Data Submission Deadline October 15: Your Data through the End of September is Due
Please plan now to collect and send your TCPI Measures Data for July 1 to September 30 to VCSQI by Monday, October 15. Q3 2018 data for your selected TCPI quality metrics is due to Eddie Fonner. Please contact Eddie Fonner, Rick Koss, Ivan Berkel or Sherri White if you have questions about how to submit this data. It is aggregate data (numerators and denominators) for your selected measures, NOT patient-level data.
Very Important 2018 MIPS Note: If you’ve not yet selected and started collecting data for 2018 MIPS reports, please contact Debbie, Ivan, or Eddie for assistance. We’re here to help!
Congratulations to 13 Practices Successfully Completing All 5 Phases of TCPI!
- Cedar Edge Chiropractic
- Davidson Dermatology
- Dobyns – Amos Medical
- Gump – PA
- Havascu Cardiac Surgery
- Heart Care Associates Cardiology, Hopewell, Va.
- Hurwitz and Gessert
- McLeod Chiropractic
- NE Texas Neurology Associates
- Options Rehab
- Paul K. Wein, MD
- Sentara & Mid-Atlantic Cardiac Surgery
To Help You Accelerate Meeting TCPI Milestones and Progressing thru TCPI’s 5 Phases, Here are Previously Recorded 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.
- You can access the recording of the class on Improvement Goals – Milestones 1, 2, 3, and 13 (18) we held on August 17 here.
- You can access the Recording of Staff Engagement – Teamwork & Joy – Milestones 6 and 19 for specialty care and Milestones 6 and 24 for primary care practices held on August 21 here.
- You can access the recording of Identifying Patient Risk and Using Best Practices – Milestones 7 & 11 for Specialty Care, and 8, 9, 10 & 16 for Primary Care held on August 28 here.
- You can access the recording of Streamlining Clinical and Office Work – Milestone 22 for Specialty Care and 27 for Primary Care held on September 4 here.
- You can access the recording of Coordinated Care and Population Management – Milestones 8, 9, 10 for specialty care and 11, 12, 13, 14 for primary care held on September 11 here.
- You can access the recording of Person and Family-Centered Care – Milestones 4, 5, 12, 17 for specialty practices (4, 5, 7, 15 and 22 for primary care) recorded on September 18 here.
- You can access the recording ofBusiness Strategies & APM’s – Milestones 18, 20, 21 for specialty practices & 23, 25, 26 for primary care recorded on Tuesday, September 25 here.
2018 MIPS Participation Information Webinar Recording
CMS May Have Miscalculated Your MIPS Payment Adjustments: 4 Things to Know
CMS recently disclosed it made an error when processing quality scores for physicians participating in the Merit-based Incentive Payment System.
- CMS recently released feedback for physicians included in MIPS during the 2017 performance year. The agency also launched the targeted review process, which allows providers to request a review of their MIPS payment adjustment factors if they believe there is an error with the 2019 MIPS payment adjustment calculation.
- “The requests that we received through targeted review caused CMS to take a closer look at a few prevailing concerns,” CMS said. “Those concerns included the application of the 2017 Advancing Care Information and Extreme and Uncontrollable Circumstances hardship exceptions, the awarding of Improvement Activity credit for successful participation in the Improvement Activities Burden Reduction Study, and the addition of the All-Cause Readmission measure to the MIPS final score.”
- CMS reviewed the concerns and identified “a few errors in the scoring logic and implemented solutions,” the agency said. Correcting the mistakes resulted in changes to the 2017 MIPS final score and associated 2019 MIPS payment adjustment for some clinicians. CMS did not disclose how many physicians were affected or how much providers were overpaid or underpaid as a result of the errors.
- CMS has extended the targeted review deadline from Sept. 30 to Oct. 15 to give physicians more time to access and review their performance feedback.
Date Due Extended: October 15, 2018 is the Deadline for Submitting a MIPS Targeted Review Request
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 reviewif you believe an error has been made in your 2019 MIPS payment adjustment calculation.
View New Quality Payment Program Demo Videos on How to Access 2017 MIPS Performance Feedback and How to Request a Targeted Review
- How to Request a Targeted Review
- How to Access Performance Feedback for APM Entities
- How to Access Performance Feedback for Individuals
- How to Access Performance Feedback for Voluntary Submitters
- How to Access Performance Feedback for Groups
Please note: TIN/NPI information within these demonstration videos conveys mock data only.
- Performance feedback user guide
- Enterprise Identity Data Management (EIDM) User Guide
- Enterprise Identity Data Management (EIDM) ACO User Guide
- Targeted review user guide
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
New MIPS Resources: CMS has posted the following new Merit-based Incentive Payment System (MIPS) resources on CMS.gov:
- 2019 Virtual Groups Toolkit: Includes an overview fact sheet, which details what virtual groups are and how to participate in a virtual group in 2019; an election process fact sheet that describes the process for forming a virtual group; a sample virtual group election submission email; and a virtual group agreement template.
- 2018 Cost Performance Category Fact Sheet(updated): Offers an overview of the Cost performance category including how the cost performance category is weighted and scored.
- 2018 Claims Data Submission Fact Sheet: Providesdetails on how to submit Quality performance category data through claims for the 2018 performance year.
- 2018 MIPS Specialty Measures Guides for Anesthesiologists and Certified Registered Nurse Anesthetists (CRNAs), Cardiologists, and Radiologists: Highlights a non-exhaustive list of measures and activities for the Quality, Cost, Improvement Activities and Promoting Interoperability performance categories that may apply to anesthesiologists and CRNAs, cardiologists, and radiologists in 2018.
- MIPS Data Validation Criteria: Includes an overview fact sheet and the 2018 criteria used to audit and validate data submitted in the Quality, Improvement Activities, and Promoting Interoperability performance categories.
- 2018 Eligible Measure Applicability (EMA) Resources: Provides an overview of the Eligibility Measure Applicability (EMA) process and lists individual quality measures for both registry and claims data submission.
Quality Payment Program: Updated Participation Status Tool Includes 2018 Data Snapshot
CMS updated the Quality Payment Program Participation Status Tool to include 2018 Qualifying Alternative Payment Model (APM) Participant (QP) and Merit-Based Incentive Payment System (MIPS) APM status. The tool is updated based on calculations from Medicare Part B claims with dates of service between January 1 and March 31, 2018.
- QP Methodology Fact Sheet
- MIPS Overview
- APMs Overview
- Enterprise Identity Data Management Account Guide
3 New AMA Accredited Web-Based Training Courses Now Available
Now available on the Medicare Learning Network (MLN) Learning Management System (LMS) are three AMA accredited web-based training programs. All offer continuing education credit through the AMA. You’ll need to log in to the MLN LMS and then search by title to access these new trainings.
- Quality Payment Program Year 2 (2018) OverviewWeb-Based Training Course
- Quality Payment Program Merit-based Incentive Payment System (MIPS): Promoting Interoperability Performance Category Year 2 (2018) Web-Based Training Course
- Quality Payment Program: Merit-based Incentive Payment System (MIPS) Quality Performance Category Year 2 (2018) Web-Based Training Course
APM Guidance Resources
While there are many different definitions of APMs, a payment model must link quality and value to payment to meet AIM 6. The following resources explain and define the criteria associated with APMs:
The first resource is the Health Care Payment Learning and Action Network’s (HCP-LAN’s) APM Framework, a White Paper/framework that provides guidance on the definition and character ofAPMs. In this document, payments have been classified into four discrete categories defined on pages 12-16. Based on the alternative payment model (APM) Framework, only Categories 2-4 should be considered as representing a possible APM that will be acceptable as meeting TCPI AIM 6.
A second resource defines CMS APMs and can be referenced at the Center for Medicare and Medicaid Innovation (CMMI) website: https://innovation.cms.gov/initiatives/index.html#views=models
Please note that these resources are intended only to inform your self-reported determinations related to AIM 6. As this model is reliant on self-reported information when submissions are reviewed, we recommend using the information available from these sources whenever possible.
Working Together We Can Achieve Our Goals