Commercial and Medicaid Shared Savings Program: Year 1 Payment and Reporting Measures
|
|
|
- Blanche Lindsey
- 7 years ago
- Views:
Transcription
1 Commercial and Medicaid Shared Savings Program: Year 1 Payment and Reporting Measures Green Mountain Care Board November 21, /22/2013 1
2 Outline Overview of decision points Review of Year 1 Payment and Reporting Measures Discussion of new information since 10/10/2013 Review of Proposal for Evaluation of Reporting Measures Review of proposed Gate and Ladder Methodology Review of recommendations from Core Team 11/22/2013 2
3 GMCB Decision Points GMCB Decision Points New Information Since 10/10/2013 GMCB Measures Update Proposed Year 1 Commercial and Medicaid Shared Savings Program payment and reporting measures Yes Proposal for evaluating reporting measures Yes Proposed Gate and Ladder methodology to determine impact of payment measures on shared savings No 11/22/2013 3
4 Recommended Core Measure Set: Measure Use Terminology Payment Performance on these measures will be considered when calculating shared savings. Reporting ACOs will be required to report on these measures. Performance on these measures will be not be considered when calculating shared savings; ACO submission of the clinical data-based reporting measures may be considered when calculating shared savings. Pending Measures that are included in the core measure set but are not presently required to be reported. Pending measures are considered of importance to the ACO model, but are not required for initial reporting for one of the following reasons: target population not presently included, lack of availability of clinical or other required data, lack of sufficient baseline data, lack of clear or widely accepted specifications, or overly burdensome to collect. 11/22/2013 4
5 Recommended Year 1 Payment Measures (Claims data) Commercial and Medicaid Shared Savings Programs: All-Cause Readmission Adolescent Well-Care Visits Follow-Up After Hospitalization for Mental Illness (7-day) Initiation and Engagement of Alcohol and Other Drug Dependence Treatment Avoidance of Antibiotic Treatment for Adults with Acute Bronchitis Chlamydia Screening in Women Cholesterol Management for Patients with Cardiovascular Disease (LDL Screening)* Medicaid Shared Savings Program: Developmental Screening in First 3 Years of Life *Related to Medicare Shared Savings Program Measure 5
6 Recommended Year 1 Reporting Measures (Claims data) Commercial and Medicaid Shared Savings Programs: Ambulatory Sensitive Conditions Admissions: COPD or Asthma in Older Adults* Breast Cancer Screening* Rate of Hospitalization for Ambulatory Care-Sensitive Conditions: PQI Composite Appropriate Testing for Children with Pharyngitis *Medicare Shared Savings Program Measure 11/22/2013 6
7 Recommended Year 1 Reporting Measures (Clinical Data) Commercial and Medicaid Shared Savings Programs: Adult BMI Screening and Follow-Up* Screening for Clinical Depression and Follow-Up Plan* Colorectal Cancer Screening* Diabetes Composite HbA1c control* LDL control* High blood pressure control* Tobacco non-use* Daily aspirin or anti-platelet medication* Diabetes HbA1c Poor Control* Childhood Immunization Status Pediatric Weight Assessment and Counseling *Medicare Shared Savings Program Measure 11/22/2013 7
8 Recommended Year 1 Reporting Measures (Survey Data) Patient Experience Survey Composite Measures (using same survey fielded by about 70 Blueprint primary care practices): Access to Care Communication Shared Decision-Making Self-Management Support Comprehensiveness Office Staff Information Coordination of Care Specialist Care 11/22/2013 8
9 New Information: Year 1 Commercial and Medicaid Shared Savings Program Payment and Reporting Measures The Depression Screening by 18 Years of Age was removed from the Medicaid Shared Savings Program Year 1 Payment Measures. Medicaid claims analysis revealed that providers are not using this code and that data collected on the measure would be inaccurate. The Quality and Performance Measures Work Group was informed that this measure could not be reported on accurately. Screening for Clinical Depression and Follow-Up Plan for persons 12+ is a Year 1 Reporting Measure and MSSP Measure. 11/22/2013 9
10 New Information: Proposal for Evaluation of Reporting Measures Proposal from VHCIP Quality and Performance Measures Work Group if measure set not substantively changed; supported by Core Team: ACO will make good faith effort to submit all reporting measures completely and in timely manner. Reporting will include analysis of barriers and costs to reporting, and plan to mitigate barriers. GMCB will provide guidelines for content and format of analysis and plan. Failure to report will have no financial consequences in Year 1 if ACO makes good faith effort to report all measures. Recommendations for Years 2 and 3 will be made by Work Group to Core Team and GMCB after considering barriers and costs identified during Year 1. 11/22/
11 Impact of Payment Measures: Commercial Commercial Gate and Ladder Approach: Compare each payment measure to national benchmark and assign 1, 2 or 3 points based on whether the ACO is at the national 25 th, 50 th or 75 th percentile. If ACO does not achieve at least 55% of maximum available points across all payment measures, it is not eligible for any shared savings ( quality gate ). In proposed commercial SSP quality ladder, ACO earns: 75% of potential savings for achieving 55% of available points, 85% of potential savings for achieving 65% of available points, 95% of potential savings for achieving 75% of available points. 11/22/
12 Commercial Shared Savings Program Ladder (proposed) Percentage of Percentage of available points earned savings 55% 75% 60% 80% 65% 85% 70% 90% 75% 95% 80% 100% 11/22/
13 Impact of Payment Measures: Medicaid Medicaid Gate and Ladder Approach: For most measures, compare each payment measure to national benchmark and assign 1, 2 or 3 points based on whether ACO is at national 25 th, 50 th or 75 th percentile. For two measures without national Medicaid benchmark (All-Cause Readmission and Developmental Screening), compare each payment measure to VT Medicaid benchmark, and assign 0, 2 or 3 points based on whether ACO performance declines, stays the same, or improves relative to benchmark. If ACO does not achieve at least 35% of maximum available points across all payment measures, it is not eligible for any shared savings ( quality gate ). In proposed commercial SSP quality ladder, ACO earns: 75% of potential savings for achieving 35% of available points, 85% of potential savings for achieving 45% of available points, 95% of potential savings for achieving 55% of available points. 11/22/
14 Medicaid Shared Savings Program Ladder (proposed) Percentage of available points Percentage of earned savings 35% 75% 40% 80% 45% 85% 50% 90% 55% 95% 60% 100% 11/22/
15 GMCB Decision Points and VCHIP Core Team Recommendations GMCB Decision Points Proposed Year 1 Commercial and Medicaid Shared Savings Program payment and reporting measures VCHIP Core Team Recommendation Adopt, with the caveat that the VHCIP Quality and Performance Measures Work Group explores adding a substance abuse screening measure to the Payment and Reporting Measure Set Proposal for evaluating reporting measures Adopt Proposed Gate and Ladder methodology to determine impact of payment measures on shared savings Adopt 11/22/
16 Work Group Process Over the course of nine months (January October 2013), the multi-stakeholder ACO Measures Work Group engaged in an intensive and inclusive process. The Work Group met approximately every two weeks to identify measures and recommend the impact of the selected measures on payment. 11/22/
17 Work Group Process (continued) Work Group members: Created crosswalk of over 200 measures from numerous measure sets, including the Medicare Shared Savings Program measure set Identified priority measures for consideration Focused on measures in various domains, with national specifications, with benchmarks, and with opportunities for improvement Eliminated measures through application of agreed-upon criteria and extensive discussion Expressed support for and concerns about measures Compromised Expressed widespread support, but not unanimity (see comments) 11/22/
Accountable Care Organizations and Shared Savings Programs (What are they and how do they differ)
Accountable Care Organizations and Shared Savings Programs (What are they and how do they differ) Presentation to: House Health Care Committee January 30, 2015 Georgia Maheras, Esq. Director, Vermont Health
Vermont ACO Shared Savings Program: Recommendations for Year 2 Quality Measures
Vermont ACO Shared Savings Program: Recommendations for Year 2 Quality Measures Green Mountain Care Board October 9, 2014 10/9/2014 1 ACOs & SSPs Accountable Care Organizations (ACOs) are composed of and
Vermont ACO Shared Savings Program Quality Measures: Recommendations for Year 2 Measures from the VHCIP Quality and Performance Measures Work Group
Vermont ACO Shared Savings Program Quality Measures: Recommendations for Year 2 Measures from the VHCIP Quality and Performance Measures Work Group Presentation to VHCIP Steering Committee August 6, 2014
ACO Shared Savings Program: Adolescent Health Measures
ACO Shared Savings Program: Adolescent Health Measures December 20, 2013 Alicia Cooper, MPH, PhD Dept. of VT Health Access Vermont Health Care Innovation Project 3/24/2014 1 Overview Beginning in 2014,
11/2/2015 Domain: Care Coordination / Patient Safety
11/2/2015 Domain: Care Coordination / Patient Safety 2014 CT Commercial Medicaid Compared to 2012 all LOB Medicaid Quality Compass Benchmarks 2 3 4 5 6 7 8 9 10 Documentation of Current Medications in
Finding Common Ground: Vermont s Blueprint for Health and ACO Shared Savings Programs
Finding Common Ground: Vermont s Blueprint for Health and ACO Shared Savings Programs Presentation to: Rhode Island Care Transformation Collaborative February 27, 2015 Pat Jones, Health Care Project Director,
A COMPARISON OF MEDI-CAL MANAGED CARE P4P MEASURE SETS
A COMPARISON OF MEDI-CAL MANAGED CARE P4P MEASURE SETS The matrix below provides a comparison of all measures included in Medi-Cal P4P programs and the measures includes in DHCS s External Accountability
SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES
Summary Table of Measures, Product Lines and Changes 1 SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES General Guidelines for Data Collection and Reporting Guidelines for Calculations and Sampling
Medicare Shared Savings Program Quality Measure Benchmarks for the 2014 Reporting Year
Medicare Shared Savings Program Quality Measure Benchmarks for the 2014 Reporting Year Release Notes/Summary of Changes (February 2015): Issued correction of 2014 benchmarks for ACO-9 and ACO-10 quality
NCQA Health Insurance Plan Ratings Methodology March 2015
NCQA Health Insurance Plan Ratings Methodology March 205 REVISION CHART Date Published March 205 Description Final version (next update will be based on the 50% measure exclusion rule) TABLE OF CONTENTS
TO: FROM: DATE: RE: Mid-Year Updates Note: NCQA Benchmarks & Thresholds 2014
TO: Interested Organizations FROM: Patrick Dahill, Assistant Vice President, Policy DATE: July 25, 2014 RE: 2014 Accreditation Benchmarks and Thresholds Mid-Year Update This document reports national benchmarks
1. How are you using health IT enabled clinical quality measures for internal quality improvement efforts and patients care?
1. How are you using health IT enabled clinical quality measures for internal quality improvement efforts and patients care? Sharp Rees-Stealy medical group (SRSMG), a 400-physician multispecialty group
HEDIS/CAHPS 101. August 13, 2012 Minnesota Measurement and Reporting Workgroup
HEDIS/CAHPS 101 Minnesota Measurement and Reporting Workgroup Objectives Provide introduction to NCQA Identify HEDIS/CAHPS basics Discuss various components related to HEDIS/CAHPS usage, including State
SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES
Summary Table of Measures, Product Lines and Changes 1 SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES General Guidelines for Data Collection and Reporting Guidelines for Calculations and Sampling
Clinical Quality Measure Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW
Clinical Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW NQF 0105 PQRS 9 NQF 0002 PQRS 66 Antidepressant Medication Management Appropriate Testing for Children with Pharyngitis (2-18 years)
Performance Results for Health Insurance Plans
WASHINGTON STATE COMMON MEASURE SET FOR HEALTH CARE QUALITY AND COST Performance Results for Health Insurance Plans DECEMBER 2015 Table of Contents Introduction... 3 About the Results... 4 How to Read
ACO Name and Location Allina Health Minneapolis, Minnesota
ACO Name and Location Allina Health Minneapolis, Minnesota ACO Primary Contact Patrick Flesher Director, Payer Contracting & Pioneer ACO Program Email: Patrick.Flesher@allina.com Phone: 612-262-4865 Composition
Improving Quality of Care for Medicare Patients: Accountable Care Organizations
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Improving Quality of Care for Medicare Patients: FACT SHEET Overview http://www.cms.gov/sharedsavingsprogram On October
MEASURING CARE QUALITY
MEASURING CARE QUALITY Region November 2015 For Clinical Effectiveness of Care Measures of Performance From: Healthcare Effectiveness Data and Information Set (HEDIS ) HEDIS is a set of standardized performance
MaineCare Value Based Purchasing Initiative
MaineCare Value Based Purchasing Initiative The Accountable Communities Strategy Jim Leonard, Deputy Director, MaineCare Peter Kraut, Acting Accountable Communities Program Manager Why Value-Based Purchasing
Medicare Shared Savings Program Quality Measure Benchmarks for the 2015 Reporting Year
Medicare Shared Savings Program Quality Measure Benchmarks for the 2015 Reporting Year Release Notes/Summary of Changes (February 2015): Issued correction of 2015 benchmarks for ACO-9 and ACO-10 quality
Quality Improvement Program
Quality Improvement Program Section M-1 Additional information on the Quality Improvement Program (QIP) and activities is available on our website at www.molinahealthcare.com Upon request in writing, Molina
Accountable Care Organization
Accountable Care Organization April 13, 2011 The Indianapolis Association of Health Underwriters Drivers of Payment Reform Increased attention to regional variation in costs and quality Payment for care
2013 ACO Quality Measures
ACO 1-7 Patient Satisfaction Survey Consumer Assessment of HealthCare Providers Survey (CAHPS) 1. Getting Timely Care, Appointments, Information 2. How well Your Providers Communicate 3. Patient Rating
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business Quality Management Program 2012 Overview Quality Improvement
Implementing a Patient Centered Medical Home and ACO to Improve Health Outcomes and Reduce Medicare Costs
Implementing a Patient Centered Medical Home and ACO to Improve Health Outcomes and Reduce Medicare Costs Medicare Market Innovations Forum July 14, 2014 Donna Zimmerman Senior Vice President, Government
SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES
Summary Table of Measures, Product Lines and Changes 1 SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES General Guidelines for Data Collection and Reporting Guidelines for Calculations and Sampling
Improving Quality of Care for Medicare Patients: Accountable Care Organizations
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Improving Quality of Medicare Patients: Overview The Centers for Medicare & Medicaid Services (), an agency within the Department
SUMMARY TABLE OF MEASURE CHANGES
Summary Table of Measure 1 SUMMARY TABLE OF MEASURE CHANGES Guidelines for Physician Measurement Effectiveness of Preventive Care Guidelines for Physician Effectiveness of Care Adult BMI Assessment Weight
OBJECTIVES AGING POPULATION AGING POPULATION AGING IMPACT ON MEDICARE AGING POPULATION
OBJECTIVES Kimberly S. Hodge, PhDc, MSN, RN, ACNS-BC, CCRN- K Director, ACO Care Management & Clinical Nurse Specialist Franciscan ACO, Inc. Central Indiana Region Indianapolis, IN By the end of this session
Total Health Quality Indicators For Providers 2015
Total Health Quality Indicators For Providers 2015 Adult- Preventive Measure Test/Procedure Parameters Frequency CPT/HCPCS CPT II ICD-9 BMI Assessment BMI Recording 18-74 yrs Yearly G8417, G8418, G8420
Radiology Business Management Association Technology Task Force. Sample Request for Proposal
Technology Task Force Sample Request for Proposal This document has been created by the RBMA s Technology Task Force as a guideline for use by RBMA members working with potential suppliers of Electronic
Texas Medicaid Managed Care and Children s Health Insurance Program
Texas Medicaid Managed Care and Children s Health Insurance Program External Quality Review Organization Summary of Activities and Trends in Healthcare Quality Contract Year 2013 Measurement Period: September
Contra Cost Health Plan Quality Program Summary November, 2013
Contra Cost Health Plan Quality Program Summary November, 2013 Mission Statement: Contra Costa Health Plan, along with our community and county health care providers, is committed to ensure our diverse
ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION)
ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION) Hello and welcome. Thank you for taking part in this presentation entitled "Essentia Health as an ACO or Accountable Care Organization -- What
Medicare 2015 QI Program Evaluation
Color Code: Red does not meet 5 star threshold, or target. Green meets or exceeds 5 star threshold/target. Improving or Maintaining Physical Health (HOS) Improving or Maintaining Mental Health (HOS) Diabetes
2016 HEDIS & Quality Assurance Reporting Requirements Measures Provider Reference Guide
2016 HEDIS & Quality Assurance Reporting Requirements Measures Provider Reference Guide HEDIS Measure: Test/Care Needed for Compliance Adult BMI Assessment Individuals ages 18-74 Documentation of BMI and
ACO Public Reporting
ACO Public Reporting ACO Name and Location AHS ACO LLC (Atlantic Accountable Care Organization) 465 South Street, Suite 205 Morristown, NJ 07960 (973) 971-7499 atlanticaco@atlantichealth.org www.atlanticaco.org
SUMMARY TABLE OF MEASURE CHANGES
SUMMARY TABLE OF MEASURE CHANGES Measure Name Effectiveness of Preventive Care Adult BMI Assessment Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents Childhood
Mar. 31, 2011 (202) 690-6145. Improving Quality of Care for Medicare Patients: Accountable Care Organizations
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 Office of Media Affairs MEDICARE FACT SHEET FOR IMMEDIATE RELEASE
ACO Public Reporting
ACO Public Reporting ACO Name and Location AHS ACO LLC (Atlantic Accountable Care Organization) 465 South Street, Suite 205 Morristown, NJ 07960 (973) 971-7499 atlanticaco@atlantichealth.org www.atlanticaco.org
Colorado Medicaid HEDIS 2014 Results STATEWIDE AGGREGATE REPORT
Colorado Medicaid HEDIS 2014 Results STATEWIDE AGGREGATE REPORT December 2014 This report was produced by Health Services Advisory Group, Inc. for the Colorado Department of Health Care Policy and Financing.
OUR ACO QUALITY RESULTS 2012 AND 2013
OUR ACO QUALITY RESULTS 2012 AND 2013 2012-2013 Patient and Caregiver Experience Source 2012 2013 ACO - 1 CAHPS: Getting Timely Care, Appointments and Information Survey 81.98 84.47 ACO - 2 CAHPS: How
Performance Measurement for the Medicare and Medicaid Eligible (MME) Population in Connecticut Survey Analysis
Performance Measurement for the Medicare and Medicaid Eligible (MME) Population in Connecticut Survey Analysis Methodology: 8 respondents The measures are incorporated into one of four sections: Highly
NQS Priority #1: Making Care Safer by Reducing the Harm Caused in the Delivery of Care
NQS Priority #: Making Care Safer by Reducing the Harm Caused in the Delivery of Care Measure: Hospital-acquired Conditions (HAC) Incidence of measurable hospital-acquired conditions 45 HACs per,000 admissions
Mid-Hudson Adherence to Antipsychotic Medications for People Living With Schizophrenia
Adherence to Antipsychotic Medications for People Living With Schizophrenia 83 81 71 70 68 68 66 71 A. Behavioral Health 880 151 396 134 325 41 317 65 63 The percentage of recipients living with schizophrenia,
Ohio Health Homes Learning Community Meeting. Overview of Health Homes Measures
Ohio Health Homes Learning Community Meeting Overview of Health Homes Measures Tuesday, March 5, 2013 Presenter: Amber Saldivar, MHSM Associate Director, Informatics Analysis Health Services Advisory Group,
Welcome to Magellan Complete Care
Magellan Complete Care of Florida Provider Newsletter Welcome to Magellan Complete Care On behalf of Magellan Complete Care of Florida, thank you for your continued support and collaboration. As the only
Table 1 Performance Measures. Quality Monitoring P4P Yr1 Yr2 Yr3. Specification Source. # Category Performance Measure
Table 1 Performance Measures # Category Performance Measure 1 Behavioral Health Risk Assessment and Follow-up 1) Behavioral Screening/ Assessment within 60 days of enrollment New Enrollees who completed
Chapter Three Accountable Care Organizations
Chapter Three Accountable Care Organizations One of the most talked-about changes in health care delivery in recent decades is Accountable Care Organizations, or ACOs. Having gained the attention of both
AETNA BETTER HEALTH OF MISSOURI
Aetna Better Health of Missouri 10 South Broadway, Suite 1200 St. Louis, MO 63102 800-566-6444 AETNA BETTER HEALTH OF MISSOURI HEDIS Quick Reference Billing Guide 2014 Diagnosis and/or procedure codes
MEDICARE. Results from the First Two Years of the Pioneer Accountable Care Organization Model
United States Government Accountability Office Report to the Ranking Member, Committee on Ways and Means, House of Representatives April 2015 MEDICARE Results from the First Two Years of the Pioneer Accountable
A Detailed Data Set From the Year 2011
2012 HEDIS 2012 A Detailed Data Set From the Year 2011 Commercial Product We are pleased to present the AvMed HEDIS 2012 Report, a detailed data set designed to give employers and consumers an objective
CQMs. Clinical Quality Measures 101
CQMs Clinical Quality Measures 101 BASICS AND GOALS In the past 10 years, clinical quality measures (CQMs) have become an integral component in the Centers for Medicare & Medicaid Services (CMS) drive
Dania Palanker Senior Health Policy Advisor National Women s Law Center December 5, 2012
National Family Planning and Reproductive Health Association ACA Implementation: Health Insurance Exchanges Dania Palanker Senior Health Policy Advisor National Women s Law Center December 5, 2012 Why
Oregon Standards for Certified Community Behavioral Health Clinics (CCBHCs)
Oregon Standards for Certified Community Behavioral Health Clinics (CCBHCs) Senate Bill 832 directed the Oregon Health Authority (OHA) to develop standards for achieving integration of behavioral health
DRAFT. To Whom It May Concern:
DRAFT Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1345-P, P.O. Box 8013, Baltimore, MD 21244-8013 To Whom It May Concern: As a nonprofit, nonpartisan
Meaningful Use 2014 Changes
Meaningful Use 2014 Changes Lisa Sagwitz HIT Workflow & Implementation Coordinator September 4, 2014 1 PA Reach Who are we? Designated by ONC as the PA East and PA West Regional Extension Center We have
HEDIS 2010 Summary Table of Measures, Product Lines and Changes Applicable to:
HEDIS 2010 Summary Table of Measures, Product Lines and Changes Adult BMI Assessment Added CPT codes 99341 99345, 99347 99350 to Table ABA-A. Added ICD-9-CM Diagnosis codes 678, 679 to Table ABA-C. Weight
NCQA PCMH 2011 Standards, Elements and Factors Documentation Guideline/Data Sources
NCQA PCMH 2011 Standards, Elements and Factors Documentation Guideline/Data Sources Key: DP = Documented Process N/D = Report numerator and denominator creating percent of use RPT = Report of data or information
IN-NETWORK MEMBER PAYS. Out-of-Pocket Maximum (Includes a combination of deductible, copayments and coinsurance for health and pharmacy services)
HMO-OA-CNT-30-45-500-500D-13 HMO Open Access Contract Year Plan Benefit Summary This is a brief summary of benefits. Refer to your Membership Agreement for complete details on benefits, conditions, limitations
Small Physician Groups Aim High
Small Physician Groups Aim High Arch Health Partners A medical foundation in San Diego formed by Palomar Health and PIMG, a 20 year old multispecialty medical group formerly known as Centre for Health
Steven E. Ramsland, Ed.D., Senior Associate, OPEN MINDS The 2015 OPEN MINDS Performance Management Institute February 13, 2015 10:15am 11:30am
Steven E. Ramsland, Ed.D., Senior Associate, OPEN MINDS The 2015 OPEN MINDS Performance Management Institute February 13, 2015 10:15am 11:30am The execution or accomplishment of work, acts, or feats The
2010 QARR QUICK REFERENCE GUIDE Adults
2010 QARR QUICK REFERENCE GUIDE Adults ADULT MEASURES (19 through 64 years) GUIDELINE HEDIS COMPLIANT CPT/ICD9 CODES DOCUMENTATION TIPS Well Care Access to Ambulatory Care Ensure a preventive or other
Metrics for Coordinated Care Organizations: Measuring Health Inequities. Lori Coyner, MA Director of Accountability and Quality
Metrics for Coordinated Care Organizations: Measuring Health Inequities Lori Coyner, MA Director of Accountability and Quality 2 Accountability Plan Addresses the Special Terms and Conditions that were
Demonstrating Meaningful Use Stage 1 Requirements for Eligible Providers Using Certified EMR Technology
Demonstrating Meaningful Use Stage 1 Requirements for Eligible Providers Using Certified EMR Technology The chart below lists the measures (and specialty exclusions) that eligible providers must demonstrate
Key Performance Measures for School-Based Health Centers
Key Performance Measures for School-Based Health Centers As health care reform continues to take shape and additional provisions of the Affordable Care Act are implemented, there is an increasing demand
2011 Comprehensive Performance Report Commercial HMO, POS, and PPO Health Benefit Plans in Maryland
2011 Comprehensive Performance Report Commercial HMO, POS, and PPO Health Benefit Plans in Maryland Maryland Health Care Commission Marilyn Moon, PhD Chair Garret A. Falcone, NHA Vice Chair Reverend Robert
Huron County Community Health Profile
2014 Huron County Community Health Profile ` Prepared by: Eileen Unruh RN, MSN Samantha Fackler RN, MSN 11/1/2014 1 HURON COUNTY COMMUNITY HEALTH PROFILE TABLE OF CONTENTS INTRODUCTION.... 4 DEMOGRAPHICS...
IS HERE OPEN ENROLLMENT EMPLOYEE BENEFITS TIME TO MAKE YOUR BENEFIT CHOICES. BAYADA Home Health Care Employee Benefits
2015 OPEN ENROLLMENT IS HERE EMPLOYEE BENEFITS TIME TO MAKE YOUR BENEFIT CHOICES BAYADA Home Health Care values the contributions of our employees. In appreciation of your dedicated service, BAYADA Home
CREATING A POPULATION HEALTH PLAN FOR VIRGINIA
CREATING A POPULATION HEALTH PLAN FOR VIRGINIA Life Expectancy 1900, 2013 1900 50.6 years old 2013 78.8 years old 0 20 40 60 80 100 Age (Years) Source: http://ucatlas.ucsc.edu/health.php Year - 2000 Source:
Health Plan Quality Metrics Work Group. Final Recommendations Report. May 2014
Health Plan Quality Metrics Work Group Final Recommendations Report May 2014 Health Plan Quality Metrics Work Group Members Lori Coyner Director of Accountability and Quality Oregon Health Authority Dr.
Quality Oversight in the Health Care Marketplace, Spring 2010 Tufts Health Care Institute
Quality Oversight in the Health Care Marketplace, Spring 2010 Tufts Health Care Institute Session 16: C.1. Performance Reports National Reports Some reports present information on a category of providers
2013 MEDICARE FEE-FOR-SERVICE QUALITY AND RESOURCE USE REPORT
2013 MEDICARE FEE-FOR-SERVICE QUALITY AND RESOURCE USE REPORT Sample Medical Practice Last Four Digits of Your Taxpayer Identification Number (TIN): 1530 ABOUT THIS REPORT FROM MEDICARE WHAT This Quality
Maximizing Limited Care Management Resources to Improve Clinical Quality and Ensure Safe Transitions
Maximizing Limited Care Management Resources to Improve Clinical Quality and Ensure Safe Transitions Scott Flinn MD Deborah Schutz RN JD Fritz Steen RN Arch Health Partners A medical foundation formed
Medical Management. G.2 At a Glance. G.3 Procedures Requiring Prior Authorization. G.5 How to Contact or Notify Medical Management
G.2 At a Glance G.3 Procedures Requiring Prior Authorization G.5 How to Contact or Notify Medical Management G.6 When to Notify Medical Management G.9 Case Management Services G.12 Special Needs Services
Medicare Physician Group Practice Demonstration
Medicare Physician Group Practice Demonstration Heather Grimsley Medicare Demonstrations Program Group Center for Medicare and Medicaid Innovation Centers for Medicare & Medicaid Services April 2011 PGP
Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents BMI Percentile (Total)
Appendix C: New Performance Measures DOM Performance Measures Relevant HEDIS Measure(s) HEDIS 2012 Benchmark 50 th Percentile The 50 th percentile benchmarks are an indicator that half of the health plans
The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including
The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including charts, tables, and graphics may be difficult to read using
Stage 1 Meaningful Use for Specialists. NYC REACH Primary Care Information Project NYC Department of Health & Mental Hygiene
Stage 1 Meaningful Use for Specialists NYC REACH Primary Care Information Project NYC Department of Health & Mental Hygiene 1 Today s Agenda Meaningful Use Overview Meaningful Use Measures Resources Primary
Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases
Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Epidemiology Over 145 million people ( nearly half the population) - suffer from asthma, depression and other chronic
Achieving Quality and Value in Chronic Care Management
The Burden of Chronic Disease One of the greatest burdens on the US healthcare system is the rapidly growing rate of chronic disease. These statistics illustrate the scope of the problem: Nearly half of
Understanding Meaningful Use. Review of Part 1 and Part 2
Understanding Meaningful Use Review of Part 1 and Part 2 Understanding Meaningful Use Pat Wise RN, MA, MS, FHIMSS COL (USA ret'd) Vice President, Healthcare Information Systems Meaningful Use Financial
Changes for Calendar Year 2015 Physician Quality Programs and Other Programs in the Medicare Physician Fee Schedule
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 FACT SHEET FOR IMMEDIATE RELEASE October 31, 2014 Contact: CMS
SMD# 13-001 ACA #23. Re: Health Home Core Quality Measures. January 15, 2013. Dear State Medicaid Director:
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 SMD# 13-001 ACA #23 Re: Health Home Core Quality
Early Results of a Marketwide ACO Initiative: The Alternative Quality Contract (AQC)
Early Results of a Marketwide ACO Initiative: The Alternative Quality Contract (AQC) Dana Gelb Safran, Sc.D. Senior Vice President Performance Measurement and Improvement 13 July 2011 Twin Goals of Improving
Preventive Services for Pregnancy SERVICE WHAT IS COVERED INTERVALS OF COVERAGE Anemia Screening Screening Annual screening for pregnant women
Preventive Services for Pregnancy SERVICE WHAT IS COVERED INTERVALS OF COVERAGE Anemia Annual screening for pregnant women Bacteriuria For pregnant women at 12-16 weeks gestation or first prenatal visit
NY Medicaid EHR Incentive Program. Eligible Professionals Meaningful Use Stage 2 (MU2) Webinar www.emedny.org/meipass
Eligible Professionals Meaningful Use Stage 2 (MU2) Webinar www.emedny.org/meipass May 2015 2 Meaningful Use Stage 2 Overview of EHR Introduction to Meaningful Use Meaningful Use Stage 2 Objectives Clinical
Focus on Obesity and on Medicare Plan Improvement
Focus on Obesity and on Medicare Plan Improvement The State of Health Care Quality 2012 Focus on Obesity and on Medicare Plan Improvement The State of Health Care Quality 2012 2 n at i o n a l c o m m
Clinical Quality Measures (CQMs) What are CQMs?
Clinical Quality Measures (CQMs) What are CQMs? What are CQMs? Clinical quality measures, or CQMs, are tools that help eligible providers (EPs) measure and track the quality of health care services provided
What to Expect in Next Year & Developing Your ACO Action Plan
What to Expect in Next Year & Developing Your ACO Action Plan Welcome The webinar will start at 3:00 pm ET. It is interactive, so please make sure that you have connected via phone with your audio pin.
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida Medicare Quality Management Program Overview Quality Improvement (QI) Overview At Coventry, we
New Jersey Delivery System Reform Incentive Program
New Jersey Delivery System Reform Incentive Program The New Jersey Delivery System Reform Incentive Program (DSRIP) is part of New Jersey s Comprehensive Medicaid Waiver. The program provides incentive
An ANALYSIS of Medicare Benefits per the 2016 Medicare and You Handbook & The State of Delaware's Special Medicfill Plan Benefits
An ANALYSIS of Medicare Benefits per the 2016 Medicare and You Handbook & The State of Delaware's Special Medicfill Plan Benefits The chart below presents the list of benefits covered by Medicare, and
Ohio s Community Behavioral Health Center Health Homes: A New Service Delivery Model
Ohio s Community Behavioral Health Center Health Homes: A New Service Delivery Model 1 C E N T E R F O R E V I D E N C E - B A S E D P R A C T I C E S A T C A S E W E S T E R N R E S E R V E U N I V E
Advancing Health Equity. Through national health care quality standards
Advancing Health Equity Through national health care quality standards TABLE OF CONTENTS Stage 1 Requirements for Certified Electronic Health Records... 3 Proposed Stage 2 Requirements for Certified Electronic
ACO Program: Quality Reporting Requirements. Jennifer Faerberg Mary Wheatley April 28, 2011
ACO Program: Quality Reporting Requirements Jennifer Faerberg Mary Wheatley April 28, 2011 Agenda for Today s Call Overview Quality Reporting Requirements Benchmarks/Thresholds Scoring Model Scoring Methodology
2012 Physician Quality Reporting System:
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services R Official CMS Information for Medicare Fee-For-Service Providers 2012 Physician Quality : Medicare Electronic Health Record
Explanation of CMS Proposed Performance Measurement Framework for ACOs and Comparison with IHA P4P Measure Set April 2011
Explanation of CMS Proposed Performance ment Framework for ACOs and Comparison with IHA P4P Set April 2011 This briefing outlines Section II E ( and Other Reporting Requirements) of the Shared Savings
Price Transparency Attestation emr4md version 9.7 09/03/2014
Price Transparency Attestation emr4md version 9.7 09/03/2014 mednetmedical.com 1 Price Transparency Attestation Company Name: MedNet Medical Solutions Product Name: emr4md Version #: 9.7 mednetmedical.com