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TCPI Update for August 7: VCSQI Bi-weekly Newsletter

VCSQI to Hold 7 Upcoming Web-based “Classes” to Accelerate Your TCPI Progress Through the 5 Phases

The VCSQI staff are enjoying our time and work with each practice.  In an effort to help each practice successfully meet the TCPI milestones, we will hold a series of seven web-based “classes” over the next several weeks. Each class will address a group of milestones along common themes.  The TCPI Project for primary care clinicians includes 27 milestones and for specialists, 22.  We will repeat each class 3 times during the week to increase the likelihood that practice representatives can attend one of the times. These times were selected based on the results of the poll Sherri sent out to practices on Wednesday, August 1st. Each week we will hold a class on Tuesday at 7 am ET, Tuesday at 7pm ET, and Friday at 10 am ET. We will present identical content, although the discussion may vary depending on participation of participating practices.

You can access the recording of the Quality Improvement class we held on July 11th here

Here is the schedule of the 7 weekly classes, with milestone numbers (primary care milestones in parentheses):

  • Week of August 13th: Improvement Goals – Milestones 1, 2, 3, and 13 (18)
  • Week of August 20th: Staff Engagement – Teamwork and Joy – Milestones 6, 19 (24)
  • Week of August 27th: Identifying Patient Risk and Using Best Practices – Milestones 7, 11
  • Week of September 3rd: Streamlining Clinical and Office Work – Milestones 22 (27)
  • Week of September 17th: Coordinated Care and Population Management – Milestones 8 (11), 9 (12), and 10 (8, 9, 10, 13, 14)
  • Week of September 10th: Person and Family-Centered Care – Milestones 4, 5, 12, and 17
  • Week of September 24th: Business Strategies – Milestones 18, 20, 21

Ivan and Sherri will be talking with you about which milestone class may be of particular relevance to your practice (based on your recent milestone scores).

VCSQI Webinar:  3 Milestones Related to Quality Improvement

Recording of Class on 3 Milestones Related to Quality Improvement:  VCSQI July 26 Webinar 

Debbie, Ivan and Sherri shared tools and strategies, answer questions, and offer suggestions in this recent Webinar.  This webinar covered:

  • #14 (19 on primary care) – Practice uses an organized approach (e.g. use of PDSAs, Model for Improvement, Lean, FMEA, Six Sigma) to identify and act on improvement opportunities.
  • #15 (20 on primary care) – Practice builds QI capability in the practice and empowers staff to innovate and improve.
  • #16 (21 on primary care) – Practice regularly produces and shares reports on performance at both the organization and provider/care team level, including progress over time and how performance compares to goals. Practice has a system in place to assure follow up action where appropriate.
View webinar here

 

Resources Referenced in the 3 Milestones Webinar

 

 MIPS 2019 Proposed Rule

For MIPS in 2019, cost goes up to 15% of the final score.  There are also some scenarios for low-volume practices to opt in to MIPS if they want to (but they cannot withdraw after they make this election).  Minimum score is 30/100 to avoid a negative adjustment, with a payment swing of +/- 7%.

Below are slides on the MIPS 2019 proposed rule.

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Overview-of-Proposed-Rule-for-Year-3-2019-slides.pdf

 

Physician Fee Schedule Proposed Rule: Understanding 3 Key Topics Listening Session – August 22, 1:30-3 pm

Register here

Proposed changes to the CY 2019 Physician Fee Schedule would increase the amount of time doctors and other clinicians spend with their patients by reducing the burden of Medicare paperwork.  We encourage you to review the proposed rule prior to the call, as well as the following materials on the provisions to be covered:

 

Review Your MIPS 2017 Scores

Some incorrect scores have been noted by our participating practices and CMS has advised us that this is a known issue that is in the process of being corrected. If not resolved to your satisfaction, you should request a “Targeted Review” to correct your data scores.

  

The Deadline for Submitting a MIPS Targeted Review Request Is Now October 1, 2018

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. MIPS eligible clinicians or groups (along with their designated support staff or authorized third-party intermediary), including those who are subject to the APM scoring standard may request for CMS to review their performance feedback and final score through a targeted review.

When to Request a Targeted Review:  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.  For more information about how to request a targeted review, please refer to the Targeted Review of the 2019 Merit-based Incentive Payment System Payment Adjustment Fact Sheetand the Targeted Review of 2019 MIPS Payment Adjustment User Guide.

 

CMS to Offer Targeted Review Q&A Sessions- Sign Up Below
  • Tuesday, August 14, 2 – 3 pm ET
  • Register Here

View New Quality Payment Program Demo Videos on How to Access 2017 MIPS Performance Feedback and How to Request a Targeted Review

  1. How to Request a Targeted Review
  2. How to Access Performance Feedback for APM Entities
  3. How to Access Performance Feedback for Individuals
  4. How to Access Performance Feedback for Voluntary Submitters
  5. How to Access Performance Feedback for Groups

Please note: TIN/NPI information within these demonstration videos conveys mock data only.

Additional Resources:

 

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 end of year 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

 

Note of Interest:  TCPI is designated an APM under the Quality Payment Program

Participation in TCPI can only result in a higher overall MIPS score; it will never result in a lower score.  It is not considered an Advanced APM, nor a MIPS APM. This APM designation only provides partial scoring credit toward the MIPS Improvement Activities performance category for those MIPS eligible clinicians participating in TCPI. This assignment rewards MIPS eligible clinicians for implementing clinical practice improvement by participating in the model. Participation in TCPI does not exempt participants from MIPS, nor does it modify reporting requirements under MIPS. It also does not change the scoring requirements, as participants are scored in the same manner as other MIPS eligible clinicians. Rather, the only impact is that participating MIPS eligible clinicians automatically receive at least partial credit in the Improvement Activities performance category.

 

Quote to Ponder:

“Challenges are what make life interesting. Overcoming them is what makes life meaningful.” – Joshua Marine

 

Visit the VCSQI website and see more resources and information in the sidebar of tabs on the right. 

 

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