MIPS Tips – September (information on SOP codes can be found at the end of this message)

September 25, 2018

The Merit-based Incentive Payment System (MIPS) 2018 reporting year is quickly approaching the last part of the year, and we want to make sure you are staying on track.

If you are new to MIPS in 2018 and want to ensure you receive our MIPS Tips emails, please sign up HERE. If your needs have changed in 2018 and you no longer wish to receive our communications or there are new faces in the office and you want to edit who receives our emails, you can respond directly to this email or reach out to me at ldrennan@quatris.com and I can update our records.

Category Corner

In this section we will focus on a performance category(s) of MIPS.

Did you know that CMS provides data validation tools to help providers and staff understand what they want to see for supporting documentation should you be audited?  They do and it is the Eligible Clinicians responsibility to ensure that they are able to support their attestation for MIPS with such data.

The 2018 MIPS Validation tools can be found by going to the QPP Resource Library and then click on the MIPS Data Validation Criteria dated 9/11/2018.  This will open a zip file that contains validation criteria for the following:

  • 2018 MIPS Data Validation Fact Sheet
  • 2018 Promoting Interoperability Criteria
    • NOTE:  There is criteria for both Promoting Interoperability measures and Promoting Interoperability Transition measures
  • 2018 Improvement Activity Criteria

Program Perks

In this section we will focus on new and important updates from CMS on the Quality Payment Program.

On September 13th, CMS released the following statement via listserv regarding changes that providers are seeing in their payment adjustments for 2017 reporting.

“The requests that we received through targeted review caused us to take a closer look at a few prevailing concerns. Those concerns included the application of the 2017 Advancing Care Information (ACI) and Extreme and Uncontrollable Circumstances hardship exceptions, the awarding of Improvement Activity credit for successful participation in the Improvement Activities (IA) Burden Reduction Study, and the addition of the All-Cause Readmission (ACR) measure to the MIPS final score. Based on these requests, we reviewed the concerns, identified a few errors in the scoring logic, and implemented solutions. The targeted review process worked exactly as intended, as the incoming requests quickly alerted us to these issues and allowed us to take immediate action.

Addressing and correcting for the above elements resulted in changes to the 2017 MIPS final score and associated 2019 MIPS payment adjustment for the clinicians who were impacted by the identified issues. Additionally, in order to ensure that we maintain the budget neutrality that is required by law under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), some clinicians will see slight changes in their payment adjustment as a result of the reapplication of budget neutrality.  These revisions were made to the performance feedback on the Quality Payment Program website on September 13, 2018. We encourage you to sign-in to the Quality Payment Program website as soon as possible to review your performance feedback. If you believe an error still exists with your 2019 MIPS payment adjustment calculation, the targeted review process is available for you.”

The deadline to request a Targeted Review has been extended to October 15th.

Measurement Metrics

In this section we will focus on specific measures and how to improve your scores.

  • CMS165 – Controlling High Blood Pressure
    • This measure is looking for patients that have a diagnosis of essential hypertension as a problem on their active problem list, with a start date before or within the first 6 months of the year, to have their most recent blood pressure to be below 140/90.
      • Tips to document a lower blood pressure reading:
        • Patients are typically nervous at the beginning of their appointment.  Consider taking the blood pressure later in the visit or a second time if the first reading is above 140/90.
        • The type of cuff matters.  Generally, machines that are used to take blood pressure have a higher reading.  If the reading is high with the machine, consider taking the blood pressure manually.
        • If the patient’s blood pressure is high and does not come down during the visit, consider having the patient come back for a blood pressure check in a few weeks.
  • Security Risk Analysis
    • REMINDER:  Don’t forget that a security risk analysis must be completed and dated by December 31, 2018.
    • If you are not sure if you have a compliant Security Risk Analysis, check out the following resource, HealthIT Security Risk Analysis videos.  This site offers 3 short videos that review what must be included in a Security Risk Analysis and a free downloadable tool to complete the analysis.

Toolbox Tactics

In this section we will focus on tips for how to use CQR the Quality Reporting tool to manage and monitor your progress.

  • Are unsigned documents your culprit on achieving a higher score on your quality measures?
    • It is important to remember that many of the quality measure numerator counts are dependent upon observation terms.  Observation terms are not considered “signed” until the document is signed.  If you have several documents in a status of “On Hold” this is affecting your overall numbers!
  • Source of Payment code mapping
    • It is never too early to start on Source of Payment code mapping for attestation.  Source of Payment codes are required for anyone submitting Quality measure data using CQR, whether attesting manually or using the QSS service.    Source of Payment code mapping is done at the Insurance Carrier level for any carrier that was billed during the reporting year.
      • If Source of Payment code mapping is new to you an SOP Code FAQ document has been attached for your review.
    • Quatris has a report package to assist you with this task.  This package, along with a Job Aid, can be found on Podio, HERE.
      • If you have already received this report package, we encourage you to run the reports now and then periodically to insure that all carriers have been mapped.
      • If you do not have the report package loaded and would like for Quatris to load this free package for you, please log a ticket with our PM support team at support@quatris.com.

MIPS Consulting

If you need assistance outside of support or just want the peace of mind that comes from having an expert walk through all aspects of the process with you from capturing the correct data in Centricity workflows through attesting with you, please don’t hesitate to take advantage of this service. Please reach out to mkeller@quatris.com today for more information and pricing.

*Note: If you are a GE Direct support customer, the content of this email may not apply to you and you should work with GE on your processes for support and quality reporting programs.

 GE Attachment – Source of Payment Codes (SOP) 2018 FAQ – Sep 11

MIPS Tips – August

August 22, 2018

The Merit-based Incentive Payment System (MIPS) 2018 reporting year is in full swing, and we want to ensure you are staying on track.

If you are new to MIPS in 2018 and want to ensure you receive our MIPS Tips emails, please sign up HERE. If your needs have changed in 2018 and you no longer wish to receive our communications or there are new faces in the office and you want to edit who receives our emails, you can respond directly to this email or reach out to me at ldrennan@quatris.com and I can update our records.

Category Corner

In this section we will focus on a performance category of MIPS.

The Cost Category is new in 2018, and will be worth 10% of the final score. The cost category will use your Medicare claims data to collect Medicare payment information for the care you provided. With this new category the percentage of the Quality score was reduced to 50%. Improvement Activities stayed 15% and Promoting Interoperability (old ACI) is worth 25%.

The two most common questions we receive are:

  • How is the Cost Category calculated?
    • The 2018 Cost Category Fact Sheet is a great resource to learn more about the Cost Category and how it is scored.  In addition, CMS hosted a webinar explaining this in more detail. The link to the recorded webinar is HERE.
  • Is there any way to predict what the Cost Category score will be for my providers in 2018?
    • Yes, although the Cost Category was not a part of the final score for 2017, CMS did calculate this for the 2017 reporting period and it is included in the 2017 Final Feedback Reports available on the QPP website.  While the 2018 Cost Category score will be determined by 2018 claims, the 2017 Cost Category score is a good tool to get an estimate since the score will be calculated with the same measures and criteria.

Program Perks

In this section we will focus on new and important updates from CMS on the Quality Payment Program.

The Quality Payment Program Exception Application for PY 2018 is open from August 6, 2018 – December 31, 2018.

Please see the details listed below as presented by CMS on the Exception Application process:

If you’re participating in MIPS during the 2018 performance year as an individual, group, or virtual group—or participating in a MIPS Alternative Payment Model (APM)—you can submit a Quality Payment Program Hardship Exception Application for the PI performance category, citing one of the following specified reasons for review and approval:

  • MIPS-eligible clinicians in small practices (new for 2018)
  • MIPS-eligible clinicians using decertified EHR technology (new for 2018)
  • Insufficient Internet connectivity
  • Extreme and uncontrollable circumstances
  • Lack of control over the availability of certified electronic health record technology (CEHRT)

An approved Quality Payment Program Hardship Exception will:

  • Reweight your PI performance category score to 0 percent of the final score
  • Reallocate the 25 percent weighting of the PI performance category to the Quality performance category

Please note that simply not using CEHRT does not qualify you for reweighting of your PI performance category.

Measurement Metrics

In this section we will focus on specific measures and how to improve your scores.

There are several Quality component measures that are looking for specific diagnosis to be on a patient’s Problem list and/or medications to be on the patient’s Medication list to receive credit for the numerator and/or denominator counts in CQR.

The following list is an example of just a few of these (this is not a comprehensive list) :

  • CMS164 – Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet
  • CMS122 – Diabetes: Hemoglobin A1c Poor Control
  • CMS165 – Controlling High Blood Pressure
  • CMS144 – Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

For these measures and the others like them, it is important to review the GE Quality Reporting Guide for the specific measure criteria.  However, a few tips to look for when reviewing the guide:

  • Importance of selecting medications from the Reference List
    • Pay attention if the guide is directing you to a specific data mapping value set (found in the table at the bottom of each measure) for the medications.  This will tell you the medications that count for the measure.
  • Importance of start dates
    • Problems (diagnoses) and Medications require a start date. For Problems, do not use the Approximate check box.

Toolbox Tactics

In this section we will focus on tips for how to use CQR to manage and monitor your progress.

  • Health Information Exchange Exclusion
    • The exclusion of, “Eligible Clinicians who refer fewer than 100 patients.”, is still in place for 2018.
    • Currently in CQR, if a report is calculated for a full calendar year and there are no referrals that have hit the denominator of the measure, the exclusion is being applied.  However, if the report is calculated for any other reporting period (month, quarter or 90-days) the exclusion is not being applied.
      • This issue has been identified and will be corrected in a future CQR Upgrade.
  • Small practice bonus
    • In 2018, CMS is providing a 5-point bonus to the final score for the 2020 MIPS payment year for MIPS eligible clinicians that are designated as being in a small practices.
      • Small practice is defined as having 15 or fewer Eligible Clinicians in the practice.
    • Be sure to apply this 5-point bonus to your score in CQR by taking the following steps:
      • Log into CQR > select the provider > click on the gear setting (upper right-hand corner of the screen) > select the option for 15 or fewer clinicians > click the Standard Weighting > click OK.   If applied correctly, you will see in green, “Small Practice Bonus is Active”, just below your overall score in the upper right-hand corner.

Upgrades

Your practice will want to be on at least CPS 12.0.13 or CEMR 9.8.13 before the start of your PI (old ACI) 90-day performance period in 2018. If you are not currently on that version, please reach out to upgrades@quatris.com so an upgrade coordinator can work with you on an upgrade.

IMPORTANT:  The last 90-day performance period, which begins October 2, 2018 is quickly approaching and if you need an upgrade it must be done no later than October 1, 2018.

In 2018 you can earn a 10% PI (old ACI) bonus if you are on 2015 CEHRT for your 90-day PI (old ACI) performance period and attest using the PI (old ACI) Measures rather than the PI (old ACI) Transition measures. If you are interested in an upgrade to 2015 CEHRT, you can reach out to upgrades@quatris.com to learn more.

MIPS Consulting

If you need assistance outside of support or just want the peace of mind that comes from having an expert walk through all aspects of the process with you from capturing the correct data in Centricity workflows through attesting with you, please don’t hesitate to take advantage of this service. Please reach out to mkeller@quatris.com today for more information and pricing.

*Note: If you are a GE Direct support customer, the content of this email may not apply to you and you should work with GE on your processes for support and quality reporting programs.

 

FREE WEBINAR: PM Report Cleanup (Wednesday, Sept. 12, 11:00-noon CT)

August 20, 2018

Register now!

https://attendee.gotowebinar.com/register/7675620697597621762

For some customers, the Reports window has become an awful mess of folders, custom reports, shortcuts and criteria. This can lead to a lot of confusion on what reports you should be using, which are duplicates and which ones are no longer valid. Quatris will present a webinar on best practices for cleaning up your CPS PM Reports window.

Attention Centricity EMR Customers using Truven

August 16, 2018

August 16, 2018

Dear Centricity EMR Customers,

GE has made us aware that Truven (their partner for supplying patient education) is currently experiencing an outage. They are working to resolve it and we will provide an update when they are back up and running.

Quatris Support
817-282-0300 / support@quatris.com

Attention Centricity EMR Customers using the Qvera Interface Engine

July 30, 2018

July 30, 2018

Dear Centricity EMR Customers,

If your practice uses the Qvera interface engine (QIE), please read the important information provided below or click here.

Java 8 is a software requirement for the QIE version 3.0.45. Please ensure Java 8 is installed on the machine where the QIE services are running.

If running Java 9 or greater then there is an argument that has been deprecated by Java that needs to be removed from the QIE startup arguments. Click here for more information.

If you are a Quatris Hosted customer running QIE, Quatris EMR Support will take care of this for you in the upcoming days.

Quatris Support
817-282-0300 / support@quatris.com

MIPS Tips – July

July 25, 2018

Welcome to the latest installment of MIPS Tips! In this issue we will discuss quality reporting audits, 2018 resources and tools from CMS, GE and Quality, enrollment for QSS, upgrades for 2018 and 2019, share some tools for 2017 feedback reports, and remind you about MIPS Consulting as a valuable resource.

Audits

Inevitably the step that follows attestation is an audit. We always recommend you are preparing for an audit throughout the year rather than waiting for one to happen. The peace-of-mind that comes with having all your items secure in an “attestation binder” is one that only those of you who have been through an audit can appreciate.

While the Quality Reporting Guide offers suggestions on many measures for what to prepare for an audit, Quatris created a Quality Reporting Audit Job Aid on our Podio site (and attached to this email) to assist you (before the fact!) with how to prepare for the eventuality of an audit. Our MIPS Consultants began offering the compilation of an Audit Toolkit as part of their services in 2017 and this service has been a huge hit with MIPS Consulting customers.

2018 Resources and tools

The Quality Payment Program website has been updated with 2018 MIPS Measures and Activities.

The GE Quality Reporting Guide can be found on the new GE Service Cloud site. This guide contains the workflows and requirements for the PI and Quality measures. If you have not yet upgraded to 2015 CEHRT (CPS 12.3 or higher or CEMR 9.12 or higher) you will be using the PI Transition Objectives and Measures in 2018. You will need a GE Service Cloud login to access these resources:

  • CPS CQR resources; CQR release notes, User Manuals, Webinars, and Quality Reporting Guides
  • CEMR CQR resources: CQR release notes, User Manuals, Webinars, and Quality Reporting Guides

Quatris will be hosting a Webinar Wednesday on August 22nd at 11 am CT titled “12.3 and Quality Reporting”. Click HERE to register and receive the documentation and link to the recording.

Quality Submission Services (QSS)

If you are planning on participating in the GE Quality Submission Services (QSS) program for 2018 individual or group reporting for MIPS or CPC+, the enrollment period is now open. QSS is a Service where GE will submit quality data to CMS for enrolled customers on their behalf using the EHR Reporting method. QSS enrollment is also the only way to get Group reporting out of CQR.

  • Links to the recordings and the slides of the GE Enrollment Webinars can be found on the GE Service Cloud (login is required).

Enrolling in QSS provides access to Group reports which will incur fees even if GE does not submit data to CMS. Pricing for QSS for 2018 is as follows:

  • CPC+ = $500 per provider
  • MIPS = $400 per provider

Upgrades

Your practice will need to be on at least CPS 12.0.13 or CEMR 9.8.13 before the start of your PI (old ACI) 90-day performance period in 2018. If you are not currently on that version, please reach out to support@quatris.com so an upgrade coordinator can work with you on an upgrade.

  • IMPORTANT:  The last 90-day performance period, which begins October 2, 2018 is quickly approaching and if you need an upgrade it must be done no later than October 1, 2018.

In 2018 you can earn a 10% PI (old ACI) bonus if you are on 2015 CEHRT for your 90-day PI (old ACI) performance period and attest using the PI (old ACI) Measures rather than the PI (old ACI) Transition measures. If you are interested in an upgrade to 2015 CEHRT, you can reach out to support@quatris.com to learn more.

CMS released the Proposed Rule for Year 3 (2019) on July 12. This Fact Sheet offers an overview of the proposed policies for 2019 and compares to the current year (2018). We expect the Proposed Rule to be finalized later in 2018. The Proposed Rule for Year 3 states that a practice needs to be on 2015 CEHRT prior to their PI (old ACI) reporting period in 2019. If you are reporting a full year in 2019 for PI, that would mean an upgrade to 2015 CEHRT by 1/1/2019. If you are reporting a 90-day PI period in 2019, that would mean an upgrade to 2015 CEHRT prior to that 90 days. 2015 CEHRT is CPS 12.3 or CEMR 9.12.

2017 Performance Feedback/2019 Payment Adjustment

If you participated in the Merit-based Incentive Payment System (MIPS) in 2017, your MIPS final score and performance feedback is now available for review on the Quality Payment Program website. The payment adjustment you will receive in 2019 is based on this final score. A positive, negative, or neutral payment adjustment will be applied to the Medicare paid amount for covered professional services furnished under the Medicare Physician Fee Schedule in 2019. If you believe an error has been made in your 2019 MIPS payment adjustment calculation, you can request a targeted review until October 1, 2018.

MIPS Consulting

If your 2017 results were not what you were hoping for, we are offering MIPS Consulting services again in 2018. If you need assistance outside of support or just want the peace of mind that comes from having an expert walk through all aspects of the process with you from capturing the correct data in Centricity workflows through attesting with you, please don’t hesitate to take advantage of this service. Please reach out to mkeller@quatris.com today for more information and pricing.

*Note: If you are a GE Direct support customer, the content of this email may not apply to you and you should work with GE on your processes for support and quality reporting programs.

http://www.quatris.com/wp-content/uploads/2018/07/Quality-Reporting-Audit-Job-Aid_7.10.18.docx

Quatris Summer Newsletter

June 29, 2018

We invite you to read our summer newsletter. Click here to read about Quatris upcoming webinars and events, product tips and tricks, get to know our employees and much more!