HAVE YOU SCHEDULED YOUR TRANSITION CALL WITH VIZIENT YET?
VCSQI Practices Encouraged to Continue in TCPI & Transition to Vizient Practice Transformation Network
If you intend to transition to the Vizient PTN (and we hope you do), you must have a transition call with VCSQI and Vizient staff. These calls are only 30” in length and will review your practice’s TCPI status with Vizient to assure a smooth transition for your continuing participation in the national project through next September. This is a continuationof your work; you are not starting over. Even if you have completed all 5 phases working with VCSQI, we encourage you to transition to Vizient for continued support in participating in the Quality Payment Program (MIPS guidance), to be recognized by CMS at the end of the project, and to have access to quality improvement coaching from the Vizient experts.
If you have not already done so, please select a time from either of the following Doodle scheduling links:
November dates: https://doodle.com/poll/sqm3x4mf3ucubhws
December dates: https://doodle.com/poll/f9hiz5q2yykui4x7
To learn more about Vizient, please listen to this recording here of the November 1 recording of a presentation by Vizient.
Webinar Monday: Physician Medicare Fee Schedule Final Rule — Understanding 3 Key Topics — November 19, 2 – 3:30 pm ET Register here.
The CY 2019 Physician Fee Schedule final rule is estimated to increase the amount of time doctors and other clinicians spend with their patients by reducing the burden of Medicare paperwork. During this call, CMS experts briefly cover three provisions and address your questions:
- Streamlining Evaluation and Management (E/M) payment and reducing clinician burden
- Advancing virtual care
- Continuing to improve the Quality Payment Program to reduce burden and offer flexibilities to help clinicians successfully participate
We encourage you to review the final rule prior to the call and the following materials:
- Physician Fee Schedule: Press release, fact sheet, and E/M payment chart
- Quality Payment Program: Year 3 overview fact sheet and quick start guide for MIPS 2019 participation
VCSQI Reports Success of TCPI Participating Practices Progress through September 2018:
- 83 total practices (74 specialty and 9 primary care)
- 402 enrolled clinicians (323 specialist and 79 primary care)
Calculated from practices’ submitted quality data showed:
- 11,378 patients with improvements in process measures or health outcomes
- 34 avoided hospitalizations and 101 blood transfusions saved
- $1.6 Million in total cost savings
To Help You Accelerate Meeting TCPI Milestones and Progressing thru TCPI’s 5 Phases, Here are Previously Recorded VCSQI SAN 2.0 Classes
Each class addresses a group of milestones along common themes. The TCPI Project for primary care clinicians includes 27 milestones and for specialists, 22.
- Business Strategies: https://youtu.be/GLFZLVZRLYY
- Person and Family Centered Care: https://youtu.be/idhoQlRGJCc
- Coordinated Care & Population Management: https://youtu.be/X9wvuXtYR8o
- Streamlining Clinical & Office Work: https://youtu.be/g3FlXYUUTio
- Identifying Patient Risk and Using Best Practices: https://youtu.be/MVN9j5sKZs0
- Teamwork and Joy in Your Practice: https://youtu.be/DyW-vUs1L2g
- Setting Quality Improvement Goals: https://youtu.be/YcN5DJn2iVA
- Quality Improvement Processes & Data Capture/Analysis Best Practices: https://youtu.be/qypME-TaDM4
Congratulations Again to 19 Practices Completing 5 Phases of TCPI with VCSQI!
- Awais Humayun MD PA
- Cedar Edge Chiropractic
- Davidson Dermatology
- Dobyns – Amos Medical
- Dr. Gump – PA
- First Coastal Surgical Associates
- Grigor M. Harutunian MD Inc.
- Havasu Cardiac Surgery
- Heart Care Associates Cardiology (Hopewell)
- Hopedale Cardiology
- Hurwitz and Gessert
- Knoxville Comprehensive Breast Center
- Laurel Kidney
- McLeod Chiropractic
- NE Texas Neurology Associates
- Options Rehab
- Paul K. Wein MD
- Sentara (including Mid Atlantic Cardiac Surgery)
- Southern New Mexico Heart and Vascular Clinic
QPP Participation Status Tool Now Includes Second Snapshot of 2018 Qualifying APM Participant and MIPS APMs Data
The Centers for Medicare & Medicaid Services (CMS) updated its Quality Payment Program Participation Status Tool based on calculations from the second snapshot of Medicare Part B claims data to calculate the Alternative Payment Model (APM) entities threshold scores. The second snapshot are for dates of participation between January 1 and June 30, 2018. As a reminder, the tool includes 2018 Qualifying APM Participant (QP) and MIPS APM status.
By the end of this year, CMS will release the third QP and MIPS APM status data based on snapshots of claims between January 1, 2018 and August 31, 2018. To learn more about how CMS determines QP and MIPS APM status for each snapshot, please view the QP Methodology Fact Sheet.
The Quality Payment Program Resource Library is Back on QPP.CMS.GOV
The Centers for Medicare & Medicaid Services (CMS) has moved Quality Payment Program (QPP) resources from CMS.gov to the newly redesigned Quality Payment Program Resource Library on qpp.cms.gov. Following feedback from clinicians and others in the health care community, we wanted to make Quality Payment Program information and resources available in one place. We’ve also made it easier for you to find the resources you’re looking for by including a search function that allows you to search for resources by year, reporting track, performance category, and by document type (e.g., fact sheet, user guide, measure specifications).
- Go to the Quality Payment Program Resource Library to review Quality Payment Program resources.
- Visit the Quality Payment Program website to check your participation status, explore measures, and to review guidance on MIPS, APMs, what to report, and more.
2018 MIPS Participation Information Webinar: In case you missed the recording held in April, here is a link for more information for a better understanding of MIPS for 2018 – Click Here.
Prepare for 2018 MIPS Data Submission by Obtaining Your Enterprise Identification Management (EIDM) Credentials Now
The 2018 performance year for the Merit-based Incentive Payment System (MIPS) ends on December 31, 2018. To access the Quality Payment Program Portal and submit your 2018 performance data, you’ll need your EIDM User ID and Password. If you do not have an EIDM account, navigate to the CMS Enterprise Portal and select ‘New User Registration’ to create one. The following information is required for registration:
- Application Name
- Application Role
- Organization Legal Business Name, Address, and Phone Number
- Taxpayer Identification Number (TIN) and corresponding individual Provider Transaction Access Number (PTAN)
Once you complete your EIDM account registration, you will receive an e-mail acknowledging your successful account creation with your EIDM User ID. Use your unique EIDM User ID and Password to login to the Quality Payment Program Portal. CMS encourages you to create an EIDM account or verify your EIDM credentials now to prepare for your 2018 MIPS data submission.
MIPS Eligible Clinicians Submitting Quality Data via Claims Can Now View Performance Feedback for 2018
CMS has updated the Quality Payment Program website so individual eligible clinicians who choose to submit their Quality performance category data via claims can access performance feedback for the 2018 performance year on an ongoing basis. If you are participating in MIPS as an individual clinician and you have chosen to use claims to submit Quality performance category data, you attach quality data codes (G-codes) to your claims throughout the 2018 performance year. Those who have been doing so can now login to the Quality Payment Program website and review their performance feedback, which will be updated on a monthly basis.
Submitting Quality Performance Data via Claims
When you submit your quality data to CMS through your claims, they’ll be processed to final action by the Medicare Administrative Contractor (MAC). The last day for submitting 2018 claims with quality data codes for the 2018 performance period is determined by your MAC, but data must be submitted on claims with dates of service during the performance period and must be processed no later than 60 days after the close of the performance period. Please check with your MAC for this guidance.
As a reminder: claims-based quality measures are calculated automatically by CMS based on the quality data codes submitted on your 2018 claims. Claims data submission is only an option for Year 2 (2018) if you’re participating in MIPS as an individual (not as part of a group).
For more information about submitting your Quality performance category data via claims, review the 2018 Claims data submission fact sheet.
New QPP CME Modules, Infographics, and Scoring Guide Now Available
CMS has posted three new continuing medical education (CME) modules on the Merit-based Incentive Payment System (MIPS) performance categories and MIPS Alternative Payment Models (APMs). You can access them by logging into your Medicare Learning Network account or creating one here. The new CME modules include:
- 2018 Improvement Activities Performance Category CME Module: Covers the basics of the MIPS Improvement Activities performance category including reporting requirements, scoring, and flexibilities for small and rural practices.
- 2018 Cost Performance Category CME Module: Offers an overview of the MIPS Cost performance category and how CMS calculates Cost scores.
- 2018 MIPS APM CME Module: Provides an overview of MIPS APMs, the APM scoring standard, and reporting requirements for MIPS APM participants.
Additional Quality Payment Program Resources
CMS has also posted the following new resources:
- 2018 Quality Payment Program Participation Infographic: Explains how eligible clinicians can participate in the Quality Payment Program for the 2018 performance year.
- 2018 MIPS Data Submission Infographic: Reviews how MIPS eligible clinicians can submit data for the 2018 performance year.
- 2018 MIPS Scoring 101 Guide: Provides a detailed overview of how each MIPS performance category is scored, how CMS calculates bonus points, and how the payment adjustment is calculated based on the MIPS final score.
- Improvement Activities Performance Category Fact Sheet
- 2018 Cost Performance Category Fact Sheet
- 2018 Other MIPS APM Quality Performance Category
- Scores for Improvement Activities in MIPS APMs in the 2018 Performance Period
- MIPS Participation & Overview Fact Sheet
Requests for Small Practice Hardship Exclusion from Promoting Interoperability Category
Small practices can request a hardship exclusion from the Promoting Interoperability category. Request is due by the end of December, but you should apply sooner to be safe! Your percent for the Promoting Interoperability Category gets moved to the Quality Category. Here is the link to learn more and apply: https://qpp.cms.gov/about/small-underserved-rural-practices
Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2019
On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2019.
The calendar year (CY) 2019 PFS final rule is one of several final rules that reflect a broader Administration-wide strategy to create a healthcare system that results in better accessibility, quality, affordability, empowerment, and innovation.
For More Information:
The 2019 CMS QRDA III Implementation Guide, Schematron, and Sample Files Are Now Available
The Centers for Medicare & Medicaid Services (CMS) has published the 2019 CMS Quality Reporting Document Architecture (QRDA) Category III Implementation Guide (IG), Schematron, and Sample files. The 2019 CMS QRDA III IG will help eligible clinicians and eligible professionals report electronic clinical quality measures (eCQMs), improvement activities, and/or promoting interoperability measures for the calendar year 2019 performance period.
The IG provides technical instructions for QRDA III reporting for the following programs:
- Quality Payment Program: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs)
- Comprehensive Primary Care Plus (CPC+)
- Promoting Interoperability (PI)
Additional QRDA-Related Resources:
- You can find additional QRDA related resources, as well as current and past IGs, on the Electronic Clinical Quality Improvement Resource Center.
- For questions related to the QRDA IGs and/or Schematrons, visit the ONC QRDA JIRA Issue Tracker.
Working Together We Can Achieve Our Goals