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Cardiovascular Practice Recognition Program Webinar Slides

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Cardiovascular Practice Recognition Program Webinar Slides

  1. 1. Cardiovascular Practice Recognition Program May 14, 2008 Michael Mirro, MD, FACC Janet Wright, MD, FACC
  2. 2. What is the CVRP? <ul><li>Practice-level recognition program designed to identify quality in cardiovascular practice </li></ul><ul><li>Standardize the methodology for how cardiovascular practices are assessed and recognized </li></ul>
  3. 3. Why a CVRP from the ACC? <ul><li>We have a strong history of advocating for quality </li></ul><ul><li>We are recognized as a leader in the development of clinical guidelines, appropriateness criteria, and performance measures </li></ul><ul><li>We are committed to supporting and enhancing professionalism while implementing strategies that promote and foster practice innovation </li></ul>
  4. 4. Who Better than the ACC? <ul><li>We have a responsibility to our members and to the public to characterize quality cardiovascular care and to determine acceptable levels of performance. </li></ul>
  5. 5. How Did the CVRP Evolve? <ul><li>Consumers want to know: </li></ul><ul><li>“ How do I </li></ul><ul><li>choose a quality cardiologist?” </li></ul><ul><li>Payers want to know: </li></ul><ul><li>“ Are the cardiologists </li></ul><ul><li>in our network providing </li></ul><ul><li>quality care?” </li></ul>
  6. 6. Who Did the Work? <ul><li>The PAR 4 Task Force accepted the charge in July 2007 </li></ul><ul><li>A small working group of the PAR 4 , </li></ul><ul><li>including subspecialty society representation, produced multiple iterations for review and feedback from internal and external stakeholders </li></ul>
  7. 7. Underlying Premises: <ul><li>Be clear that the entity of interest is the practice </li></ul><ul><li>The CVRP is not an all or none program; it is a menu of quality indicators from which a practice can choose based on their interests and capabilities </li></ul><ul><li>All practices should have a reasonable ability to participate in year one </li></ul>
  8. 8. Four Domains of Practice Recognition: <ul><li>Commitment to Quality </li></ul><ul><li>Commitment to Professionalism </li></ul><ul><li>Commitment to Lifelong Learning </li></ul><ul><li>Commitment to Patient-Centered Care </li></ul>
  9. 9. Commitment to Quality <ul><li>1. IAC or ACR Diagnostic Imaging Laboratory Accreditation </li></ul><ul><li>2. NCQA Physician Practice Connections Recognition </li></ul><ul><li>3. CMS Physician Quality Reporting Initiative (PQRI) </li></ul><ul><li>4. Participation in ABIM or ABP Maintenance of Certification </li></ul><ul><li>5. PCPI/ACC/AHA Performance Measure Implementation </li></ul><ul><li>6. Active Participation in a Recognized PCI Data Registry </li></ul><ul><li>7. Active Participation in a Recognized ICD Data Registry </li></ul>
  10. 10. Commitment to Professionalism <ul><li>1. Current ABIM Cardiovascular Disease Board Certification or Current ABP Pediatric Cardiology Board Certification </li></ul><ul><li>2. Cardiovascular Subspecialty Board Certification (ABIM): Clinical Cardiac Electrophysiology </li></ul><ul><li>3. Cardiovascular Subspecialty Board Certification (ABIM): Interventional Cardiology </li></ul><ul><li>4. F.A.C.C. or F.A.H.A. Designation </li></ul><ul><li>5. Fellowship in Cardiovascular Subspecialty Designation </li></ul><ul><li>6. Cardiovascular Subspecialty Certification </li></ul>
  11. 11. Commitment to Lifelong Learning <ul><li>1. Documentation of Continuing Medical Education </li></ul><ul><li>2. Participation in Interactive Educational Activities </li></ul>
  12. 12. Commitment to Patient-Centered Care <ul><li>1. HIT: Use of CCHIT approved EMR </li></ul><ul><li>2. Patient Safety: E-Prescribing </li></ul><ul><li>3. Team-Based Care: Heart Failure Management Program </li></ul><ul><li>4. Team-Based Care: Anticoagulation Management Program </li></ul><ul><li>5. Team-Based Care: Device Management Program </li></ul><ul><li>6. Survey of Patient Experience </li></ul>
  13. 13. Criteria and Thresholds <ul><li>Q1. Non-Invasive Diagnostic Imaging Lab Accreditation </li></ul><ul><li>All individuals in practice perform tests and procedures in labs accredited or pending accreditation by IAC or ACR (hospital-based labs excluded) </li></ul>
  14. 14. Criteria and Thresholds <ul><li>Q2. NCQA Physician Practice Connections PPC (2006) </li></ul><ul><li>Active Recognition </li></ul>
  15. 15. Criteria and Thresholds <ul><li>Q3. CMS Physician Quality Reporting Initiative (PQRI) </li></ul><ul><li>Any individuals in practice participate in PQRI between July 2007 and December 2008 </li></ul>
  16. 16. Criteria and Thresholds <ul><li>Q4. Maintenance of Board Certification </li></ul><ul><li>All cardiologists in practice holding time-limited certificates from ABIM and ABP are participating in Maintenance of Certification. </li></ul>
  17. 17. Criteria and Thresholds <ul><li>Q5. PCPI/ACC/AHA Measure Implementation </li></ul><ul><li>Participation NCDR IC 3 and engagement in Data Quality Review for QI </li></ul><ul><li>OR </li></ul><ul><li>Practice submits Cat II codes to health plans per PQRI technical specifications and reporting thresholds for 2008 Measures 5, 6, 7, 8, and 118 </li></ul>
  18. 18. Criteria and Thresholds <ul><li>Q6. Active Participation in PCI Registry </li></ul><ul><li>At least 50% of the PCI cases performed by each individual operator within the practice are reported to a recognized PCI data registry </li></ul>
  19. 19. Criteria and Thresholds <ul><li>Q7. Active Participation in ICD Registry </li></ul><ul><li>At least 50% of the ICD cases performed by each individual operator within the practice are reported to a recognized ICD data registry </li></ul>
  20. 20. Criteria and Thresholds <ul><li>P1. CV Board (ABIM or ABP) Certification </li></ul><ul><li>At least 90% of cardiologists in practice hold current ABIM Cardiovascular Disease Board Certification or ABP Pediatric Cardiology Board Certification. </li></ul>
  21. 21. Criteria and Thresholds <ul><li>P2. CV Subspecialty Board (ABIM) Certification: Electrophysiology </li></ul><ul><li>At least 50% of electrophysiologists in practice hold current ABIM Subspecialty Board Certification in Clinical Cardiac Electrophysiology </li></ul>
  22. 22. Criteria and Thresholds <ul><li>P3. CV Subspecialty Board (ABIM) Certification: Interventional Cardiology </li></ul><ul><li>At least 50%% of interventionalists in practice hold current ABIM Subspecialty Board Certification in Interventional Cardiology </li></ul>
  23. 23. Criteria and Thresholds <ul><li>P4. FACC or FAHA Designation </li></ul><ul><li>At least 80% of cardiologists in practice hold FACC or FAHA designation </li></ul>
  24. 24. Criteria and Thresholds <ul><li>P5. Cardiovascular Subspecialty Designation </li></ul><ul><li>Up to 50% of sub-specialists in practice hold fellowship designation in up to two cardiovascular subspecialty organizations </li></ul>
  25. 25. Criteria and Thresholds <ul><li>P6. Cardiovascular Subspecialty Certification: </li></ul><ul><li>At least 50% of nuclear cardiologists in practice are Diplomates of the Certification Board of Nuclear Cardiology </li></ul>
  26. 26. Criteria and Thresholds <ul><li>P6. Cardiovascular Subspecialty Certification: </li></ul><ul><li>At least 50% of electrophysiologists in practice who do not hold CV Subspecialty Board Certification in Electrophysiology are Certified Cardiac Rhythm Device Specialist (CCDS) </li></ul>
  27. 27. Criteria and Thresholds <ul><li>P6. Cardiovascular Subspecialty Certification: </li></ul><ul><li>At least 50% of cardiologists performing CCT in practice are Diplomates of the Certification Board of Cardiovascular Computed Tomography </li></ul>
  28. 28. Criteria and Thresholds <ul><li>P6. Cardiovascular Subspecialty Certification: </li></ul><ul><li>At least 50% of cardiologists performing echocardiographic services (Trans-thoracic, Stress, Trans-esophageal) in practice are certified by the National Board of Echocardiography </li></ul>
  29. 29. Criteria and Thresholds <ul><li>L1. Documentation of Continuing Medical Education </li></ul><ul><li>At least 80% of cardiologists in practice have documented 100 Category CME hours with at least ½ in CV disease in prior 2 years </li></ul>
  30. 30. Criteria and Thresholds <ul><li>L2. Participation in Interactive Educational Activities </li></ul><ul><li>At least 80% of cardiologists in practice are actively engaged in educational activities that focus on quality improvement, such as the ACCF Learning Portfolio or the HRS e-Learning Platform </li></ul>
  31. 31. Criteria and Thresholds <ul><li>PC1. HIT: Use of CCHIT-approved EMR </li></ul><ul><li>Practice documents use of CCHIT-approved EMR </li></ul>
  32. 32. Criteria and Thresholds <ul><li>PC2. Patient Safety: E-Prescribing </li></ul><ul><li>Practice documents implementation of Medicare Part D e-prescribing standards released by CMS in April 2008. </li></ul>
  33. 33. Criteria and Thresholds <ul><li>PC3. Team-Based Care: Heart Failure Management Program </li></ul><ul><li>PC4. Team-Based Care: Anticoagulation Management Program </li></ul><ul><li>PC5. Team-Based Care: Device Management Program </li></ul>
  34. 34. Team-Based Care work in progress <ul><li>Practice provides a multidisciplinary care process that aims to manage activities across sources and sites of care to ensure that the physician-guided, patient-centered treatment plan is occurring as agreed and adapted as needed. </li></ul><ul><li>Practice measures and reports Program effectiveness at least annually..…. </li></ul><ul><li>(We hope to identify at least three metrics per program for implementation) </li></ul>
  35. 35. Criteria and Thresholds <ul><li>PC6. Survey of Patient Experience </li></ul><ul><li>Practice documents the use of a standardized method for collecting, reviewing, and using patient experience data. </li></ul>
  36. 36. Future Versions of CVRP <ul><li>May add indicators within domains over time </li></ul><ul><li>May move from participation and reporting thresholds to performance thresholds </li></ul><ul><li>May add domains such as “Commitment to Efficiency” or “Commitment to Outcomes” </li></ul>
  37. 37. Next Steps <ul><li>Assign points to each of the criterion within each domain using a Delphi process. </li></ul><ul><li>Each domain will be worth a certain number of points to comprise a total score. </li></ul><ul><li>Practices will need to achieve a certain number of points in order to achieve recognition status. </li></ul>
  38. 38. Next Steps <ul><li>30-day member comment period </li></ul><ul><li>Determine best approach for administration of CVRP </li></ul><ul><li>Get feedback from Health Plans </li></ul><ul><li>Develop a toolkit for practices, including clear instructions and methods for achieving indicators based on practice preference </li></ul>
  39. 39. In Summary… the CVRP <ul><li>Is a practice-level recognition program designed to identify quality in cardiovascular practice </li></ul><ul><li>Standardizes the methodology for how cardiovascular practices are assessed and recognized </li></ul><ul><li>Provides a menu of quality indicators from which a practice can choose based on their interests and capabilities </li></ul>
  40. 40. <ul><li>Questions? </li></ul><ul><li>Comments? </li></ul>

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