Quality Reporting and Registry Update: Challenges and Strategies for Success. Heather Smith, PT, MPH September 13, 2014
|
|
|
- Whitney Ford
- 8 years ago
- Views:
Transcription
1 Quality Reporting and Registry Update: Challenges and Strategies for Success Heather Smith, PT, MPH September 13,
2 SETTING THE STAGE FOR TOMORROW 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 2
3 The Present and Future of High Quality Patient Care 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 3
4 Quality Reporting and PTs in 2014 PQRS VM FLR Private payer 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 4
5 SGR Reform and Quality Reporting PRE SGR POST SGR (proposed) PQRS Quality reporting under Medicare Part B under several different programs including PQRS. Variable penalties tied to each program (2.0% +) FLR FLR participation is required by all providers billing therapy services under Medicare part B Claims based data submission Condition of payment Current programs replaced by Merit Based Incentive Payment System (MIPS) in 2018 Performance based on: quality, resource use, meaningful use and clinical practice improvement activities FLR will be expanded to include additional variable as identified by the Secretary and stakeholders in 2017 (demographic info, diagnosis, severity, expanded ICF, etc) Data to be submitted via web portal or other mechanism Data utilized to support new payment system 5 (case mix adjustments, episodic payment)
6 Future of Medicare Part B Quality Reporting Private Payers PQRS FLR Future reporting systems PTPCS SGR PAC 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 6
7 Quality Reporting Today Future Separate and distinct reporting programs (FLR, PQRS, MU, etc.) Varied methods of data reporting High percentage of process measures Multiple measures of patient function Identification of measure gaps by government/ national measurement groups One quality program under Medicare Part B Electronic reporting via patient registries, EHR Focus on outcome measures and patient/family centered measures One measure of global patient function that crosses the continuum of care Increasing role of associations in the creation of meaningful quality measures for professionals 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 7
8 REVIEWING THE NOW: FLR, PQRS, VM 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 8
9 Current Quality Reporting Programs Under Medicare Healthcare Setting Quality Program(s) Mandatory Reporting Payment Incentive/ Penalty Inpatient (Acute Care Hospitals) IQR, Readmissions & VBP Yes Yes P4R & P4P in 2013 Long Term Care Hospitals (LTCH) Beginning in 2014 Yes Yes P4R Penalty 2% Inpatient Rehabilitation Facilities (IRF) Beginning in 2014 Yes Yes P4R Penalty 2% Skilled Nursing Facilities (SNF) MDS 3.0 Yes No Hospice Beginning in 2014 Yes Yes P4R Penalty2% Home Health OASIS, HH CAHPS Yes Yes P4R Penalty 2% Outpatient PQRS No, payment adjustments for non participation beginning in 2015 (based on 2013 data) Yes P4R Incentive 0.5% through 2014, Penalty 2.0% 2016 and beyond Value based Modifier (VM) proposed CY2017 Functional Limitation Reporting (FLR) No tied to participation in PQRS Yes Yes P4P +4.0x to 4.0% Condition of payment 9
10 Functional Limitation Reporting (FLR) Middle Class Tax Relief Act of 2012 February 2012 Congress mandates CMS to collect functional info on Medicare beneficiaries receiving therapy services under Part B FLR Implementation January 1, 2013 Testing phase begins for the collection of functional data FLR Ongoing 2014 Medicare continues to work through system modifications; anticipating future evolutions of FLR Final Physician Fee Schedule Rule November 2012 Outlines the regulations around the new claimsbased reporting program for therapy services FLR Payment Adjustment Phase October 1, 2013 Originally slatted for July 1, 2013 this was delayed until October 1; providers began reporting processing issues in mid November 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 10
11 From Law to Implementation Legislative Congress MCTRA Regulations/ Guidelines Implementation CMS 2012 Final Physician Fee Schedule, FAQs, MLN Matters Medicare Administrative Contractors APTA Resources NGS CGS Novitas Palmetto Cahaba First Coast WPS Noridan 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 11
12 Initial FLR Claims Processing Issues Claims splitting (1500) Delayed/ out of sequence processing Incorrect visit counts Required reporting at 10 th /20 th /etc despite early reporting Issues with 3Gcode submission with an active POC Problems with 60 day discharge Edits in CWF on May 6 fixed many of the issues 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 12
13 60 Causes of FLR Claim Rejections 50 NUMBER OF COMPLAINTS Count Discrepancy Delayed Payment Claims Splitting Processing Out of Order Issues With 60 Day Rule Unsuccessful Resubmission of Claim 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 13
14 Current FLR Claims Processing Issues Problems with 60 day discharge Edits planned on or around September 15 Claims that were rejected prior to May 6 that have correct FLR data should be resubmitted for payment All rejected claims should be reviewed to check accuracy of FLR codes Still investigating issues case by case Claims splitting 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 14
15 Examples of FLR Errors Simple or clerical errors Use of $0.00 instead of $0.01 Leaving off the GP or severity modifiers Submitting the wrong Gcode (discharge vs current) Misunderstanding of FLR guidance Reporting a single FLR code instead of two codes Changing categories mid episode without ending reporting on original limitation Issues with tracking (beneficiary/ facility/ therapy service) 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 15
16 PT Participation in PQRS Total of 16 individual measures 1 measures group Claims based remains the most popular reporting mechanism (7 claims measures in 2014) 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 16
17 PT and OT PQRS Participation 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Claims Individual Claims Group Registry Individual Registry Group 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 17
18 Recent PPS Survey on PQRS Response: 540 members 85.0% participating in PQRS in 2014 The top reason sited for non participation: practice does not have resources to manage the PQRS reporting burden; we are willing to take the 2.0% penalty to avoid the reporting burden (8.0%) 83.7% report via claims 76.5% have never accessed a feedback report Only 31.0% have received a bonus in past years 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 18
19 2014 Top Reported Measures for PTs # Measure Description Reporting % 128 Preventive Care and Screening: Body Mass Index (BMI) Screening 34.1% and Follow up 130 Documentation and Verification of Current Medications in the 45.7% Medical Record 131 Pain Assessment Prior to Initiation of Patient Treatment 65.7% 154 Falls: Risk Assessment 48.5% 155 Falls: Plan of Care 42.4% 182 Functional Outcome Assessment 55.7% Based on on PPS survey results 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 19
20 Future Trends PQRS Move to 9 measures for successful reporting Elimination of process based measures Move toward outcomes measures Measures groups required to have at least 6 measures Move toward electronic data submission Increased use of registry, QCDR and EHR reporting 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 20
21 The Value Based Modifier (VM) Program VM was mandated by Section 3007 of the Affordable Care Act, to begin by This program is separate from PQRS. CMS will begin applying VM under the Medicare Physician Fee Schedule (MPFS) in CY2015 (using CY2013 data). The proposed CY2015 MPFS rule includes a proposal to expand the program in CY2017 (using CY2015 data) to include: Nonphysician Eligible Professionals (EPs) this includes PTs Solo practitioners and groups of 2 9 providers 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 21
22 VM Program Expansion Participants Physician groups over 100 providers* Physician groups over providers Non physician Eligible Professionals (EPs) in groups 2 9 AND solo providers Data Year VM Year Payment Adjustments % to +2.0x % to +2.0x % to +4.0x *Group size determined by number of total eligible professionals 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 22
23 The Value Based Modifier (VM) and PTs The proposal to include PTs in the VM program would begin in CY2017, however this would be based on the PTs performance in Eligible PTs (in private practice billing on the 1500 form) who do not participate OR who fail to successfully reporting under PQRS in CY2015 will be assessed a 2.0% penalty under the PQRS program in CY2017 AND a 4.0% penalty under the VM program CY American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 23
24 The Value Based Modifier (VM) and PTs The VM program has a quality tiering methodology that takes into account both quality and cost. The quality portion of the methodology is based largely on PQRS performance. The cost portion of the methodology would not typically apply to PTs and PTs would be given an average rating on this section based on CMS guidelines American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 24
25 PQRS and VM in for PTs CY2015 PQRS CY2015 (calculated on NPI/TIN) Claims as Individuals: Report on 6 measures (all available PT measures) for 50% or more of all Medicare Part B FFS patients. NO penalty in CY2017. PQRS Registry as Individuals: Report on 9 measures (or if less than 9 available 8 1 measures) for 50% or more of all Medicare Part B FFS patients. NO penalty in CY2017. GPRO in a PQRS Registry: Report on 9 measures (or if less than 9 available 8 1 measures) for 50% or more of all Medicare Part B FFS patients. NO penalty in CY2017. Non participation or failure to meet successful reporting requirements. 2.0% payment adjustment in CY2017. Value Based Modifier CY2015 (calculated on TIN) Solo practitioners or groups of 2 9 PTs or other nonphysician EPs (at least 50% of PTs/ nonphysician EPs reporting as individuals in practice must be successful in PQRS CY2015). Neutral or upward payment in CY2017. Groups of 10+ PTs or PTs and other EPs (at least 50% of PT s/ EPs reporting as individuals in group must be successful in PQRS in CY 2015). Downward, neutral or upward payment adjustment in CY2017. Solo practitioners or groups of 2 9 PTs/ nonphysician EPs AND groups of 10+ PTs or PTs/ EPs where less than 50% of PT s/ EPs in group are successful in PQRS OR Groups and solo practitioners who do not participate in PQRS % payment adjustment in CY2017.
26 BACK TO THE FUTURE: THE REGISTRY 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 26
27 27 What is the Registry? The Physical Therapy Outcome Registry is an organized system to collect data to evaluate patient function and other clinically relevant measures for the population of patients receiving physical therapy services. The registry will serve to inform reimbursement, improve practice, fulfill quality reporting requirements, and promote research.
28 28 Registry Hub & Spoke Design EHR s EMR s Components Billing vendors PTOR Facility based practices Health systems Private practice clinics Allow for data to be gathered across the continuum of care Facilitate bi-directional communication
29 29 PT Outcome Registry Guide payment policy Inform payment contract negotiations Determine clinical practice patterns Assess adherence to CPG s Payment Practice Research Quality Demonstrate the value of PT services Promote health services research Fulfill quality reporting requirements (Medicare) Support quality improvement initiatives
30 30 What Data is in the Registry? Core Data Set (All Participants) Facility data Quality Data Provider data PQRS Modules (CPGs) Patient data FLR Intervention data Condition specific outcomes
31 31 Benefits of Participation Enhance Patient Care Improve patient outcomes Increase patient satisfaction Improve physical therapist decision making Further develop best practices Support quality improvement initiatives Improve your Practice Benchmark PT and practice performance Improve efficiency Maximize productivity Justify services to payers Identify training/education al opportunities Grow your Business Objectively market your practice to a variety of payers and consumers Prove the value of your practice Differentiate your practice in the PT market Increase referrals Compare performance year-by-year Meet Regulatory Requirements Fulfil PQRS requirments Easily access PQRS feedback reports
32 32 Registry Timeline 2014 Testing and pilot launch 2016 & Beyond Continued PTOR growth 2015 Full launch of PTOR
33 That the physical therapy profession uses standardized collection, analysis, and dissemination of intervention and outcomes data as a regular part of practice at all levels to determine what interventions best improve the health of individual and society and to identify and emulate the positive deviants within our clinical communities. Alan Jette; Face into the Storm QUALITY IN THE PRESENT 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 33
34 Quality Strategies for PTs Be aware of the quality environment Fee schedule rules/ summaries: eschedule/ (VM site if the rule finalizes) Other quality programs: ce/ American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 34
35 PT and the Quality Future Opportunities Moving towards harmonization of standard functional outcome data set/ tool Measure development and collaboration Registry Challenges Responding to the ever changing quality environment trying to stay ahead of the curve Need for more PT specific measures Future of FLR Integrating QI into practice 2014 American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 35
36 Questions OR ext American Physical Therapy Association. All rights reserved. All reproduction or redistribution prohibited. 36
QUALITY BEGINNER. PQRS Training Module: QUALITY MEASUREMENT 101. Last Updated: August 2014
QUALITY 01 BEGINNER PQRS Training Module: QUALITY MEASUREMENT 101 Last Updated: August 2014 TRAINING MODULE OBJECTIVES Quality Measurement 101 is a training module for providers who are interested in learning
How to Report Once for 2015 Medicare Quality Reporting Programs: Individual Eligible Professionals
Table of Contents How to Report Once for 2015 Medicare Quality Reporting Programs: Individual Eligible Professionals 3 How to Report Once for 2015 Medicare Quality Reporting Programs: Group Practices 5
Major Changes in CY2015 MPFS Quality Provisions. Physician Compare
Major Changes in CY2015 MPFS Quality Provisions Physician Compare In addition to previously finalized Physician Quality Reporting System (PQRS) quality measure data to be publicly reported beginning in
CMS is requesting information to aid in the planning and implementation of the MIPS in the following areas:
Summary of Medicare s Request for Information on the Provisions in MACRA which Allow for Implementation of Alternative Payment Models and a Merit-Based Incentive Payment System On September 28, 2015, the
12/5/2014. What is PQRS? Performance Measurement Committee Practical Theater. Historical concerns with the program (continued)
What is PQRS? Navigating CMS Quality Initiatives: How to Successfully Report and Avoid Payment Adjustments Performance Measurement Committee Practical Theater A federally mandated Medicare Part B quality
Physician Quality Reporting System What Neurosurgeons Need to Know for 2015
Physician Quality System What Neurosurgeons Need to Know for 2015 Prepared by the: American Association of Neurological Surgeons Congress of Neurological Surgeons For More Information Contact: Rachel Groman,
How to Avoid 2016 Negative Payment Adjustments for CMS Medicare Quality Reporting Programs. September 17, 2014
How to Avoid 2016 Negative Payment Adjustments for CMS Medicare Quality Reporting Programs September 17, 2014 The Medicare Learning Network This MLN Connects National Provider Call (MLN Connects Call)
Medicare Physician Reporting: Beyond PQRS. Mary Patton Wheatley Senior Specialist, AAMC August 17, 2011
Medicare Physician Reporting: Beyond PQRS Mary Patton Wheatley Senior Specialist, AAMC August 17, 2011 Who is the AAMC? The Association of American Medical Colleges (AAMC) serves and leads the academic
2015 PQRS Requirements: What Eligible Professionals Need to Know to Avoid the PQRS Penalty in 2017
2015 PQRS Requirements: What Eligible Professionals Need to Know to Avoid the PQRS Penalty in 2017 Presented by: Camille Bonta, MHS Summit Health Care Consulting Physician Quality Reporting System What
Sustainable Growth Rate (SGR) Repeal and Replace: Comparison of 2014 and 2015 Legislation
Sustainable Growth Rate (SGR) Repeal and Replace: Comparison of 2014 and 2015 Legislation Proposal 113 th Congress - - H.R.4015/S.2000 114 th Congress - - H.R.1470 SGR Repeal and Annual Updates General
CMS s framework for Value Modifier
CMS s framework for Value Modifier Relationship between quality of care, cost composites and the Value Modifier Clinical Care Patient Experience Population/ Community Health Patient Safety Care Coordination
CMS Proposals for Quality Reporting Programs under the 2015 Medicare Physician Fee Schedule Proposed Rule. July 24, 2014
CMS Proposals for Quality Reporting Programs under the 2015 Medicare Physician Fee Schedule Proposed Rule July 24, 2014 Medicare Learning Network This MLN Connects National Provider Call (MLN Connects
CMS QCDR (Qualified Clinical Data Registry) and Other Ways PPRNet Can Help with Value-Based Payment
CMS QCDR (Qualified Clinical Data Registry) and Other Ways PPRNet Can Help with Value-Based Payment Cara Litvin MD, MS Assistant Professor MUSC Department of Medicine Agenda Provide an update of the current
September 4, 2012. Submitted Electronically
September 4, 2012 Ms. Marilyn Tavenner Acting Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1589-P P.O. Box 8016 Baltimore, MD 21244-8016
New Functional Limitation Reporting Requirements Under Medicare Part B
New Functional Limitation Reporting Requirements Under Medicare Part B Heather Smith, PT, MPH 1 BACKGROUND AND OVERVIEW 2 1 History of Medicare Therapy Caps and Reform Payment in Therapy Services 2013
Reporting Once for 2014 Medicare Quality Reporting Programs
Reporting Once for 2014 Medicare Quality Reporting Programs Use this tool* to learn how to report quality measures one time in 2014 in order to: Become incentive eligible for 2014 Physician Quality Reporting
Implications for I/T/U
Outpatient CMS Quality Measurement Programs Implications for I/T/U CAPT Michael Toedt, MD, FAAFP Acting Chief Medical Information Officer Office of Information Technology, Indian Health Service NIHB 2015
WOUND CARE POLICY UPDATE
WOUND CARE POLICY UPDATE Marcia Nusgart R.Ph. Executive Director Alliance of Wound Care Stakeholders Coalition of Wound Care Manufacturers www.woundcarestakeholders.org Presented at The Business of Wound
May 7, 2012. Submitted Electronically
May 7, 2012 Submitted Electronically Secretary Kathleen Sebelius Department of Health and Human Services Office of the National Coordinator for Health Information Technology Attention: 2014 edition EHR
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
Calendar Year 2014 Medicare Physician Fee Schedule Final Rule
Calendar Year 2014 Medicare Physician Fee Schedule Final Rule Non-facility Cap after receiving many negative comments on this issue from physician groups along with the House GOP Doctors Caucus letter,
SGR Repeal: What Are the Implications to Academic Medicine? Len Marquez Mary Wheatley April 17, 2015
SGR Repeal: What Are the Implications to Academic Medicine? Len Marquez Mary Wheatley April 17, 2015 Agenda SGR Eulogy High Level Issues in HR2 Important to Academic Medicine Overview of the SGR Replacement
Accountable Care Organizations
Accountable Care Organizations Myth, Reality, Facts Why =System Failure Low Quality - IOM report High Cost Quality Cost disconnect Low Value Problems Disconnect between Quality and Cost Care is fragmented
The Impact of Changing Federal Policies on Physician Reimbursement
The Impact of Changing Federal Policies on Physician Reimbursement Peter Margolis, MD, AGAF Chair elect, AGA Regulatory Work Group AGA Institute Practice Management & Economics Committee University Gastroenterology
Broad Issues in Quality Measurement: the CMS perspective
Broad Issues in Quality Measurement: the CMS perspective Shari M. Ling, MD Deputy Chief Medical Officer Centers for Medicare & Medicaid Services Workshop on Quality Measurement Developing Evidence-Based
Fiscal Year 2016 proposed Inpatient and Long-term Care Hospital policy and payment changes (CMS-1632-P)
Fiscal Year 2016 proposed Inpatient and Long-term Care Hospital policy and payment changes (CMS-1632-P) Date 2015-04-17 Title Fiscal Year 2016 proposed Inpatient and Long-term Care Hospital policy and
Demystifying Patient Satisfaction Surveys
Demystifying Patient Satisfaction Surveys What you need to know about the H-CAHPS, CG-CAHPS, and PQRS and the benefits of performing patient satisfaction surveys. NCMGMA Lunch and Learn Webinar, June 11,
Navigating CMS Incentive Programs for Eligible Professionals Why It Matters and What You Need to Know. Dr. Paul Mulhausen, CMO
Navigating CMS Incentive Programs for Eligible Professionals Why It Matters and What You Need to Know Dr. Paul Mulhausen, CMO Objectives Better understand CMS Incentive Programs and payment adjustments
Functional Reporting: PT, OT, and SLP Services Frequently Asked Questions (FAQs)
Functional Reporting: PT, OT, and SLP Services Frequently Asked Questions (FAQs) Table of Contents FAQs on Providers, Plans, and Payers Subject to Functional Reporting 1 FAQs on How to Report Functional
Physician Quality Reporting System (PQRS)
Physician Quality Reporting System (PQRS) and the Value-Based Payment Modifier Implementation guide for registry-based reporting for the Hepatitis C (HCV) Measures Group 2015 1 Overview of PQRS 1,2 What
Transforming Healthcare through Data-Driven Solutions. Pay for Performance Solutions
Transforming Healthcare through Data-Driven Solutions Pay for Performance Solutions Medicare Access and CHIP Reauthorization Act of 2015 MACRA Enacted April 15, 2015 10/14/2015 Copyright Mingle Analytics
Physician Quality Reporting System (PQRS) Qualified Clinical Data Registry (QCDR) QCDR Reporting Overview. Program Year 2014
Physician Quality Reporting System (PQRS) Qualified Clinical Data Registry (QCDR) QCDR Reporting Overview Program Year 2014 Disclaimers This presentation was current at the time it was published or uploaded
2015 Medicare Physician Fee Schedule Final Rule Summary
2015 Medicare Physician Fee Schedule Final Rule Summary On October 31, 2014, the Centers for Medicare and Medicaid Services (CMS) released the final Medicare Physician Fee Schedule (MPFS) for 2015. The
Last January, the parent organization of CMS, the Department of Health and
Executive White Paper Series April 2015 In Cooperation With: This white paper series is produced by the LINK Conference, whose mission is to accelerate productivity and innovation in long term care and
MACRA & APMs: More than Acronyms June 2, 2016
MACRA & APMs: More than Acronyms June 2, 2016 Agenda 1. Framework 2. CMS Quality Initiatives 3. MACRA - MIPS or APM? 4. Alternative Payment Models 5. Case Study 2 Alternative Payment Models Transitioning
CMS Quality Measurement and Value Based Purchasing Programs Kate Goodrich, MD MHS Director, Quality Measurement and Health Assessment Group, CMS
CMS Quality Measurement and Value Based Purchasing Programs Kate Goodrich, MD MHS Director, Quality Measurement and Health Assessment Group, CMS American Urological Association Quality Improvement Summit
MACRA: Looking Ahead - Implications Across the Care Continuum. May 16, 2016/ 12:00-1:00 PM EST
MACRA: Looking Ahead - Implications Across the Care Continuum May 16, 2016/ 12:00-1:00 PM EST 1 Today s Presenter Melinda Hancock Partner, DHG Healthcare Leads a team in developing DHG Healthcare s next
Medicare & Medicaid EHR Incentive Programs
Medicare & Medicaid EHR Incentive Programs Stage 2 NPRM Overview Robert Anthony Office of E-Health Standards and Services Marsha Smith Office of Clinical Standards and Quality March 21, 2012 Proposed Rule
Medicare Access and CHIP Reauthorization Act of 2015 H.R. 2
Medicare Access and CHIP Reauthorization Act of 2015 H.R. 2 The American Medical Association and over 750 national and state-based physician and specialty organizations have gone on record in support of
March 15, 2010. Dear Dr. Blumenthal:
March 15, 2010 David Blumenthal, MD, MPP National Coordinator Office of the National Coordinator for Health Information Technology (ONCHIT) Department of Health and Human Services ATTN: HITECH Initial
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
BUNDLING ARE INPATIENT REHABILITATION FACILITIES PREPARED FOR THIS PAYMENT REFORM?
BUNDLING ARE INPATIENT REHABILITATION FACILITIES PREPARED FOR THIS PAYMENT REFORM? Uniform Data System for Medical Rehabilitation Annual Conference August 10, 2012 Presented by: Donna Cameron Rich Bajner
EHR Incentive Programs in 2010 & Beyond
CMS Listening Session: EHR Incentive Programs in 2018 & Beyond Kate Goodrich, MD, MHS, Director, Center for Clinical Standards and Quality Robert Anthony, Deputy Director, Quality Measurement & Value-Based
Advanced Therapy Management
Risk Advanced Therapy Management The larger the risk the more incentive to actively change behavior to control costs and provide only those services that are medically necessary 3 Thoughts About Risk Medicare
Centers for Medicare & Medicaid Services Quality Measurement and Program Alignment
Centers for Medicare & Medicaid Services Quality Measurement and Program Alignment 1 Conflict of Interest Disclosure Deborah Krauss, MS, BSN, RN Maria Michaels, MBA, CCRP, PMP Maria Harr, MBA, RHIA Have
Welcome The AAMC, UHC and FPSC Web Conference on 2014 PQRS Proposed Changes will begin shortly.
Welcome The AAMC, UHC and FPSC Web Conference on 2014 PQRS Proposed Changes will begin shortly. Please do not place your phones on hold. If you need to leave the event, hang up and dial back into the conference.
March 15, 2010. Dear Ms. Frizzera,
March 15, 2010 Ms. Charlene Frizzera Acting Administrator Centers for Medicare & Medicaid Services (CMS) Department of Health and Human Services Attention: CMS 0033 P P.O. Box 8013, Baltimore, MD 21244
Blueprint for Post-Acute
Blueprint for Post-Acute Care Reform Post-acute care is a critical component within our nation s healthcare system and an essential aspect of care for many patients making a full recovery possible after
The following references are used throughout the billing scenarios that follow:
11 Part B Billing Scenarios for PTs and OTs The following billing scenarios formerly appeared on the Frequently Asked Questions (FAQ) website and on the Therapy Medlearn website as "11 FAQs" - posted 9/13/02
Physician Quality Reporting System (PQRS) And VBM (Value Based Modifier) A Primer on Present and Future Requirements
Physician Quality Reporting System (PQRS) And VBM (Value Based Modifier) A Primer on Present and Future Requirements Brett Bernstein, MD, AGAF Chief Quality Officer, Beth Israel Ambulatory Endoscopy Services
2015 Physician Quality Reporting System (PQRS): Implementation Guide
2015 Physician Quality Reporting System (PQRS): Implementation Guide 1/15/2015; Revised Table of Contents Introduction... 3 PQRS Measure Selection Considerations... 6 Satisfactorily Report Measures...
Overview of the Development and Implementation of CAHPS for ACOs and PQRS. Sandra Adams, RN, BSN Lauren Fuentes, MPH.
CAHPS for ACOs and PQRS Overview of the Development and Implementation of CAHPS for ACOs and PQRS Sandra Adams, RN, BSN Lauren Fuentes, MPH July 10-11, 2014 Agenda Overview of the Medicare Shared Savings
Medicare Learning Network
CMS Proposals for the Physician Quality Reporting System (PQRS) and Physician Value-Based Payment Modifier (VM) under the Medicare Physician Fee Schedule 2014 July 25, 2013 Medicare Learning Network This
Medicare Outpatient Therapy Billing
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services R Medicare Outpatient Therapy Billing August 2010 / ICN: 903663 DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare
More Meaningful Meaningful Use Solutions to help providers maximize reimbursements with minimal office disruption
More Meaningful Meaningful Use Solutions to help providers maximize reimbursements with minimal office disruption The information and materials provided and referred to herein are not intended to constitute
Physician Compare Virtual Office Hour Questions and Answers
Physician Compare Virtual Office Hour Questions and Answers The Physician Compare Virtual Office Hour session was held on January 22, 2015 via WebEx. The purpose of the session was to allow the Centers
Aligning Meaningful Use CQM and PQRS Reporting for 2015
Aligning Meaningful Use CQM and PQRS Reporting for 2015 August 19, 2015 Introductions Marni Anderson Project Specialist, MetaStar manderso@metastar.com 608-441-8253 Laura Sawyer Clinical Application Coordinator,
Section by Section Summary of The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013
Section by Section Summary of The SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 Title I Medicare Payment for Physicians Services Section 101. Short Title; Table of Contents. Section
Reforming and restructuring the health care delivery system
Reforming and restructuring the health care delivery system Are Accountable Care Organizations and bundling the solution? Prepared by: Dan Head, Principal, RSM US LLP dan.head@rsmus.com, +1 703 336 6536
How To Write A Health Care Plan
Data Standardization: Looking Forward in Post-Acute Care Stella Mandl, RN Technical Advisor Centers for Medicare & Medicaid Services As Is T ransit io n To Be Nursing Homes MDS LTCHS LTCH CARE Data Set
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
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Summary of SGR Repeal and Replacement Provisions
ACOG Government Affairs May 2015 The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Summary of SGR Repeal and Replacement Provisions This landmark bipartisan legislation, signed into law
The Medicare Quality Reporting Programs: What Eligible Professionals Need to Know in 2016
The Medicare Quality Reporting Programs: What Eligible Professionals Need to Know in 2016 Modules Module 1: Medicare Access and CHIP Reauthorization Act (MACRA) Preview Module 2: 2016 Incentive Payments
SGR Repeal and Medicare Provider Payment Modernization Act of 2015: Timeline of Implementation
SGR Repeal and Medicare Provider Payment Modernization Act of 2015: Timeline of Implementation 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026+ Base Update Jan Jun: 0 July- Dec: 0.5 0.5% 0.5%
Meaningful Use: Terms & Timelines, Changes to Stage 1, and Stage 2 Overview
Meaningful Use: Terms & Timelines, Changes to Stage 1, and Stage 2 Overview NYC REACH Primary Care Information Project NYC Department of Health & Mental Hygiene 1 Agenda Terms & Timelines of Meaningful
CMS PQRS and VBPM Incentive/Penalty Programs. Devin Detwiler Manager Quality Improvement Telligen
CMS PQRS and VBPM Incentive/Penalty Programs Devin Detwiler Manager Quality Improvement Telligen Free Resource to you Join our Network Engage providers and stakeholders in improvement initiatives through
CY 2016 Medicare Physician Fee Schedule Proposed Rule July 23, 2015
CY 2016 Medicare Physician Fee Schedule Proposed Rule July 23, 2015 2015, AAMC-UHC-FPSC Page 1 Audio: Housekeeping You will hear the audio through your computer speakers. Please make sure your computer
Accountable Care Organizations An Operational Overview
Accountable Care Organizations An Operational Overview Chris Champ Principal cchamp@eidebailly.com 701-239-8620 1 Medicare Spending 2 1 CMS Goal Transition of Risk 60 50 40 30 20 10 0 2015 2016 2018 Percentage
Billing App Update: Version 2.012
Billing App Update: Presented by M. Aaron Little, CPA BKD, LLP Springfield, MO mlittle@bkd.com Today s Agenda 2012 prospective payment system (PPS) rates Timely filing Healthcare Common Procedure Coding
Regulations Overview
Meaningful Use - Stage 2 Regulations Overview Brought to you by Presented by: Travis Broome, MPH, MBA September 18, 2012 Objectives Specific regulatory changes and requirements based on the CMS Stage 2
VNAA Brief Summary of Medicare Home Health Rule for 2015
VNAA Brief Summary of Medicare Home Health Rule for 2015 On July 7, 2014, CMS published in the Federal Register the Proposed Rule for Medicare Home Health for Calendar Year (CY) 2015.The Proposed Rule
2015 Physician Quality Reporting System (PQRS): Implementation Guide
2015 Physician Quality Reporting System (PQRS): Implementation Guide Table of Contents Introduction... 3 PQRS Measure Selection Considerations... 6 Satisfactorily Report Measures... 11 Reporting Electronically
FY2015 Hospice Wage Index Proposed Rule
FY2015 Hospice Wage Index Proposed Rule To: NHPCO Members From: NHPCO Health Policy Team Date: May 6, 2014 Summary of FY2015 Hospice Wage Index Proposed Rule On Friday, May 2 2014, CMS released the FY2015
RE: CMS-1605-P; Medicare Program - Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2015
June 27, 2014 Marilyn Tavenner Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Attention: CMS-1605-P Room 445-G Hubert H. Humphrey Building 200 Independence
A Guidebook to the 2012 Physician Quality Reporting System
A Guidebook to the 2012 Physician Quality Reporting System Last Updated: February 2, 2012 Getting Started With PQRS The Patient Protection and Affordable Care Act made participation in Medicare s Physician
Enterprise Analytics Strategic Planning
Enterprise Analytics Strategic Planning June 5, 2013 1 "The first question a data driven organization needs to ask itself is not "what do we think?" but rather "what do we know? Big Data: The Management
White Paper: Standardizing Rehab Outcome Measures
optimahcs.com White Paper: Standardizing Rehab Outcome Measures Ellen Strunk, Rehab Resources & Consulting, Inc. in partnership with Optima Healthcare Solutions 4229 SW High Meadows Avenue Palm City, Florida
ELECTRONIC PRESCRIBING
GAO United States Government Accountability Office Report to Congressional Committees February 2011 ELECTRONIC PRESCRIBING CMS Should Address Inconsistencies in Its Two Incentive Programs That Encourage
June 27, 2016. Dear Mr. Slavitt:
Mr. Andrew M. Slavitt Acting Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-5517-P Submitted electronically to: http://www.regulations.gov
Insurance Industry Issue Paper: OT/PT Billing and Medicare G-Codes
Issue Background and History In 2012, the United States Congress passed the Middle Class Tax Relief and Jobs Creation Act of 2012 (MCTRJCA). The MCTRJCA included a subsection Sec. 3005(g) that requires
Accountable Care Organizations (ACO) Proposed Rule Summary March 31, 2011
Accountable Care Organizations (ACO) Proposed Rule Summary March 31, 2011 On March 31, 2011, the Centers for Medicare & Medicaid Services (CMS) released the longawaited proposed rule on Accountable Care
Physician Quality Reporting System (PQRS)
Physician Quality Reporting System (PQRS) Presenter: Alexandra Mugge 4 PQRS Overview CY2018 payment adjustments, based on PY2016 reporting: -2.0% MPFS Changes to PQRS Definition of eligible professional
A Guidebook to the 2015 Physician Quality Reporting System
A Guidebook to the 2015 Physician Quality Reporting System Last Updated: December 22, 2014 What is PQRS? The Physician Quality Reporting System (PQRS), formally known as the Physician Quality Reporting
Timeline for Health Care Reform
Patient Protection and Affordable Care Act (H.R. 3590) and the Reconciliation Bill (H.R. 4872) March 24, 2010 Color Code: Hospitals Insurance Coverage Other/Workforce Delivery System 2010 Expands the RAC
MediServe. More than 25 Years Serving the Rehab and Respiratory Communities
MediServe More than 25 Years Serving the Rehab and Respiratory Communities Who We Are Rehabilitation Inpatient Outpatient Acute Care Private Practice Respiratory CORE Focus (Compliance, Outcomes, Revenue,
RE: CMS-1455-P Medicare Program; Part B Inpatient Billing in Hospitals
Marilyn Tavenner Acting Administrator and Chief Operating Officer Centers for Medicare and Medicaid Services Department of Health and Human Services Room 445-G Hubert H. Humphrey Building 200 Independence
LOOKING FORWARD TO STAGE 2 MEANINGFUL USE. 2012 Louisiana HIPAA & EHR Conference Presenter: Kathleen Keeley
LOOKING FORWARD TO STAGE 2 MEANINGFUL USE 2012 Louisiana HIPAA & EHR Conference Presenter: Kathleen Keeley Topics of Discussion Stage 2 Eligibility Stage 2 Meaningful Use Clinical Quality Measures Payment
An Overview of 2015 CMS Physician Quality Reporting Programs
An Overview of 2015 CMS Physician Quality Reporting Programs Carol Saavedra, BA Health Informatics Specialist Health Services Advisory Group (HSAG) September 8, 2015 Presentation Outline HSAG Ohio s Quality
Medicare Inpatient Rehabilitation Facility Prospective Payment System
Medicare Inpatient Rehabilitation Facility Prospective Payment System Payment Rule Brief FINAL RULE Program Year: FFY 2014 Overview and Resources On August 6, 2013, the Centers for Medicare and Medicaid
MEANINGFUL USE. stoltenberg consulting inc. Meeting Stage 2 Meaningful Use Requirements. simplifying healthcare technology. www.stoltenberg.
Meeting Stage 2 Meaningful Use Requirements No matter what form the final rule of Stage 2 MU takes, HCOs can t afford to bide their time Despite the growing number of MU attestations and the impressive
Physician Compare. Virtual Office Hour Session. January 22, 2015
Physician Compare Virtual Office Hour Session January 22, 2015 Alesia Hovatter Health Policy Analyst Division of Electronic and Clinician Quality Quality Measurement and Health Assessment Group Center
September 4, 2012. Dear Acting Administrator Tavenner:
Ms. Marilyn Tavenner Acting Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1358-P P.O. Box 8016 Baltimore, MD 21244-8016 RE: CMS-1358-P; Medicare
Health Care Economics and Audiology: Why are WE Feeling the Pain? Disclosures. Disclosure 1/6/2016
Health Care Economics and Audiology: Why are WE Feeling the Pain? Robert Fifer, Ph.D. University of Miami Miller School of Medicine Mailman Center for Child Development Disclosures Employed by the University
IMPACT Act: Connecting Post-Acute Care Across the Care Continuum
IMPACT Act: Connecting Post-Acute Care Across the Care Continuum Jennie Harvell, M.Ed, Senior Technical Adviser, Centers for Medicare & Medicaid Services Terrence A. O Malley, MD, Physician, Massachusetts
Updates on CMS Quality, Value and Public Reporting
Updates on CMS Quality, Value and Public Reporting Federation of American Hospitals Policy Conference Kate Goodrich, MD MHS Director, Quality Measurement and Value Based Incentives Group, CMS June 17,
PL 111-148 and Amendments: Impact on Post-Acute Care for Health Care Systems
PL 111-148 and Amendments: Impact on Post-Acute Care for Health Care Systems By Kathleen M. Griffin, PhD. There are three key provisions of the law that will have direct impact on post-acute care needs
Data Element Uniformity and Cross Se4ng Quality Measures
Data Element Uniformity and Cross Se4ng Quality Measures Stella Mandl, RN, Technical Advisor Tara McMullen, MPH, PhD(c), Analyst Anita Yuskauskas, PhD, Technical Director Data Assessment Elements Goal
Quantitative Assessment of PT Outcomes A Physical Therapy Selfie
Quantitative Assessment of PT Outcomes A Physical Therapy Selfie What s a Selfie? It was the Word of the Year for 2013 Defined as a photograph that one has taken of oneself, typically with a smartphone
Allscripts CQS Planning for 2014 Webinar: FAQs
Allscripts CQS Planning for 2014 Webinar: FAQs Listed below are questions asked by attendees based on the CQS Planning for 2014 Webinars, held on May 8, May 28, and May 30, 2014. Answers are provided below.