperability User Guide
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WRAP-UP ACTIVITIES▸
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Links to Q&A documents, transcripts, and recordings of the event are available here: www.qppsurs.com
Implications of the Year 4 Final Rule for Solo and Small Group Practices
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.
Comagine Readiness Checklists, To Join or Join ACO
Alternative Payment Models and Risk Readiness; An In-Depth Analysis of the CMS “Pathways to Succes” Final Rule, HealthPOINTCompass PTN TCPI Learning Community, Don Klitgaard, MD, FAAFP
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.
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APPENDIX: ACRONYMSAPM – Alternative Payment ModelACO – Accountable Care Organization CERT—Certified EHR TechnologyCMS – Centers for Medicare & Medicaid ServicesFFS- Fee for ServiceMIPS – Merit-based Incentives Payment SystemPCMH— Patient Centered Medical HomePCP— Primary Care ProviderPI— Promoting Interoperability PFS-Physician Fee ScheduleIA – 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 NumberQI-Quality ImprovementQP- Qualifying APM ParticipantVBP- Value-Based Purchasing
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