This document provides an overview of electronic clinical quality measures (eCQMs) and the transition from manual chart abstraction to electronic reporting of quality measures. It discusses upcoming requirements for eCQM reporting to CMS programs like IQR and the vision for a unified set of electronically specified measures. The document reviews the eCQM reporting process including planning, testing, validation and submission. Challenges and opportunities of eCQM reporting are also addressed.
This presentation walks through the transition from chart abstracted quality reporting to electronic quality reporting for the CMS and The Joint Commission
New clinical quality measure reporting in Practice Fusion [slides]Practice Fusion
Learn about the new data elements, which quality measures they can be used for, and information on reporting quality measures using Practice Fusion for Meaningful Use, PQRS EHR Reporting, and other quality improvement programs.
Measuring & Monitoring Clinical Quality Measures Using Practice FusionPractice Fusion
Review CMS quality measures, how to capture the data in Practice Fusion, and how this data can be used to earn incentive payments through quality reporting programs, including Meaningful Use and PQRS.
Understanding the Physician Quality Reporting System (PQRS) Requirements in 2014Practice Fusion
This webinar, Understanding the Physician Quality Reporting System (PQRS) Requirements in 2014, goes over which reporting options are available, what the incentives and penalties are for participating, reporting requirements, and how to choose quality measure for reporting.
Clinical Quality Measures: Measuring and monitoring clinical quality measures...Practice Fusion
Learn about:
1. CMS quality measures.
2. How to capture the data in Practice Fusion.
3. How this data can be used to earn incentive payments through quality reporting programs, including Meaningful Use and PQRS.
This slide deck provides a detailed overview of the PQRS program, including helpful information on how to report for PQRS using the claims-based reporting method. Learn how to report Quality Data Codes for PQRS on Medicare claims and avoid penalties!
Using Practice Fusion for PQRS EHR Reporting in 2014Practice Fusion
This presentation is an overview of PQRS requirements in 2014, requirements for PQRS EHR reporting, and measure selection and EHR reporting applicability. The presentation will also give a deep dive into using Practice Fusion for PQRS reporting.
This presentation walks through the transition from chart abstracted quality reporting to electronic quality reporting for the CMS and The Joint Commission
New clinical quality measure reporting in Practice Fusion [slides]Practice Fusion
Learn about the new data elements, which quality measures they can be used for, and information on reporting quality measures using Practice Fusion for Meaningful Use, PQRS EHR Reporting, and other quality improvement programs.
Measuring & Monitoring Clinical Quality Measures Using Practice FusionPractice Fusion
Review CMS quality measures, how to capture the data in Practice Fusion, and how this data can be used to earn incentive payments through quality reporting programs, including Meaningful Use and PQRS.
Understanding the Physician Quality Reporting System (PQRS) Requirements in 2014Practice Fusion
This webinar, Understanding the Physician Quality Reporting System (PQRS) Requirements in 2014, goes over which reporting options are available, what the incentives and penalties are for participating, reporting requirements, and how to choose quality measure for reporting.
Clinical Quality Measures: Measuring and monitoring clinical quality measures...Practice Fusion
Learn about:
1. CMS quality measures.
2. How to capture the data in Practice Fusion.
3. How this data can be used to earn incentive payments through quality reporting programs, including Meaningful Use and PQRS.
This slide deck provides a detailed overview of the PQRS program, including helpful information on how to report for PQRS using the claims-based reporting method. Learn how to report Quality Data Codes for PQRS on Medicare claims and avoid penalties!
Using Practice Fusion for PQRS EHR Reporting in 2014Practice Fusion
This presentation is an overview of PQRS requirements in 2014, requirements for PQRS EHR reporting, and measure selection and EHR reporting applicability. The presentation will also give a deep dive into using Practice Fusion for PQRS reporting.
The Alphabet Soup of Clinical Quality Measures ReportingBill Presley
CMS is transitioning to what the they call "a new and more responsive regulatory framework" for quality reporting and reimbursement. CMS goals are "…electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people". Over the next couple years, we will see a transformation of fee for service into value-based care models driven by the VBP, Quality Payment Program, MACRA, Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APM). Healthcare organizations will no longer be motivated by implementing and meeting Meaningful Use, but instead will be driven by value-based care and risk-based payment models that focus on quality outcomes for reimbursements.
In this Education Session we will review:
• How CMS is aligning clinical quality measures (CQMs) to reduce the reporting burden for healthcare organizations and providers. We will cover the vision and goals for achieving quality alignment for CMS.
• We will dive into the following CMS reporting programs and how they interact with each other: Value-Based Purchasing (VBP), Medicare Access and CHIP Reauthorization Act (MACRA), Merit-based Incentive Payments (MIPS), Hospital Inpatient Quality Reporting (IQR), The Joint Commission (ORYX), Outpatient Quality Reporting (OQR), and Alternative Payment Models (APM).
Meaningful Use Stage 2 Summary of Care Data Exchange with Practice FusionPractice Fusion
Stage 2 of Meaningful Use requires that providers complete three Summary of Care measures related to sending referrals. Practice Fusion has enabled providers to complete these measures through our new referral workflows.
To learn about how these referral workflows work (including Direct messaging) and how these workflows relate to Meaningful Use, review the slideshow. This detailed guide will walk you through understanding Direct and how to enable it, the variety of ways to send a referral in Practice Fusion, and how to achieve the related Meaningful Use measures.
Riding the Rapids of Payment Reform: Downstream Effects of Quality Reporting ...Bill Presley
In this presentation, we highlighted how quality measurement programs impact reimbursement affecting your revenue. The revenue at risk in your organization. We focused on quality programs like Value-Based Purchasing (VBP), Merit-Based Incentive Program (MIPS) and Alternative Payment Models (APM) and their impact on Part A and Part B reimbursements.
It’s no surprise that reimbursement tied to quality performance is quickly becoming a reality for hospitals and physicians. CMS’ aggressive goals aimed at increasing the percentage of Medicare payments associated with quality versus quantity can be achieved through such programs as Value-based Purchasing and MACRA. This session will cover scoring methodologies, reporting requirements, reimbursement impact, infrastructure (and other resource needs), EMR tools and tactics, and workflow modifications.
Revenue at Risk: Understanding Financial Impacts of Quality ReportingBill Presley
Jodi Frei, Northwestern Medical Center Vermont, and I co-presented at the MUSE Executive Institute on Revenue at Risk: Understanding Financial Impacts of Quality Reporting. The Executive Institute featured many amazing CXO's discussing the changing landscape of revenue cycle management and how finance, quality, and IT departments are converging on revenue cycle.
Though pay for performance is the common theme, the logistics of programs including Value Based Purchasing (VBP), Inpatient Quality Reporting (IQR), Hospital Acquired Condition (HAC) Reduction Program, Readmission Reduction, MACRA, MIPS and APMs, are very different. In this session, the specifics of each Quality Program including reporting requirements, scoring methodologies, and associated incentives and penalties will be covered. In addition, tools to track performance and quantify financial risk will be shared.
Reimbursement in this era of health care reform is challenging. We all seek success under this new normal in health care. Optimizing revenue capture in a quality reimbursement model requires acquisition of new knowledge and the use of new tools and strategies. Join us in the conversation; share your strategies; learn from others.
MIPS APM for ACOs: A Hybrid Reimbursement ModelCitiusTech
CMS announced the Quality Payment Program (QPP) final rule in October 2017, stating how it plans to implement the clinician payment changes to QPP, mandated under the Medicare Access and CHIP Reauthorization (MACRA) act. The implementation of the MACRA act impacts different type of organizations, one such being the Accountable Care Organizations (ACOs). ACOs are evaluated for payments on the basis of quality care and the cost factors associated in achieving their quality goals. Post MACRA implementation, all clinicians will receive payments as per the MIPS (Merit based incentive payments) and Advanced APMs (Advanced alternative payment models). ACO’s can register as APM entities and are eligible to receive payments under Advanced APMs. There is a third category of APM entities which participate in Advanced APMs models but do not meet the threshold of payments and patients set by CMS. Such entities fall into a category that is straddling the line between APM and the MIPS track, called MIPS APM (partially qualifying APM participants). This document discusses about the reporting, scoring and payments for the MIPS APM entities
Dr. Andres Perez - Tempero-Spatial Sequence Analysis, Bayesian Phylodynamic M...John Blue
Tempero-Spatial Sequence Analysis, Bayesian Phylodynamic Methods on 1-7-4 PRRSv - Dr. Andres Perez, from the 2015 Allen D. Leman Swine Conference, September 19-22, 2015, St. Paul, Minnesota, USA.
More presentations at http://www.swinecast.com/2015-leman-swine-conference-material
Online survey, task analysis, & design sketch presentation for an iPhone application that helps you track workouts and meet your fitness goals. This was created for a computer science course at the University of Washington.
The Alphabet Soup of Clinical Quality Measures ReportingBill Presley
CMS is transitioning to what the they call "a new and more responsive regulatory framework" for quality reporting and reimbursement. CMS goals are "…electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people". Over the next couple years, we will see a transformation of fee for service into value-based care models driven by the VBP, Quality Payment Program, MACRA, Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APM). Healthcare organizations will no longer be motivated by implementing and meeting Meaningful Use, but instead will be driven by value-based care and risk-based payment models that focus on quality outcomes for reimbursements.
In this Education Session we will review:
• How CMS is aligning clinical quality measures (CQMs) to reduce the reporting burden for healthcare organizations and providers. We will cover the vision and goals for achieving quality alignment for CMS.
• We will dive into the following CMS reporting programs and how they interact with each other: Value-Based Purchasing (VBP), Medicare Access and CHIP Reauthorization Act (MACRA), Merit-based Incentive Payments (MIPS), Hospital Inpatient Quality Reporting (IQR), The Joint Commission (ORYX), Outpatient Quality Reporting (OQR), and Alternative Payment Models (APM).
Meaningful Use Stage 2 Summary of Care Data Exchange with Practice FusionPractice Fusion
Stage 2 of Meaningful Use requires that providers complete three Summary of Care measures related to sending referrals. Practice Fusion has enabled providers to complete these measures through our new referral workflows.
To learn about how these referral workflows work (including Direct messaging) and how these workflows relate to Meaningful Use, review the slideshow. This detailed guide will walk you through understanding Direct and how to enable it, the variety of ways to send a referral in Practice Fusion, and how to achieve the related Meaningful Use measures.
Riding the Rapids of Payment Reform: Downstream Effects of Quality Reporting ...Bill Presley
In this presentation, we highlighted how quality measurement programs impact reimbursement affecting your revenue. The revenue at risk in your organization. We focused on quality programs like Value-Based Purchasing (VBP), Merit-Based Incentive Program (MIPS) and Alternative Payment Models (APM) and their impact on Part A and Part B reimbursements.
It’s no surprise that reimbursement tied to quality performance is quickly becoming a reality for hospitals and physicians. CMS’ aggressive goals aimed at increasing the percentage of Medicare payments associated with quality versus quantity can be achieved through such programs as Value-based Purchasing and MACRA. This session will cover scoring methodologies, reporting requirements, reimbursement impact, infrastructure (and other resource needs), EMR tools and tactics, and workflow modifications.
Revenue at Risk: Understanding Financial Impacts of Quality ReportingBill Presley
Jodi Frei, Northwestern Medical Center Vermont, and I co-presented at the MUSE Executive Institute on Revenue at Risk: Understanding Financial Impacts of Quality Reporting. The Executive Institute featured many amazing CXO's discussing the changing landscape of revenue cycle management and how finance, quality, and IT departments are converging on revenue cycle.
Though pay for performance is the common theme, the logistics of programs including Value Based Purchasing (VBP), Inpatient Quality Reporting (IQR), Hospital Acquired Condition (HAC) Reduction Program, Readmission Reduction, MACRA, MIPS and APMs, are very different. In this session, the specifics of each Quality Program including reporting requirements, scoring methodologies, and associated incentives and penalties will be covered. In addition, tools to track performance and quantify financial risk will be shared.
Reimbursement in this era of health care reform is challenging. We all seek success under this new normal in health care. Optimizing revenue capture in a quality reimbursement model requires acquisition of new knowledge and the use of new tools and strategies. Join us in the conversation; share your strategies; learn from others.
MIPS APM for ACOs: A Hybrid Reimbursement ModelCitiusTech
CMS announced the Quality Payment Program (QPP) final rule in October 2017, stating how it plans to implement the clinician payment changes to QPP, mandated under the Medicare Access and CHIP Reauthorization (MACRA) act. The implementation of the MACRA act impacts different type of organizations, one such being the Accountable Care Organizations (ACOs). ACOs are evaluated for payments on the basis of quality care and the cost factors associated in achieving their quality goals. Post MACRA implementation, all clinicians will receive payments as per the MIPS (Merit based incentive payments) and Advanced APMs (Advanced alternative payment models). ACO’s can register as APM entities and are eligible to receive payments under Advanced APMs. There is a third category of APM entities which participate in Advanced APMs models but do not meet the threshold of payments and patients set by CMS. Such entities fall into a category that is straddling the line between APM and the MIPS track, called MIPS APM (partially qualifying APM participants). This document discusses about the reporting, scoring and payments for the MIPS APM entities
Dr. Andres Perez - Tempero-Spatial Sequence Analysis, Bayesian Phylodynamic M...John Blue
Tempero-Spatial Sequence Analysis, Bayesian Phylodynamic Methods on 1-7-4 PRRSv - Dr. Andres Perez, from the 2015 Allen D. Leman Swine Conference, September 19-22, 2015, St. Paul, Minnesota, USA.
More presentations at http://www.swinecast.com/2015-leman-swine-conference-material
Online survey, task analysis, & design sketch presentation for an iPhone application that helps you track workouts and meet your fitness goals. This was created for a computer science course at the University of Washington.
Course on Regulation and Sustainable Energy in Developing Countries - Session 8Leonardo ENERGY
Session 8 deals with standards and labels for white appliances and air conditionners which have achieved tremendous energy savings in some developing countries.
How to define standards – how to test them - how to implement them - how to enforce them.
This session will rely on cases notably from Ghana, Tunisia and Egypt.
The alphabet soup of clinical quality measures reporting and reimbursement 2...Bill Presley
CMS is transitioning to what the they call "a new and more responsive regulatory framework" for quality reporting and reimbursement. CMS goals are "…electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people". Over the next couple years, we will see a transformation of fee for service into value-based care models driven by the VBP, Quality Payment Program, MACRA, Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APM). Healthcare organizations will no longer be motivated by implementing and meeting Meaningful Use, but instead will be driven by value-based care and risk-based payment models that focus on quality outcomes for reimbursements.
In this Education Session we will review:
• How CMS is aligning clinical quality measures (CQMs) to reduce the reporting burden for healthcare organizations and providers. We will cover the vision and goals for achieving quality alignment for CMS.
• We will dive into the following CMS reporting programs and how they interact with each other: Value-Based Purchasing (VBP), Medicare Access and CHIP Reauthorization Act (MACRA), Merit-based Incentive Payments (MIPS), Hospital Inpatient Quality Reporting (IQR), The Joint Commission (ORYX), Outpatient Quality Reporting (OQR), and Alternative Payment Models (APM).
• How the Eligible Hospital and Eligible Professional reimbursement models will change in 2017 and going forward.
• Compare and contrast the requirements for quality measure reporting and identify strategies to ensure compliance.
• The potential impact to hospital reimbursement of current and proposed programs that will affect quality reporting for hospitals and providers.
• How to improve efficiency and quality by aligning measures across initiatives.
• Where to find current information (and breaking news) on each of these Quality Initiatives.
In the past, organizations participating in quality reporting initiatives involved abstractors sifting through a small sample set of unstructured data in paper charts to then manually convert their findings to discrete reportable data. This approach is time consuming and requires extensive amount of resources from both IT and Quality staff. Aligning quality initiatives can improve efficiencies and processes, and contribute to population health management efforts, both locally and nationally.
At the conclusion of this presentation, attendees will be able to apply what they’ve learned about aligning Clinical Quality Measures across initiatives specific to their organization to improve reimbursements, reduce their reporting burden, increase efficiencies, and realize the benefits of Population Health Management.
If you are responsible for hospital quality, IT, clinical quality measure initiatives or have a vested interest in making sure your organization is aligning quality measures reporting, this informational session is a must.
Our Insights webinar this week tackles a little-known program that will have a big impact on fee-for-service Medicare providers. The Value-Based Payment Modifier (or Value Modifier for short) is something every Medicare provider should know about as soon as possible. One way or another, providers will wind up on either the incentive or penalty side of this legislation. Take advantage of our webinar for in-depth information on this complex and far-reaching topic.
Go deeper with athenahealth specialists to discover all that you need to know and some things you may not know about Meaningful Use Stage 2 and the newest government updates.
Keynote Presentation "Meaningful Use Stage 2 and Meaningful Use Audit Insight"
Think far beyond just threshold increases. The differences between Meaningful Use (MU) Stage 1 and Stage 2, including the 2014 Clinical Quality Measures, are technically and clinically challenging. And just when you thought you could safely look at Stage 1 in the rearview mirror, here come the audits! I will highlight the Stage 1 and Stage 2 differences and talk about the challenges they have initiated at Tenet. I will touch on the impact of Quality measures and will also provide you with insight into the basics of MU Audits and will take you through the actual audit experience at Tenet.
Learning Objectives:
∙ Review the program and measure changes from Stage 1 to Stage 2 and how the changes are being managed at Tenet
∙ Provide insight into the 2014 Clinical Quality Measures chosen by Tenet, the challenges posed, solutions that work and a little about the overall
impact of Quality measures
∙ Discuss Meaningful Use Audits, covering the basics as well as providing the benefit of the Tenet experience
The Relationship Between Quality of Care and Choice of Clinical Computing System: Retrospective Analysis of Family Practice Performance Under the UK Quality and Outcomes Framework
The Latest Regulations, Simplified: MU, PQRS & MIPSathenahealth
Changing governmental regulations for the advancement of healthcare is more than difficult and we have simplified these changes to keep you up to date.
PYA Highlights Next Steps of Meaningful UsePYA, P.C.
At the 2013 AICPA Healthcare Industry Conference, PYA Principal David McMillan and Senior Manager Chris Wilson recently explored the “new normal” of meaningful use as compliance and strategic standards in new care/reimbursement-model development.
The CMS Innovation Center hosted a special webinar featuring Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer, on Monday, November 10, 2014 from 10:30am – 11:30 am ET. Dr. Conway will provided an update about the work of the CMS Innovation Center and the models being tested to improve better care for patients, better health for our communities, and lower costs through improvement for our health care system. Opportunities for questions were provided.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Health IT Summit Houston 2014 - Case Study "EHR Optimization for Organizational Value in a Changing Healthcare Environment"
Luis Saldana, MD, MBA, FACEP
CMIO
Texas Health Resources
iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.
A compliant CER should support strong clinical evidence that your device achieves its intended purpose without exposing users and patients to risk. The CER must be based on clinical data, which may include clinical data from existing literature, clinical experience, clinical trials, or any combination of the three.
You are required to prepare and submit a clinical evaluation report with your technical file as part of the CE Marking/conformity assessment process. However, approach the CER as a standalone document.
1. Data Repository Experts Since 1998
In a Galaxy NOT So Far Far Away... eCQMs
Jodi Frei, PT, MSMIIT
Manager of Organizational Informatics
Northwestern Medical Center
Bill Presley
Vice President, Product Development
Acmeware
2. Objectives
Participants will understand the following concepts and their
relevance to healthcare settings:
2016 IPPS Final Rules for Inpatient Quality Reporting (IQR)
eCQM Definition and Background
Clinical Quality Measure Program Initiatives
Reporting Process – Selection to Submission
What’s On The Horizon?
Opportunities and Challenges
3. Why are eCQMs Important?
2016 Inpatient Prospective Payment
System (IPPS) Rule
2016 IPPS eCQM Submission Requirements - NEW
◦ 4 eCQMs reflecting Q3 or Q4 CY 2016
4. Additional Programs Moving to eCQMs
In 2015 Joint Commission issued guidance that they were
transitioning from Core Measures to CMS eCQM Specifications
Outpatient Quality Reporting Program (OQR) has a proposed
2017 eCQM requirement
Comprehensive Primary Care Initiatives have embedded eCQM
submission into their reporting options.
5. CMS Demonstrates Commitment to eCQMs
Federal Register:
“We do not agree that electronic clinical quality measure
reporting should remain voluntary... We believe that
electronic clinical quality measures have matured since
their inception and we will address any specific eCQMs in
future rulemaking. “
6. Vision for Quality Reporting Programs
Unified and aligned set of clinical quality measures and
reporting requirements to synchronize and integrate CMS
quality programs which will reduce reporting burden and
improve on patient outcomes.
7. Quality Reporting Direction
The Future - One Specification
Core Measures
(Chart Abstraction)
•Manual Chart Abstracted
•Paper-based
specifications
•Translated to CMS
Specification Manual
Clinical Quality
Measure (eCQM)
•Electronically Captured
•Measure Concepts
•Electronic Codification
•Electronic Specification
•eCQM Library (One Spec)
8. Human vs Machine
Patient Care
documented
Capture
Manual
chart review
by
abstraction
and coding
Interpret
Manual
interpreted
results
calculated
Calculate
Manual Abstraction Process
9. Human vs Machine
Patient Care
documented
Capture
Data codified
and coding
reviewed
Codify
Electronically
calculate and
report
Calculate
Electronic Measure Process
10. Quality Reporting Specification Manual
Specifications Manual
The Specifications Manual for National Hospital
Inpatient Quality Measures
Uniform set of national hospital quality measures
Paper tools for use in abstracting data for each
collection (discharge) period are provided with the
Specifications Manual
eCQM Library
Electronically specified versions of traditionally
chart-abstracted Clinical Quality Measures
Developed specifically so Certified Electronic Health
Record Technology (CEHRT) can capture, calculate,
export, and transmit the measure data
For eReporting of eCQMs to demonstrate
meaningful use or for Quality Reporting Programs
Data Collection Period Specifications Manual
10/01/15 - 06/30/16 Version 5.0
01/01/15 - 09/30/15 Version 4.4a
01/01/14 - 12/31/14 Version 4.3b
Reporting Year eCQM Specifications
2016 May 2015 Update
2015 April 2014 Update
2014 April 2013 Update
11. Quality Measure Programs
Hospital
Quality
• EHR Incentive Program
• PPS-Exempt Cancer Hospitals
• Inpatient Psychiatric Facilities
• Inpatient Quality Reporting
• HAC payment reduction program
• Readmission reduction program
• Outpatient Quality Reporting
• Ambulatory Surgical Centers
• The Joint Commission (TJC)
Physician
Quality
• EHR Incentive Program
• Physician Quality Reporting System
(PQRS)
• eRX Quality Reporting
Payment
Model
• Medicare Shared Savings Program
• Hospital Value-Based Purchasing
• Accountable Care Organizations
(ACO)
• ESRD QIP
12. Hospital Quality Measures
• Mean in g fu l Use ( MU)
• In p atient Qu ality Rep ortin g ( IQR )
• Joint Commission ( O RYX )
* Excluded from IQR and ORYX
13. Program Requirements - IQR
4 measures submitted via eCQM
8 measures submitted via Chart Abstraction
6 measures via NHSN Submission
24 measures via Claims
4 measures via Web Entry
1 measure via Patient Survey
18. Physician Quality Reporting Reductions
Year PQRS EHR VBPM+ Sequestration Total
2013 0.5% N/A N/A -2.0% -1.5%
2014 0.5% N/A N/A -2.0% -1.5%
2015 -1.5% -1.0% -1.0% -2.0% -5.5%
2016 -2.0% -2.0% -2.0% -2.0% -8.0%
2017 -2.0% -3.0% -4.0% -2.0% -11.0%
Applied to all Medicare reimbursements
Schedule of payment adjustments depends on the size of the medical practice,
starting with 100+ EPs in 2015, followed by 10 to 99, then all. Table reports maximum penalty.
20. Beginning the Reporting Process
Planning
Select your team
Choose your eCQM vendor
Choose a minimum of 4 eCQMs
Declare your intent to submit and submission vendor
24. Building the Foundation
System Updates
Assure reporting system is upgraded with applicable
eCQM specifications
Update EMR nomenclature mapping with prior year’s
specifications
25. Assuring Accurate Data
Validation and Reconciliation
Validate data measure by measure
Focus on patients who did not meet the measure
Reconcile electronic results with abstracted results
Data sources will be different
Checks and balances for nomenclature mapping
26. Testing the Waters
Practice Submissions
Your vendor will use program specific tools to submit test
files
Pre-Submission Validation Application (PSVA) tool for IQR
Submission Validation Engine Tool (SEVT) for PQRS
Performance Measurement System Extranet Track (PET) for
ORYX
Intent is to work through submission errors
31. Wrapping It Up:
Final Submission
IQR submission deadline: Feb 28, 2017
PQRS submission deadline: Feb 28, 2017
ORYX submission deadline: March 15, 2017
32. NMC Approach to eCQM Selection
Many Factors to Consider
What are the 2016 reporting requirements for clinical
quality measures by program?
IQR, MU EH, ORYX, VBP
OQR, MU EP, PCMH, ACO
What measures are being tracked now?
What is the current reporting mechanism for each?
What CQMs are currently being electronically monitored?
34. Checks and Balances: Meeting Requirements?
IQR: Am I submitting a minimum of 4 eCQMs?
YES!
IQR: Am I abstracting my 8 required measures?
YES!
MU EH: If I submit 4 eCQMs, do I fulfill my MU CQM
requirement?
YES!
ORYX: Am I covering 6 measure sets?
YES!
35. Labor Comparison: Pre vs Post eCQM
0
10
20
30
40
50
60
70
80
90
100
Jan Feb March April May June
Pre eCQM Hrs (Abs Only) Post eCQM Hrs (eCQM & Abs)
- An NMC Study
36. Going Above the Regulatory Requirements!
eCQMs will not go away…
Beyond meeting the regulations, however, reporting
eCQMs:
Creates efficiencies
Requires hospitals to standardize their processes
Creates dashboards which allow real time tracking
of performance, which leads to
Real time improvements in clinical outcomes
37. Description:
This measure assesses the number of patients diagnosed with confirmed VTE who received an overlap of parenteral
(intravenous [IV] or subcutaneous [subcu]) anticoagulation and warfarin therapy. For patients who received less than five
days of overlap therapy, they should be discharged on both medications or have a reason for discontinuation of overlap
therapy. Overlap therapy should be administered for at least five days with an international normalized ratio (INR) greater
than or equal to 2 prior to discontinuation of the parenteral anticoagulation therapy, discharged on both medications or
have a reason for discontinuation of overlap therapy.
Data criteria (QDM Data Elements):
"Medication, Administered: Warfarin" using "Warfarin RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.232)"
"Medication, Discharge not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set
(2.16.840.1.113883.3.117.1.7.1.473)"
"Medication, Discharge not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set
(2.16.840.1.113883.3.117.1.7.1.93)"
"Medication, Discharge: Parenteral Anticoagulant" using "Parenteral Anticoagulant RXNORM Value Set
(2.16.840.1.113883.3.117.1.7.1.266)"
"Medication, Discharge: Parenteral anticoagulant ingredient specific" using "Parenteral anticoagulant ingredient specific
RXNORM Value Set (2.16.840.1.113762.1.4.1021.4)"
"Medication, Order not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set
(2.16.840.1.113883.3.117.1.7.1.473)"
"Medication, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set
(2.16.840.1.113883.3.117.1.7.1.93)"
eMeasure Identifier: CMS-73
Reconcile and Validate eCQMs
VTE-3 Reporting Example
38. This shows a value set for a class of medications (Warfarin)
VTE-3 Reporting Example
Data criteria (QDM Data Elements):
"Medication, Administered: Warfarin" using "Warfarin RxNorm Value Set (2.16.840.1.113883.3.117.1.7.1.232)“
Value Set Table:
eMeasure Identifier: CMS108
39. VTE-3 Reporting Example
Data criteria (QDM Data Elements):
"Medication, Administered: Warfarin" using "Warfarin RxNorm Value Set (2.16.840.1.113883.3.117.1.7.1.232)“
Value Set Table:
eMeasure Identifier: CMS108
40. Data criteria (QDM Data Elements):
"Medication, Administered: Warfarin" using "Warfarin RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.232)"
"Medication, Discharge not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set
(2.16.840.1.113883.3.117.1.7.1.473)"
"Medication, Discharge not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set
(2.16.840.1.113883.3.117.1.7.1.93)"
"Medication, Discharge: Parenteral Anticoagulant" using "Parenteral Anticoagulant RXNORM Value Set
(2.16.840.1.113883.3.117.1.7.1.266)"
"Medication, Discharge: Parenteral anticoagulant ingredient specific" using "Parenteral anticoagulant ingredient specific
RXNORM Value Set (2.16.840.1.113762.1.4.1021.4)"
"Medication, Order not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set
(2.16.840.1.113883.3.117.1.7.1.473)"
"Medication, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set
(2.16.840.1.113883.3.117.1.7.1.93)"
VTE-3 Reporting Example
eMeasure Identifier: CMS108
48. eCQM Reporting Submission
Meaningful
Use EP
Meaningful
Use EH
Electronic Clinical Quality Measures (eCQM)
PQRS IQR
Joint
Commission
QualityNet PQRS QualityNet IQR PET
QRDA I or III
49. What’s On The Horizon?
2017 IPPS Proposed Rule
Medicare Access & CHIP Reauthorization Act of 2016
Merit-based Incentive Payment System (MIPS)
Advancing Care Information replaces Meaningful Use
Enhanced Oversight and Accountability
50. 2017 IPPS Proposal
Full year, four quarters of data for all eCQMs included in the
Hospital IQR Program measure set in CY 2017
Removed 13 eCQM measures
Report 15 eCQM measures
Removed 2 chart-abstracted measures
Report 6 chart-abstracted measures
Modify the current validation process starting CY 2018
51. 2017 IPPS Proposal - eCQMs Removed
Mean in g fu l Use ( MU)
In p atient Qu ality Rep ortin g ( IQR )
* Excluded from IQR and ORYX
52. Finalized List of eCQMs for 2017
AMI-8a - Primary PCI Received Within 90 Minutes of Hospital Arrival
CAC-3 - Home Management Plan of Care Document Given to Patient/Caregiver
ED-1 - Median Time from ED Arrival to ED Departure for Admitted ED Patients
ED-2 - Admit Decision Time to ED Departure Time for Admitted Patients
EHDI-1a - Hearing Screening Prior to Hospital Discharge 1354
PC-01 - Elective Delivery
PC-05 - Exclusive Breast Milk Feeding
STK-02 - Discharged on Antithrombotic Therapy
STK-03 - Anticoagulation Therapy for Atrial Fibrillation/Flutter
STK-05 - Antithrombotic Therapy by the End of Hospital Day Two
STK-06 - Discharged on Statin Medication
STK-08 - Stroke Education
STK-10 - Assessed for Rehabilitation
VTE-1 - Venous Thromboembolism Prophylaxis
VTE-2 - Intensive Care Unit Venous Thromboembolism Prophylaxis
53. 2017 IPPS Proposal - Chart-Abstracted
Measure Measure Name
ED-1 Median Time from ED Arrival to ED Departure for Admitted ED
Patients
ED-2 Admit Decision Time to ED Departure Time for Admitted Patients
IMM-2 Influenza Immunization
SEP-1 Severe Sepsis and Septic Shock: Management Bundle (Composite
Measure)
STK-04 Thrombolytic Therapy
VTE-5 Venous Thromboembolism Discharge Instructions
VTE-6 Incidence of Potentially Preventable Venous Thromboembolism
PC-01 Elective Delivery (Collected in aggregate and submitted via Web-based
tool)
58. MIPS Eligibility
EC EC EC EC EC
Hospitalist ED Provider Ortho Practice Family Practice
EC
Private Practice
Acute Ambulatory
59. Advancing Care Measures
1. Protect Patient Health Information - Security Risk Analysis
2. Electronic Prescribing
3. Patient Electronic Access
a. Patient Access
b. Patient-specific education
4. Coordination of Care through Patient Engagement
a. View/Download/Transmit
b. Secure Messaging
c. Patient Generated Health Data
5. Health Information Exchange - Patient Care Record Exchange
a. Request/Accept Patient Care Record
b. Clinical Information Reconciliation
6. Public Health and Clinical Data Registry Reporting - Immunization Registry
Reporting
60. Enhanced Oversight and Accountability
ONC expands role of oversight
Attest to cooperation with certain authorized IT
surveillance and oversight activities
Clinicians required to give access to their EHR
No restriction of data sharing and interoperability
61.
62. Advancing Care Requirements
Submission for full year, CY 2017, Objective Measures
Requires 2014 or 2015 Edition Certified EHR
Report on either (8) stage 2 or (6) stage 3 Advancing Care
Information objectives and measures
Previously known as Meaningful Use measures
Attest to cooperation with certain authorized IT
surveillance and oversight activities
63. Opportunities and Challenges
CQM reporting is the focus of the present and future
◦ Electronic submission will become more pervasive
Opportunities and Challenges Exist
◦ Patient Population Tracking
◦ Concurrent Review for Nursing Quality
◦ Clinical Care Team Alerting
◦ Custom Report Development
Prepare your teams and systems now