Transition from VCSQI to Vizient must be done immediately or your practice will be disenrolled from the TCPI.
Most of you have already either had a transition call with Vizient staff, or have received an email from Debbie stating it is now up to you to arrange transitioning with Vizient. VCSQI must now conclude our work with practices to complete our final contract steps by the end of this month. If you are still interested in transitioning to the Vizient PTN, please contact Shannon Hale at firstname.lastname@example.org .
As of now, those of you that have not arranged transitioning will be noted as “disenrolled” on VCSQI’s report to CMS on December 31stunless we hear from Shannon that you have contacted him.
Thank you for your attention to this matter. Please feel free to email or call me if you have any questions about this process.
Deborah (Nadzam) Melnyk, PhD, RN, FAAN
Project Director, VCSQI SAN 2.0/PTN
Congratulations — 31 Practices Have Now Completed All 5 Phases of TCPI with VCSQI!
- Auburn Optical
- Awais Humayun MD PA
- Cardiovascular Orlando
- Cedar Edge Chiropractic
- Davidson Dermatology
- Dobyns – Amos Medical
- Dr. Gennaro, Vascular Surgery
- Dr. Gump – PA
- Essentials Geriatric Care
- 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
- OPA Medical
- Options Rehab
- Paul K. Wein MD
- Basel Refai, MD – Lake Martin
- Raul Rodriguez, MD PA
- Rocky Mount Eye
- San Antonio Vascular and Endovascular
- Dr. Raymond Schultz
- Sentara (including Mid Atlantic Cardiac Surgery)
- Southern New Mexico Heart and Vascular Clinic
- Dr. Cynthia Thaik
- Surgical Healing Arts
Value Based Payment Models: Bundled Payments as an Alternative Payment Model — Implications of BPCI Advanced
At the December 6 Quarterly VCSQI Meeting held in Richmond, Dr. Jeff Rich provided more background and new information on Value Based Payment Models. Dr. Rich formerly led the Center for Medicare Management, is a past president of the Society of Thoracic Surgeons, and co-founder of the VCSQI. He currently serves as chairman of Operations and Strategy for the Cleveland Clinic and its Miller Family Heart & Vascular Institute. (A recording will soon be available.)
Check Your Final 2018 MIPS Eligibility Status
You can now check the Quality Payment Program (QPP) Participation Status Tool to view your final 2018 eligibility status for the Merit-based Incentive Payment System (MIPS). Your initial 2018 MIPS eligibility status was based on CMS review of Medicare Part B claims and PECOS data from September 1, 2016, to August 31, 2017. Now, CMS has updated your eligibility status based on our second review of Medicare Part B claims and PECOS data, from September 1, 2017, to August 31, 2018.
Your status may have changed, so we encourage you to use the QPP Participation Status Tool to confirm your final 2018 MIPS eligibility. If, after the first review earlier this year, you were determined to be:
- Eligible for MIPS: Your eligibility status might change, and you may no longer be eligible. You should use the tool to make sure you’re still eligible.
- Not eligible for MIPS at a particular practice: Your eligibility status, based on your association with that particular practice, will not change.
Please note, if you joined a new practice (meaning you billed under, or assigned your billing rights to, a new or different TIN) between September 1, 2017, and August 31, 2018, CMS evaluated your MIPS eligibility based on your association with that new practice (identified by TIN) during this second review.
If you joined a new practice after August 31, 2018, you are not eligible for MIPS as an individual based on your association with that new practice (identified by TIN). However, you may be eligible to receive a MIPS payment adjustment based on your group’s participation, if the new practice you joined chooses to participate in MIPS as a group.
Changes to the Low-Volume Threshold in 2018:
Remember, CMS increased the low-volume eligibility thresholds for 2018. Clinicians and groups are now excluded from MIPS if they:
- billed $90,000 or less in Medicare Part B allowed charges for covered professional services during either of the two determination periods (September 1, 2016 – August 31, 2017 or September 1, 2017 – August 31, 2018) OR
- provided covered professional services to 200 or fewer Part B-enrolled patients during either of the two review periods
In order to be eligible for MIPS, an eligible clinician or group must exceed both criteria listed above. For More Information
- Visit the About MIPS Participation page on the Quality Payment Program website
- View the Participating in the Quality Payment Program in 2018 Infographic
To Help You Accelerate Meeting TCPI Milestones and Progressing thru TCPI’s 5 Phases, Links to Previously Recorded VCSQI SAN 2.0 Classes are Below
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
New Quality Payment Program Resources Available in the QPP Resource Library
CMS has posted the following new Merit-based Incentive Payment System (MIPS) resources to the QPP Resource Library:
· 2018 MIPS Cost User Guide: Provides an overview of the MIPS Cost performance category including measures, reporting requirements, and scoring.
· 2018 MIPS Improvement Activities User Guide: Offers an overview of the MIPS Improvement Activities performance category including participation requirements, reporting methods, and scoring.
· 2018 MIPS Specialty Measures Guides for Emergency Medicine Clinicians, Ophthalmologists, Optometrists, Orthopedists, Pathologists, Podiatrists, and Primary Care Providers: Offers an overview of MIPS and provides a non-exhaustive list of measures and activities that may apply to these specialty clinicians.
· 2019 MIPS Quick Start Guide: Provides a high-level overview of who is eligible for MIPS in 2019, and how to participate.
· 2018 CMS Web Interface Sampling Methodology: Outlines the sampling methodology for the 15 clinical quality measures reported via the CMS Web Interface, and provides background information regarding the number of beneficiaries each organization is expected to report on for purposes of the CMS Web Interface and how those beneficiaries are selected.
CMS also posted an updated QP Methodology fact sheet, which provides an overview of how CMS determines who is eligible to be a Qualifying Alternative Payment Model Participant (QP) and Partial QP in the Quality Payment Program.
· Visit the Quality Payment Program Resource Library for more Quality Payment Program resources.
· Go to the Quality Payment Program website to check your participation status, explore measures, and review guidance on MIPS, APMs, what to report, and more.
Now Available: NEW Accredited Online Course
A NEW Quality Payment Program: Merit-based Incentive Payment System (MIPS) Participation in 2018 Web-Based Training Course is available through the MLN LMS.
· Eligible and exempt clinicians
· The difference between individual, group and virtual group reporting
· Data submission mechanisms for 2018
Participants will gain knowledge and insight on the program all while earning valuable continuing education credit. Keep checking back with us for updates on new courses. First time participants will need to register for the MLN Learning Management System. Once registered, you will be able to access additional courses without having to register. For information on how to login or find training, please visit our MLN Learning Management System FAQ sheet.
Extreme and Uncontrollable Circumstances Policy for MIPS Eligible Clinicians Affected by Hurricanes Florence and Michael
CMS understands that if you’re a clinician living or practicing in an area affected by Hurricane Florence and Hurricane Michael, you may experience difficulties collecting and submitting data for the Merit-based Incentive Payment System (MIPS) on time during the 2018 MIPS performance period. Most recently, for those affected by Hurricane Florence, Hurricane Michael, and California Wildfires we’ve tried to lessen your burden by not requiring you to submit an application to reweight the performance categories under MIPS.
CMS Updates Electronic Clinical Quality Measure (eCQM) Resources for the 2019 Performance Period for Eligible Clinicians and Eligible Professionals
The Centers for Medicare & Medicaid Services (CMS) has updated the list of Electronic Clinical Quality Measures (eCQMs) that are fully specified and are available to be used for the 2019 performance period in the Quality Payment Program, which were finalized in the Medicare Physician Fee Schedule (PFS) Final Rule.
Updated list of eCQMs and supporting documents can be found on the eCQI Resource Centerfor the following programs:
· Medicaid Promoting Interoperability Program for Eligible Professionals(formerly known as the Medicaid Electronic Health Record (EHR) Incentive Program)
New and Improved eCQI Resource Center Website
The Centers for Medicare & Medicaid Services (CMS) is excited to share an updated and redesigned Electronic Clinical Quality Improvement (eCQI) Resource Center website. The eCQI Resource Center is a one-stop shop for federal eCQI initiatives that includes the most current electronic clinical quality measure (eCQM) specifications, as well as links to the tools, standards, education, and materials critical to support development, testing, implementation, and reporting of eCQMs.
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.
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