Volume 1 Ed. 10 | September 2018
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If You Missed
Public Reporting on Physician Compare:
What You Need to Know,
the Webinar Materials are Now Available Online
In July and August, the Physician Compare support team hosted
Public Reporting on Physician Compare: What You Need to Know
. The team presented information about public reporting and what’s in the pipeline for potential inclusion on the website starting in late 2018, including Year 1 Quality Payment Program (QPP) performance information. A recording and transcript of the presentation is now available. Visit the
Physician Compare Initiative page
t
o find the presentation slides and public reporting resources mentioned during the webinar.
Materials from other webinars related to the QPP are available on
CMS.gov
.
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Quality Payment Program Participation Status Tool Now Includes First Snapshot of 2018 Qualifying APM Participant and MIPS APMs Data
The Centers for Medicare & Medicaid Services (CMS) has updated its
Quality Payment Program Participation Status Tool
to include 2018 Qualifying APM Participant (QP) and Merit-Based Incentive Payment System (MIPS) Advanced Payment Model (APM) status. The tool was updated based on calculations from the first snapshot of data from APM entities. The first snapshot includes data from Medicare Part B claims with
dates of service between
January 1 and March 31, 2018
.
Later this year, CMS will release and announce the second and third QP and MIPS APM status data based on snapshots of claims between
January 1 and August 31, 2018
. To learn more about how CMS determines QP and MIPS APM status for each snapshot, please review the
QP Methodology Fact Sheet.
What Does QP Status and MIPS APM Status Mean?
If you qualify as a QP, this means you are:
- Eligible for the five percent APM incentive bonus.
- Exempt from participating in MIPS.
How Do I Check My QP or MIPS APM Status?
To view your QP or MIPS APM status at the individual level:
To check your group’s 2018 eligibility at the APM entity level:
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Now Available: 2019 Eligible Clinician
Electronic Clinical Quality Measure Flows
CMS has developed and published the 2019 performance period electronic clinical quality measure (eCQM) flows for eligible clinicians and eligible professionals (EPs) to the
eCQI Resource Center
. The eCQM flows are designed to assist in interpretation of the eCQM logic and calculation methodology for performance rates. eCQM flows provide an overview of each of the population criteria components and associated data elements that lead to the inclusion or exclusions into the eCQM’s quality action (numerator).
eCQM flows supplement eCQM specifications for eligible clinicians and EPs for the:
- QPP: MIPS and Advanced APMs
- Comprehensive Primary Care Plus (CPC+) program
- The Promoting Interoperability Programs
These flows are intended to be used as an additional resource when implementing eCQMs and should not be used in place of the eCQM specification or for reporting purposes.
CMS plans to publish flows for eligible hospital and critical access hospital (CAH) eCQMs in September. This will be a new resource for EHs and CAH eCQMs for 2019 reporting, developed in response to stakeholder feedback.
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Virtual Groups Toolkit for 2019 MIPS Performance Year Now Available
If you’re interested in forming a virtual group for the 2019 Merit-based Incentive Payment System (MIPS) performance year, you must follow an election process and submit your election to the Centers for Medicare & Medicaid Services (CMS) via email between
October 1 and December 31, 2018
. CMS has posted the
2019 Virtual Groups Toolkit
to help you understand the election process to participate in MIPS as a virtual group in 2019, which includes a:
- 2019 Virtual Groups Overview Fact Sheet Provides an overview of what a virtual group is, who can participate in a virtual group, how virtual groups collect and submit data, and how virtual groups are scored.
- 2019 Virtual Groups Election Process Details the two-stage election process for forming a virtual group, and what needs to be included in a virtual group agreement.
- Virtual Group Election Submission Email A sample e-mail that can be used for a virtual group election submission.
- Virtual Agreement Template A template that can be used to develop a virtual group agreement.
Learn More
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QPP Frequently Asked Questions
of the Month
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Question:
I am concerned about syndromic surveillance in 2019, when we won’t get points for immunizations without a second registry. Should I submit my concern during the comment period?
Answer:
Yes, the Proposed Rule is open for comment until September 10, 2018.
Question:
There are not enough measures for the specialty to meet the minimum course of action. (Referring to 2016 PQRS)
Answer:
PQRS is a legacy program. It is now called Quality, and under MIPS. It requires practices to report on six measures; one of them must be an outcome or a high priority measure or all measures in your specialty measure set. We recommend you call our HSAG QPP Service Center at 844.472.4227 to discuss your practice’s participation and look at the different specialty quality measures to see what we can help you with.
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Top Three Tips for 2018 MIPS
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- Determine early if your practice should Consider filing a Hardship Exception for the Promoting Interoperability category in MIPS in 2018. Click here for Frequently Asked Questions on Promoting Interoperability Hardship Exceptions.
- Download the 2018 MIPS Data Validation File by clicking here to view suggested documentation for your Improvement Activities.
- You only need 15 points in the MIPS 2018 Performance Year to avoid a negative payment adjustment. This can be accomplished in many ways, such as completing the Improvement Activities category completely. To learn other ways you can earn 15 points, call HSAG’s QPP Service Center today at 1.844.472.4227.
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Upcoming Learning Forum Friday Events
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September 14, 2018
1 p.m. ET
Deep Dive into the Various Submission Methods
Join HSAG to:
- Identify the various QPP submission methods.
- Determine possible advantages and disadvantages of each submission method.
- Recognize strategies to determine which submission method is most advantageous to meet the 2018 QPP requirements.
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October 12, 2018
1 p.m. ET
QPP Year 3 (2019) Proposed Rule: What You Need to Know
Join HSAG to:
- Identify proposed rule changes in Year 3 (2019) of the QPP.
- Recognize strategies in preparing for Year 3.
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Here's What Your Peers are Saying About Learning Forum Fridays:
- The information was delivered as simple as possible any participants can understand.
- Links to sites and information was most valuable to me.
- Clarification of the 2017 MIPS Feedback Reports was most helpful.
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Upcoming Webinars for Small Practices
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Understanding Advanced Alternative Payment Models (APMs): Advice for Solo and Small Group Specialty Practices
Participants will learn:
- What APMs and advanced APMs are
- Criteria for participating in them
- How to effectively transition from MIPS to an APM
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Centers for Medicare & Medicaid Services (CMS) Webinars and Updates
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2018 MIPS Improvement Activities (IA) Performance Category Call for Technical Expert Panel (TEP)
As part of its IA development process, CMS is seeking feedback from a group of stakeholders, consumers, patients, and experts who can contribute direction and thoughtful input on the IAs during development and maintenance. HealthInsight, a subcontractor on this project, is working to convene a TEP around the effectiveness and accuracy of the IAs included in Year 2 (2018) of the QPP under the MIPS IA performance category. They are seeking approximately 10–12 clinicians and individuals with the following perspectives and areas of expertise to participate on the TEP:
- Subject matter/clinical expertise with IAs
- Consumer/patient/family (non-medical caregiver)
- Healthcare disparities
- Performance measurement
- Quality improvement
The nomination period closes at
8 p.m. EDT
on
September 22, 2018
.
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Targeted Review of 2019 MIPS Payment Adjustment
If you participated in MIPS in 2017, the payment adjustment you receive in 2019 will be based on your 2017 MIPS 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 that CMS review their performance feedback and final score through a process called
targeted review
.
Examples of circumstances for requesting this detailed review of your final score include:
- Errors or data quality issues on the measures and activities you submitted.
- Eligibility issues
- e.g., You fall below the low-volume threshold and should not have received a payment adjustment.
- Being erroneously excluded from the APM participation list and not being scored under APM scoring standard.
The deadline has been extended to October 1, 2018 at 8 p.m. EDT.
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New Medicare Card Mailing Update: Wave 5 Begins, Wave 3 Ends
Under the
Medicare Access and CHIP Reauthorization Act
of 2015 (MACRA)
, the law requires the Centers for Medicare & Medicaid Services (CMS) to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. CMS has started mailing new Medicare cards to beneficiaries who live in the Wave 5 states of Alabama, Florida, Georgia, North Carolina, and South Carolina. New cards continue to be mailed to beneficiaries who live in Wave 4 states, as well as nationwide to people who are new to Medicare.
Check this
website
as the mailings progress. Continue to direct your Medicare patients to
Medicare.gov/NewCard
for information about the mailings and to sign up to get email about the status of card mailings in their state.
For more information on the transition to the new MBI, view:
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Wednesday, September 12, 2018
1–3 p.m. ET
All-Payer Combination Option Overview
Webinar
During the webinar, CMS will discuss:
- Overview of APMs and Advanced APMs
- All-Payer Combination Option Basics
- Determinations of Other Payer Advanced APMs
- Payer and Eligible Clinician Initiated Processes
- Determinations for QPs under the All-Payer Combination Option
- Frequently Asked Questions
- Additional Resources
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Medicare Learning Network (MLN) Updates
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2018 QPP Courses on the MLN
Learning Management System Now Available
QPP courses are available to assist you with 2018 MIPS reporting. CMEs and CEs are also available. To access these courses, you must register
here
. Following registration, in the search bar enter “QPP.” The available courses will appear. Some sessions are short; all sessions are available 24 hours a day, 7 days a week.
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We Want to Hear Your Story
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Have a QPP/MIPS reporting best practice or success story you would like to share? Let us know by clicking “Share a Best Practice” and complete the online form. You may be selected to be featured in our next QPP Quest!
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Quality Initiative Spotlight: Immunization
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The Centers for Disease Control and Prevention (CDC) Publishes Updated Recommendations for the 2018–2019 Flu Season
What’s new this flu season?
Click here
to review the CDC’s FAQs for the 2018–2019 Flu Season.
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HSAG QPP Service Center Feedback
Here's what your peers are saying about HSAG's technical assistance and educational support...
- My question was answered, and references were provided to me to support the answer. Great job!
- Helpful, informative and repeatedly willing to walk this office through the jungle to achieve the goal. I will be a frequent caller as this office attempts to comply.
- She was very helpful and took the time to explain and show me on the computer where all the websites were that was very helpful
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Make use of these helpful tools as you prepare for MIPS in 2018:
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Subscribe to Get the Information You Need
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Subscribe to HSAG's QPP Quest Digest
Invite your practice staff, practices you refer patients to, and other colleagues to subscribe to HSAG’s QPP Quest Digest!
Stay informed of all monthly QPP updates, deadlines, no-cost webinars and best practices by subscribing
here
.
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CMS QPP Listserv
Don't forget to sign up on the
C
MS.gov QPP website
.
Once you've accessed the QPP page, scroll to
[Subscribe to Updates]
at the bottom of the page and insert your email address before clicking
[Subscribe]
. The QPP listserv is a valuable resource to stay informed of webinars and important QPP deadlines.
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This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for Arizona, California, Florida, Ohio, and the U.S. Virgin Islands, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. QN-11SOW-D.1-09062018-01
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