Who Reports NQF 18 NCQA

Transcription

1 Who Reports NQF 18 Various providers & health care systems are required and/or incentivized to annually report this clinical measure to payers such as CMS and national quality entities. The next slides will show you how NQF 18 is reported to specific national quality programs along with how to find your state specific information. 1

2 Who Reports NQF 18 NCQA National Committee for Quality Assurance You can see which clinicians report and are recognized by NCQA in your State/Town by going to the NCQA Recognition Site : 2

3 NCQA Select State Select Program: Heart/ Stroke Recognition Program for NQF 18 measure 3

4 NCQA You will then see the NCQA Recognition Directorylisting each clinician, address and programs recognized (as shown in the example to the left) 4

5 Who Reports NQF 18 Meaningful Use (MU) An important objective set forth in the Meaningful Use Stage 1 final rule is that eligible professionals and hospitals who participate in the program must be able to record, store, and report clinical quality measures (CQM). In the Meaningful Use Stage 1 final rule, CMS defines CQM as the processes, experience, and/or outcomes of patient care, observations or treatment that relate to one or more quality aims for health care such as effective, safe, efficient, patient-centered, equitable, and timely care. 5

6 MU Eligible Provider - Eligible professionals must report on 6 total clinical quality measures: 3 required core measures (or 3 alternate core measures) and 3 additional measures (selected from a set of 38 clinical quality measures). NQF 18 is one of the specified clinical measures but you can find the complete list of Proposed 2014 clinical measures at: Proposed-EHR-Incentive-Program-CQM.pdf 6

7 MU Hospitals- Eligible hospitals and Critical Access Hospitals (CAHs) must report on all 15 of their clinical quality measures. However NQF 18 is not required reporting for hospital organizations, NQF 18 only applies to eligible providers. For a list of proposed 2014 hospital clinical quality measures go to: Incentive-Program-CQM.pdf 7

8 Who Reports NQF 18 PQRS Physician Quality Reporting System Certified Providers (also known as Eligible Providers),as defined by Medicare, are able to submit data for the PQRS program. These designated providers have a NPI (National Provider Identification) Number which allows them to bill for services. The list of providers include, Medical Doctor (MD), Doctor of Osteopathy (DO), Physician Assistant (PA), and Nurse Practitioner (NP). 8

9 PQRS NQF 18 is Measure 236 for PQRS. You can find the PQRS Measures by going to this link: Instruments/PQRS/MeasuresCodes.html 9

10 Who Reports NQF 18 UDS Uniform Data System The Uniform Data System (UDS) is a core set of information appropriate for reviewing the operation and performance of health centers. In the next few slides you will learn how to look up individual State information to include; grant awardees and overall clinical results 10

11 UDS Go to Link: Select your state, then click on Go 11

12 UDS You then receive a list of State Program Grantee Data and Health Center Program Grantees. Select a Health Center and Click on It. 12

13 UDS Once you click on one of the Health Centers, you will be brought to the Health Center s Profile page. You can now choose which category to review. For example, click on Clinical Data 13

14 UDS You will now see the last few years of Clinical Data for the Health Center you have chosen. 14

15 UDS If you look at the next to the last measure listed, under the Chronic Disease Management Category, you will see the information for NQF