Accountable Care Project EMR Reporting Guide January 6, 2014

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Accountable Care Project EMR Reporting Guide January 6, 2014"

Transcription

1 Accountable Care Project EMR Reporting Guide January 6, 2014 Web Reporting System The system can be accessed at You will need the ID and password assigned to you by NHIHPP to access the system. Each provider site has been assigned a Practice ID. Please include this correct ID number in the pracid field of the data file. Reporting Period The baseline reporting period will begin as of The initial data load will include data for Q1, Q2 for The initial data load is requested by September 13 th, Ongoing reporting will be quarterly, beginning with Q data. Please report on going quarterly data by 30 days after the close of the quarter. Reports will be run for each quarter in which data was submitted. A median report of all reporting sites will aggregate the data loaded by all sites within the project. Measures For all measures against which the site cannot report, leave both the numerator and denominator as zeros. For measures that must be completed through chart audit, please follow the guideline for chart audit. References for questions related to the measures are found at the end of the document. Please refer to the list of measures below. Assistance For assistance, please contact Hwasun Garin at Page 1 of 8

2 2 1. Percentage of patients recent HbA1c less than 8% 2. Percentage of patients recent HbA1C greater than 9% New Hampshire Accountable Care Project Numerator: Number of active patients age years with diabetes with HbA1C less than 8% during the measurement year Denominator: Total number active patients 3 age with Numerator: Number of active patients age years with diabetes with HbA1C greater than 9% on their most recent measurement, or most recent HbA1c result is missing or greater than 12 mos Denominator: Total number active patients 3 age with 1 /NQF/ NQF 0575 PQRS 313 nid=944#k=0575&e=1 NQF 0059 PQRI 1 nid=1225#k=0059&e=1 1 measures as included in DHHS/CMS National Proposed Rule-Making (NPRM) Dec 2009; measures listed are meaningful use measures proposed for Primary Care unless otherwise noted 2 defined per Physician Recognition Program - See Appendix A 3 Active patients in practice = patients who identify the practice as their primary care provider and have been seen in practice at least once in past 2 years (may exclude patients seen once in past 2 years who are known to receive majority of their primary care from another primary care practice) Page 2 of 8

3 1 /NQF/ 3. Percentage of patients with diabetes where blood pressure measurement was recorded Numerator: Number of active patients age with diabetes who had visits where blood pressure measurement was recorded during the measurement year diabetes NQF 0061 PQRS 3 4. Percentage of patients recent BP less than 140/90 mmhg Numerator: Number of patients age years with diabetes with BP less than 140/90 on their most recent measurement NQF 0061 PQRI 3 5. Percentage of patients with diabetes with a record of lipid test Numerator: Number of active patients age with diabetes and a record of a lipid test in the measurement year diabetes NQF 0064 PQRS #2 6. Percentage of patients recent LDL less than 100 mg/dl Numerator: Number of patients age years with diabetes with LDL less than 100 mg/dl on their most recent measurement NQF 0064 PQRI 2 nid=1228#k=0064 Page 3 of 8

4 7. Percentage of patients recent LDL 130 mg/dl or greater Numerator: Number of patients age years with diabetes with LDL 130 mg/dl or greater on their most recent measurement, or who did not have an LDL measurement in the past 12 months 1 /NQF/ Influenza immunization Pneumococcal immunization 8. Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31, who received an influenza immunization OR patient reported previous receipt of an influenza immunization 9. Percentage of patients 65 yrs with at least one pneumococcal immunization in their lifetime Numerator: Number of active patients aged 6 months and older seen for a visit between October 1 and March 31, who received an influenza immunization OR patient reported receipt of an influenza immunization Denominator: Total number of active patients 3 age 6 months or older with a record for visit between October 1 and March 31 Numerator: The number of active patients age 65 years or older, who have received a pneumococcal vaccination or responded Yes to the question Have you ever had a pneumonia shot? Denominator: Total number of active patients in the practice 3 age 65 and over. AMA PCPI NQF 0041 PQRI 110 nid=397#k=0041 (Pulmonary) NQF 0043 PQRI 111 nid=492#k=0043 Page 4 of 8

5 Colon cancer screening Adult Weight Screening and Follow Up ( Core Measure) Adult Weight Screening and Follow Up ( Core Measure) 10. Percentage of patients years of age who had appropriate screening for colorectal cancer 11. Percentage of patients with a calculated BMI in the last six months 12. Percentage of patients whose calculated BMI in last six months is outside normal parameters Numerator: Number of active patients years of age who had appropriate screening for colorectal cancer within appropriate time interval, defined as follows: fecal occult blood test (FOBT) during the measurement year flexible sigmoidoscopy during the measurement year or the four years prior to the measurement year double contrast barium enema (DCBE) during the measurement year or the four years prior to the measurement year. Colonoscopy during the measurement year or the nine years prior to the measurement year Denominator: Total number of active patients 3 age years as of December 31 of the measurement year Numerator: Number of active patients with a calculated BMI within the last six months or during the current visit Denominator: Total number of active patients 3 age 18 or older Numerator: Number of active patients with a calculated BMI in the past six months or during the current visit that is outside of normal parameters. Normal parameters: Age 65 and older BMI > 23 and < 30; Age BMI > 18.5 and < 25 Denominator: Total number of active patients in the practice 3 age 18 years and older. 1 /NQF/ NQF 0034 (uses 50 80yo) PQRI 113 (uses 50 75yo) nid=394#k=0034&e=1 NQF 0421 PQRS #128 NQF 0421 PQRI 128 nid=526#k=0421&e=1 Page 5 of 8

6 Preventive Care and Screening Measure Pair: a. Tobacco Use b. Tobacco Cessation Intervention ( Core Measure) Preventive Care and Screening Measure Pair: a. Tobacco Use b. Tobacco Cessation Intervention ( Core Measure) Depression screening 13. Percentage of patients who were screened for tobacco use at least once during the two year measurement period 14. Percentage of patients who were screened for tobacco use at least once during the two year measurement period AND who received cessation counseling intervention if identified as a tobacco user 15. Percentage of patients age > 12 and <18 years screened for clinical depression using an age appropriate standardized tool Numerator: Number of active patients age 18 years or older who were screened for tobacco use at least once during the two year measurement period Denominator: Total number of active patients 3 age 18 years or older who were seen two or more times for any visit OR who had at least 1 preventive care visit in the last two years Numerator: Number of active patients age 18 years or older who were screened for tobacco use at least once during the two year measurement period AND who received tobacco cessation counseling intervention** if identified as a tobacco user Denominator: Total number of active patients 3 age 18 years or older who were seen two or more times for any visit OR who had at least 1 preventive care visit in the last two years Numerator: Number of active patients aged > 12 and <18 years screened for clinical depression using an age appropriate standardized tool Denominator: Total number of active patients 3 age > 12 and <18 years 1 /NQF/ AMA PCPI NQF 0028a PQRS #226 nid=391#k=0028&e=1 AMA PCPI NQF 0028a PQRS #226 nid=391#k=0028&e=1 NQF 418 PQRS #134 Page 6 of 8

7 Depression screening 16. Percentage of patients screened for clinical depression using an age appropriate standardized tool Numerator: Number of active patients aged 12 years and older screened for clinical depression using an age appropriate standardized tool Denominator: Total number of active patients 3 age 18 years and older 1 /NQF/ NQF 418 PQRS #134 APPENDIX A: Definition of Mellitus Definition: 1. Adult patient between ages of 18 and 75 years old. 2. Has had a diagnosis of diabetes using American Association criteria (see below) and any of the following: ICD x (diabetes mellitus); (diabetes complicating pregnancy, but excludes gestational diabetes, 648.8); (diabetic polyneuropathy); (diabetic retinopathy); or (diabetic cataract) And/or has notation of prescribed routine use of insulin or oral hypoglycemics/antihyperglycemics within past 12 months. 3. Has been under the care of the participating physician or physician group for diabetes for at least 12 months. This is defined by documentation of a face to face visit for diabetes care between the physician and the patient that predates the most recent visit by at least 12 months. In addition, please adhere to the following criteria when reporting diabetes clinical quality measures: Include all patients regardless of payer (e.g. commercial, Medicare, Medicaid, self pay, uninsured, etc.). Include only patients who are active patients in your practice i.e. the patient has had 1 or more visits of any type to the practice within the past 2 years, and there is no other known primary care provider. May exclude patients seen once in past 2 years who are known to receive majority of their primary care from another primary care practice. Clinically verify that all the patients meet the ADA definition for diabetes (see below). Page 7 of 8

8 American Association (ADA) Criteria 1 for Diagnosis of Mellitus: 1) Hemoglobin A1C 6.5%*, OR 2) Fasting Plasma Glucose 126 mg/dl (7.0 mmol/l). Fasting is defined as no caloric intake for at least 8 hrs*, OR 3) Two hour plasma glucose 200 mg/dl (11.1 mmol/l) during an oral glucose tolerance test (OGTT). The test should be performed as described by the World Health Organization, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water, OR 4) In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose 200 mg/dl (11.1 mmol/l). (*In the absence of unequivocal hyperglycemia, criteria 1 3 should be confirmed by repeat testing.) *As outlined in National Committee on Quality Assurance () Physician Recognition Program: ** From ADA s Clinical Practice Recommendations 2010 see Page 8 of 8

2013 ACO Quality Measures

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

More information

Medicare Shared Savings Program Quality Measure Benchmarks for the 2014 Reporting Year

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

More information

ACO QUICK-REFERENCE SETUP GUIDE

ACO QUICK-REFERENCE SETUP GUIDE ACO QUICK-REFERENCE SETUP GUIDE FOR NON-eCW USERS V 9.0 eclinicalworks, 2013. All rights reserved Contents CONTENTS ACO SETUP 3 Demographics 3 ACO 12 4 ACO 13 5 ACO 14 5 ACO 15 7 ACO 16 8 ACO 17 15 ACO

More information

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 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

More information

ACO Name and Location Allina Health Minneapolis, Minnesota

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

More information

Medicare Shared Savings Program Quality Measure Benchmarks for the 2015 Reporting Year

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

More information

2016 HEDIS & Quality Assurance Reporting Requirements Measures Provider Reference Guide

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

More information

There have been significant

There have been significant Managing Clinical Quality Measures for Meaningful Use and PQRS Using the EHR Method These tips will make it easier to qualify. By Seth Flam, DO Charlieaja Dreamstime.com There have been significant changes

More information

Clinical Quality Measure Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW

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)

More information

Overview of Clinical Quality Measures Reporting in the Centers for Medicare & Medicaid Services (CMS) Final Rule on Meaningful Use

Overview of Clinical Quality Measures Reporting in the Centers for Medicare & Medicaid Services (CMS) Final Rule on Meaningful Use Overview of Clinical Quality Measures Reporting in the Centers for Medicare & Medicaid Services (CMS) Final Rule on Meaningful Use Clinical Quality Measures Clinical quality measures have been defined

More information

PARTI: HOW TO IMPORT A CUSTOM EXAM TEMPLATE FOR TOP ASaP PARTICIPATION

PARTI: HOW TO IMPORT A CUSTOM EXAM TEMPLATE FOR TOP ASaP PARTICIPATION PARTI: HOW TO IMPORT A CUSTOM EXAM TEMPLATE FOR TOP ASaP PARTICIPATION 1. Login to your Wolf EMR. 2. Open Internet Explorer 3. Go the TOP ASaP web site to the EMR Knowledge Resources area at: http://www.topalbertadoctors.org/asap/resourcestools/emrkt/

More information

ACCOUNTABLE CARE ORGANIZATION QUICK-REFERENCE SETUP GUIDE

ACCOUNTABLE CARE ORGANIZATION QUICK-REFERENCE SETUP GUIDE ACCOUNTABLE CARE ORGANIZATION QUICK-REFERENCE SETUP GUIDE V 9.0 eclinicalworks, 2013. All rights reserved Contents CONTENTS ACO SETUP 3 Demographics 3 ACO 12 4 ACO 13 6 ACO 14 7 ACO 15 8 ACO 16 9 ACO 17

More information

Health Maintenance Guidelines for Women

Health Maintenance Guidelines for Women Health Maintenance Guidelines for Women Customize your plan: These guidelines apply to healthy women in the general population. The right plan for your care may differ based on your medical history, family

More information

ASaP Chart Review Instructions - for EMR Based Charts

ASaP Chart Review Instructions - for EMR Based Charts ASaP Chart Review Instructions - for EMR Based Charts 1 Table of Contents Overview... 3 Chart Review Preparation... 3 One Day before Baseline Chart Review:... 6 Day of Baseline Chart Review (At Clinic):...

More information

Vermont ACO Shared Savings Program: Recommendations for Year 2 Quality Measures

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

More information

Panel Management, Performance Measures and Reporting (PM 2 R)

Panel Management, Performance Measures and Reporting (PM 2 R) Panel Management, Performance Measures and Reporting (PM 2 R) -the evolving story of Quality Improvement *** Allan L. Bailey, MD, CCFP Grace Moe, BPT, MSc, PCMH-CCE Branden Ayotte, MD Candidate 2017 Accelerating

More information

CLINICAL PRACTICE GUIDELINE

CLINICAL PRACTICE GUIDELINE CLINICAL PRACTICE GUIDELINE Procedure: Diabetes Guideline Review Cycle: Biennial Reviewed By: Amish Purohit, MD, MHA, CPE, FACHE Review Date: November 2014 Committee Approval Date: 11/12/2014 PURPOSE:

More information

Oregon Standards for Certified Community Behavioral Health Clinics (CCBHCs)

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

More information

0 What is Meaningful Use and where are we? 0 What is the Physician Quality Reporting System and where stage are we on?

0 What is Meaningful Use and where are we? 0 What is the Physician Quality Reporting System and where stage are we on? Outline 0 What is Meaningful Use and where are we? 0 What is the Physician Quality Reporting System and where stage are we on? 0 How can we leverage the EMR to demonstrate the quality of our care? Meaningful

More information

"2015 ACO quality measures- What's new? How can we be successful?"

2015 ACO quality measures- What's new? How can we be successful? "2015 ACO quality measures- What's new? How can we be successful?" ACO Announcements Reminders: ACO Notifications, Requests for Tax ID information from PECOS, Upcoming Boardline Upcoming Specialty Initiative

More information

Primary Care Quality Care Indicators - Accuro EMR Prevention

Primary Care Quality Care Indicators - Accuro EMR Prevention Quality Indicators Primary Care Quality Care Indicators - Accuro EMR Prevention Data needs to be entered as indicated in order to auto populate the worksheet Date of colon cancer screening Exemption from

More information

BCBSTX Bridges to Excellence Diabetes Care Program Guide

BCBSTX Bridges to Excellence Diabetes Care Program Guide BCBSTX Bridges to Excellence Diabetes Care Program Guide Blue Cross and Blue Shield of Texas (BCBSTX) is pleased to offer an innovative program that recognizes Texas physicians who deliver excellent care

More information

Annually for adults ages 55 80 years with 30 pack/year smoking history and currently smoke or quit within the past 15 years Hepatitis B screening

Annually for adults ages 55 80 years with 30 pack/year smoking history and currently smoke or quit within the past 15 years Hepatitis B screening Preventive Care Schedule Effective January 1, 2016 Highmark Blue Cross Blue Shield Express Scripts The plan pays for preventive care only when given by a network provider. Use your Highmark BCBS ID card

More information

Annually for adults ages 55 80 years with 30 pack/year smoking history and currently smoke or quit within the past 15 years Hepatitis B screening

Annually for adults ages 55 80 years with 30 pack/year smoking history and currently smoke or quit within the past 15 years Hepatitis B screening Preventive Care Schedule Effective January 1, 2016 Highmark Blue Cross Blue Shield Express Scripts The plan pays for preventive care only when given by a network provider. Certain vaccines are available

More information

Total Health Quality Indicators For Providers 2015

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

More information

VIII. Dentist Crosswalk

VIII. Dentist Crosswalk Page 27 VIII. Dentist Crosswalk Overview The final rule on meaningful use requires that an Eligible Professional (EP) report on both clinical quality measures and functional objectives and measures. While

More information

WHAT ARE CLINICAL QUALITY MEASURES? IMPORTANT TERMS

WHAT ARE CLINICAL QUALITY MEASURES? IMPORTANT TERMS Practice Fusion 2014 Clinical Quality Measure Guide This guide will provide in depth information on the clinical quality measures that are available in Practice Fusion. WHAT ARE CLINICAL QUALITY MEASURES?

More information

OBJECTIVES AGING POPULATION AGING POPULATION AGING IMPACT ON MEDICARE AGING POPULATION

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

More information

Primary Care in the U.S. Measuring and Improving Primary Care in the United States ISQua Indicators Summit 2012. CMS Measures. Primary Care Measures

Primary Care in the U.S. Measuring and Improving Primary Care in the United States ISQua Indicators Summit 2012. CMS Measures. Primary Care Measures Primary Care in the U.S. Measuring and Improving Primary Care in the United States ISQua Indicators Summit 2012 Cliff Fullerton, MD, MS VP Chronic Disease Baylor Health Care System Number of PCPs in the

More information

Mar. 31, 2011 (202) 690-6145. Improving Quality of Care for Medicare Patients: Accountable Care Organizations

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

More information

Ophthalmology Meaningful Use Attestation Guide Stage 1 2013 Edition

Ophthalmology Meaningful Use Attestation Guide Stage 1 2013 Edition Ophthalmology Meaningful Use Attestation Guide Stage 1 2013 Edition Ophthalmologists can register for the Medicare electronic health record (EHR) incentive program on the CMS website: https://ehrincentives.cms.gov

More information

Medicare 2013 QI Program Evaluation

Medicare 2013 QI Program Evaluation #1 Priority Measures Diabetes Medication Adherence D 3 69% 71% High Risk Meds in the Elderly D 3 8% 3% Sleep medications were added to the measure after the 2013 formulary was accepted. A number of high

More information

Psychiatrists and Reporting on Meaningful Use Stage 1. August 6, 2012

Psychiatrists and Reporting on Meaningful Use Stage 1. August 6, 2012 Psychiatrists and Reporting on Meaningful Use Stage 1 August 6, 2012 Quick Overview Functional Measures Providers (tracked by NPI) must report on 15 core objectives and associated measures and 5 objectives

More information

PCMH Quality Metrics Report Deadline: March 31, 2015 Guidance Packet

PCMH Quality Metrics Report Deadline: March 31, 2015 Guidance Packet PCMH Quality Metrics eport Deadline: March 31, 2015 Guidance Packet Monica J. Lindeen Commissioner of Securities & Insurance Montana State Auditor 840 Helena Ave. Helena, MT 59601 Phone: 406.444.2040 or

More information

Radiology Business Management Association Technology Task Force. Sample Request for Proposal

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

More information

Using Wolf EMR for Panel Identification and Screening

Using Wolf EMR for Panel Identification and Screening Using Wolf EMR for Panel Identification and Screening Part I Begin Panel Identification Before you begin panel processes, it is useful to have some data to inform your starting point. Note: Useful Help

More information

Baskets of Care Diabetes Subcommittee

Baskets of Care Diabetes Subcommittee Baskets of Care Diabetes Subcommittee Disclaimer: This background information is not intended to be a comprehensive scientific discussion of the topic, but rather an attempt to provide a baseline level

More information

2015 PROVIDER TOOLKIT Understanding the Centers for Medicare and Medicaid (CMS) Stars Rating System

2015 PROVIDER TOOLKIT Understanding the Centers for Medicare and Medicaid (CMS) Stars Rating System Understanding the Centers for Medicare and Medicaid (CMS) Stars Rating System 7990 IH 10 West, Suite 300 San Antonio, TX 78230 What is CMS Quality Star Ratings program? CMS evaluates health insurance plans

More information

Medicare s Preventive Care Services. Manage Your Chronic Kidney Disease (CKD stages 3-4) with Diet

Medicare s Preventive Care Services. Manage Your Chronic Kidney Disease (CKD stages 3-4) with Diet s Preventive Care Services Manage Your Chronic Kidney Disease (CKD stages 3-4) with Diet What do the kidneys do? Your kidneys have important jobs to do in your body. Two of the kidneys most important jobs

More information

Manitoba Primary Care Quality Indicators Guide Plain Language Summary - v1.9.1

Manitoba Primary Care Quality Indicators Guide Plain Language Summary - v1.9.1 Manitoba Primary Care Quality Indicators Guide Plain Language Summary - v1.9.1 Prevention 2.01 Cervical Cancer Screening (CIHI Derived from indicator # 50) Percentage of female enrolled patients 21 to

More information

ABELMed EHR-EMR/PM version 12, an ONC HIT 2014 Edition Complete EHR, has been certified for the following 42 clinical quality measures (CQMs).

ABELMed EHR-EMR/PM version 12, an ONC HIT 2014 Edition Complete EHR, has been certified for the following 42 clinical quality measures (CQMs). ABELMed EHR-EMR/PM version 12, an ONC HIT 2014 Edition Complete EHR, has been certified for the following 42 clinical quality measures (CQMs). The information contained in this document is also available

More information

Clinical Practice Guidelines for Diabetes Management

Clinical Practice Guidelines for Diabetes Management Clinical Practice Guidelines for Diabetes Management Diabetes is a disease in which blood glucose levels are above normal. Over the years, high blood glucose damages nerves and blood vessels, which can

More information

PTE Pediatric Asthma Metrics Reporting Updated January 2015

PTE Pediatric Asthma Metrics Reporting Updated January 2015 PTE Pediatric Asthma Metrics Reporting Updated January 20 Introduction: The Maine Health Management Coalition s (MHMC) Pathways to Excellence (PTE) Program is preparing for its next round of PTE Pediatric

More information

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 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

More information

Improving Quality of Care for Medicare Patients: Accountable Care Organizations

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

More information

Clinical Quality Measures for Providers

Clinical Quality Measures for Providers Meaningful Use White Paper Series Paper no. 6a: Clinical Quality Measures for Providers Published September 15, 2010 Clinical Quality Measures for Providers Papers 5a and 5b in this series reviewed the

More information

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 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

More information

Improving Quality of Care for Medicare Patients: Accountable Care Organizations

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

More information

James R. Christina, DPM FPMA 2014 Annual Meeting Naples, FL

James R. Christina, DPM FPMA 2014 Annual Meeting Naples, FL Stage 2 Meaningful Use: A Deep Dive James R. Christina, DPM FPMA 2014 Annual Meeting Naples, FL Latest CMS Data April 2014 Provider Summary 1 Payment Summary What Stage Am I In? 2 2 CMS Proposed Rule On

More information

Prevents future health problems. You receive these services without having any specific symptoms.

Prevents future health problems. You receive these services without having any specific symptoms. Preventive Care To help you live the healthiest life possible, we offer free preventive services for most Network Health members. Please refer to your member materials, which you received when you enrolled

More information

DEMONSTRATING MEANINGFUL USE STAGE 1 REQUIREMENTS FOR ELIGIBLE PROVIDERS USING CERTIFIED EHR TECHNOLOGY IN 2014

DEMONSTRATING MEANINGFUL USE STAGE 1 REQUIREMENTS FOR ELIGIBLE PROVIDERS USING CERTIFIED EHR TECHNOLOGY IN 2014 DEMONSTRATING MEANINGFUL USE STAGE 1 REQUIREMENTS FOR ELIGIBLE PROVIDERS USING CERTIFIED EHR TECHNOLOGY IN 2014 The chart below lists the measures (and specialty exclusions) that eligible providers must

More information

Allscripts CQS Planning for 2014 Webinar: FAQs

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.

More information

Objectives. Introduction

Objectives. Introduction 1 Lab 1: Diabetes Reading 13 th Edition Hole s Diabetes Clinical Application & From Science To Technology (pages 516-517) Table Appendix C (pages 928-930) Objectives 1. To define diabetes mellitus. 2.

More information

Core Set of Objectives and Measures Must Meet All 15 Measures Stage 1 Objectives Stage 1 Measures Reporting Method

Core Set of Objectives and Measures Must Meet All 15 Measures Stage 1 Objectives Stage 1 Measures Reporting Method Stage 1 Meaningful Use Criteria Physicians must meet all 15 Core Set objectives and measures and five of the 10 Menu Set objectives and measures. They also must report clinical quality measures (see separate

More information

Martin Arron, MD, MBA Brenda Matti-Orozco, MD. CHP-IPA April 16, 17, 18, 2013

Martin Arron, MD, MBA Brenda Matti-Orozco, MD. CHP-IPA April 16, 17, 18, 2013 Martin Arron, MD, MBA Brenda Matti-Orozco, MD CHP-IPA April 16, 17, 18, 2013 1. Describe the history and scope of Medicare s preventive services 2. Explain differences between the Welcome to Medicare Initial

More information

CQMs. Clinical Quality Measures 101

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

More information

See page 331 of HEDIS 2013 Tech Specs Vol 2. HEDIS specs apply to plans. RARE applies to hospitals. Plan All-Cause Readmissions (PCR) *++

See page 331 of HEDIS 2013 Tech Specs Vol 2. HEDIS specs apply to plans. RARE applies to hospitals. Plan All-Cause Readmissions (PCR) *++ Hospitalizations Inpatient Utilization General Hospital/Acute Care (IPU) * This measure summarizes utilization of acute inpatient care and services in the following categories: Total inpatient. Medicine.

More information

Medicare & Dual Options. 1. Every page of the EMR document must include: a. Member Name b. Patient Identifiers (i.e. Date of Birth) c.

Medicare & Dual Options. 1. Every page of the EMR document must include: a. Member Name b. Patient Identifiers (i.e. Date of Birth) c. Medicare & SUBMITTING PROGRESS NOTES OR EMR You may use your own progress notes or Electronic Medical Record (EMR) to document the annual comprehensive examination. The EMR must include the elements indicated

More information

New Medicare Preventive

New Medicare Preventive New Medicare Preventive Services Screening Tests You Can Perform in the Office Charles B. Root, PhD Medicare is finally getting serious about preventive services. Until now, the limited preventive testing

More information

2016 Performance Recognition Program PROVIDER INCENTIVE PROGRAM FOR: BCN Commercial HMO BCN AdvantageSM HMO-POS BCBSM Medicare Plus BlueSM PPO

2016 Performance Recognition Program PROVIDER INCENTIVE PROGRAM FOR: BCN Commercial HMO BCN AdvantageSM HMO-POS BCBSM Medicare Plus BlueSM PPO every card. Confidence comes with 2016 Performance Recognition Program PROVIDER INCENTIVE PROGRAM FOR: BCN Commercial HMO BCN AdvantageSM HMO-POS BCBSM Medicare Plus BlueSM PPO CONTENTS Performance Recognition

More information

TYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY. Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU

TYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY. Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU TYPE 2 DIABETES IN CHILDREN DIAGNOSIS AND THERAPY Ines Guttmann- Bauman MD Clinical Associate Professor, Division of Pediatric Endocrinology, OHSU Objectives: 1. To discuss epidemiology and presentation

More information

Preventive Health Services

Preventive Health Services understanding Preventive Health Services For the most current version of this document, visit www.wellwithbluemt.com or www.bcbsmt.com. Preventive health services include evidence-based screenings, immunizations,

More information

Chapter Three Accountable Care Organizations

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

More information

ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION)

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

More information

ATLANTIC and OPTIMUS ACCOUNTABLE CARE ORGANIZATIONs CMS QUALITY MEASURES

ATLANTIC and OPTIMUS ACCOUNTABLE CARE ORGANIZATIONs CMS QUALITY MEASURES CARE / PATIENT SAFETY ATLANTIC and OPTIMUS ACCOUNTABLE CARE ORGANIZATIONs CMS QUALITY MEASURES This tool is for REFERENCE USE ONLY and serves as an Emergency Backup Documentation Tool (downtime procedure

More information

Humana Physician Quality Rewards Program 2014

Humana Physician Quality Rewards Program 2014 Humana Physician Quality Rewards Program 2014 Medicare Name Date External Presentation 1430ALL0114 B Humana s Accountable Care Continuum Provider Quality Rewards HEDIS based quality metrics Clinical +

More information

Coverage for preventive care

Coverage for preventive care Coverage for preventive care Understanding your preventive care coverage Preventive care, like screenings and immunizations, helps you and your family stay healthier and can help lower your overall out-of-pocket

More information

OUR ACO QUALITY RESULTS 2012 AND 2013

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

More information

Behavioral Health Phase 3: Standards Under Review

Behavioral Health Phase 3: Standards Under Review Behavioral Health Phase 3: Standards Under Review Measure Number Title Description Measure Steward 0108 Follow-Up Care for Children Prescribed ADHD Medication (ADD) The percentage of children newly prescribed

More information

CME Test for AMDA Clinical Practice Guideline. Diabetes Mellitus

CME Test for AMDA Clinical Practice Guideline. Diabetes Mellitus CME Test for AMDA Clinical Practice Guideline Diabetes Mellitus Part I: 1. Which one of the following statements about type 2 diabetes is not accurate? a. Diabetics are at increased risk of experiencing

More information

Preventive Services Explained

Preventive Services Explained Preventive Services Explained Medicare covers many preventive care services without charge. Most of these services have been recommended by the U.S. Preventive Services Task Force. However, which beneficiaries

More information

IHS Clinical Reporting System

IHS Clinical Reporting System RESOURCE AND PATIENT MANAGEMENT SYSTEM IHS Clinical Reporting System (BGP) Version 12.1 Office of Information Technology (OIT) Division of Information Resource Management Albuquerque, New Mexico Revision

More information

Medicare Part B Covered Preventive Services

Medicare Part B Covered Preventive Services Prior to providing the following PREVENTATIVE services: for ONLINE ELIG via Patient Insurance Maintenance screen for Ins Code MC to determine if the patient is eligible, i.e., not exceeding the maximum

More information

Health Services Advisory Group of California, Inc.

Health Services Advisory Group of California, Inc. Physician Quality Reporting Shanti Wilson, MBA, PMP Health IT Director, California June 25 26, 2013 CPCA Conference 1 Health Services Advisory Group of California, Inc. The Medicare Quality Improvement

More information

Contra Cost Health Plan Quality Program Summary November, 2013

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

More information

2012 Physician Quality Reporting System:

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

More information

Preventive Services Explained

Preventive Services Explained Preventive Services Explained Medicare covers many preventive care services without charge. Most of these services have been recommended by the U.S. Preventive Services Task Force. However, which beneficiaries

More information

SHIIP Combo Form. 1-855-408-1212 www.ncshiip.com. North Carolina Department of Insurance Wayne Goodwin, Commissioner

SHIIP Combo Form. 1-855-408-1212 www.ncshiip.com. North Carolina Department of Insurance Wayne Goodwin, Commissioner SHIIP Combo Form Seniors Health Insurance Information Program North Carolina Department of Insurance Wayne Goodwin, Commissioner 1-855-408-1212 www.ncshiip.com What is SHIIP? Seniors Health Insurance Information

More information

Test Procedure for 170.304 (j) Calculate and Submit Clinical Quality Measures

Test Procedure for 170.304 (j) Calculate and Submit Clinical Quality Measures Test Procedure for 170.304 (j) Calculate and Submit Clinical Quality Measures This document describes the draft test procedure for evaluating conformance of complete EHRs or EHR modules 1 to the certification

More information

Price Transparency Attestation emr4md version 9.7 09/03/2014

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

More information

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 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

More information

Understanding your coverage. Preventive health care guidelines

Understanding your coverage. Preventive health care guidelines Understanding your coverage Preventive health care guidelines Preventive services are immunizations, screenings, lab tests and other services that either help prevent illness or help find diseases or medical

More information

Procedure Code(s): n/a This counseling service is included in a preventive care wellness examination or focused E&M visit.

Procedure Code(s): n/a This counseling service is included in a preventive care wellness examination or focused E&M visit. Coding Summary for Providers NOTE THE FOLLOWING: The purpose of this document is to provide a quick reference of the applicable codes for UnitedHealthcare plans that cover preventive care services in accordance

More information

Diabetes Health Plan Member Guide

Diabetes Health Plan Member Guide Diabetes Health Plan Member Guide Welcome UnitedHealthcare Diabetes Health Plan Welcome to the Diabetes Health Plan. Our goal is to ensure you are getting the most out of your program. Please use this

More information

Manitoba EMR Data Extract Specifications

Manitoba EMR Data Extract Specifications MANITOBA HEALTH Manitoba Data Specifications Version 1 Updated: August 14, 2013 1 Introduction The purpose of this document 1 is to describe the data to be included in the Manitoba Data, including the

More information

ACO Public Reporting

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

More information

Understanding preventive care

Understanding preventive care Understanding preventive care We want you to be your healthiest. That s why the preventive services listed here are free for most members. What services are recommended? Know before you go. Preventive

More information

What is the ideal A1C goal for people with diabetes? a) Under 7% b) 6.5% or less c) 4%- 6%

What is the ideal A1C goal for people with diabetes? a) Under 7% b) 6.5% or less c) 4%- 6% A1C Test Quiz: Are You in the Know About the A1C Test? The dreaded A1C test. Twice or more a year, you have to face this "judge" of all you have done the two or three months before. No matter how hard

More information

2010 QARR QUICK REFERENCE GUIDE Adults

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

More information

Clinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Frequency of visit as recommended by PCP

Clinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Frequency of visit as recommended by PCP SCREENING EXAMINATION & COUNSELING UPMC Health Plan Clinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Annually Physical Exam and Counseling 1 Blood Pressure 2 At each visit. At least

More information

PROGRAM ASSISTANCE LETTER

PROGRAM ASSISTANCE LETTER PROGRAM ASSISTANCE LETTER DOCUMENT NUMBER: 2014-01 DATE: December 13, 2013 DOCUMENT TITLE: Approved Uniform Data System Changes for Calendar Year 2014 TO: Health Centers Primary Care Associations Primary

More information

MEDICAL POLICY POLICY TITLE DIABETIC SELF-MANAGEMENT TRAINING PROGRAM POLICY NUMBER MP- 2.076

MEDICAL POLICY POLICY TITLE DIABETIC SELF-MANAGEMENT TRAINING PROGRAM POLICY NUMBER MP- 2.076 Original Issue Date (Created): July 1, 2005 Most Recent Review Date (Revised): Effective Date: May 24, 2011 August 31, 2011- RETIRED I. POLICY Initial diabetic self-management training (DSMT) may be considered

More information

AAP Meaningful Use: Becoming a Meaningful User An Outpatient Checklist

AAP Meaningful Use: Becoming a Meaningful User An Outpatient Checklist AAP Meaningful Use: Becoming a Meaningful User An Outpatient Checklist On July 13, 2010, the US Centers for Medicare and Medicaid Services (CMS) released a Final Rule establishing the criteria with which

More information

The Guide to Medicare Preventive Services for Physicians, Providers, Suppliers, and Other Health Care Professionals. May 2005

The Guide to Medicare Preventive Services for Physicians, Providers, Suppliers, and Other Health Care Professionals. May 2005 for Physicians, Providers, Suppliers, and Other Health Care Professionals May 2005 DISCLAIMER This Guide was prepared as a tool to assist providers and is not intended to grant rights or impose obligations.

More information

Achieving Quality and Value in Chronic Care Management

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

More information

Mastering UDS: Implementing New Measures and Improving Your Outcomes

Mastering UDS: Implementing New Measures and Improving Your Outcomes Mastering UDS: Implementing New Measures and Improving Your Outcomes Danielle Oryn, DO, MPH Chief Medical Informatics Officer Petaluma Health Center Elizabeth Scott, APRN Community Health Center, Inc.

More information

Your Guide to Medicare s Preventive Services

Your Guide to Medicare s Preventive Services Your Guide to Medicare s Preventive Services C E N T E R S F O R M E D I C A R E & M E D I C A I D S E R V I C E S This is the official government booklet with important information about: What disease

More information

Medicare & Medicaid EHR Incentive Program Meaningful Use Stage 1 Requirements Summary. http://www.cms.gov/ehrincentiveprograms/

Medicare & Medicaid EHR Incentive Program Meaningful Use Stage 1 Requirements Summary. http://www.cms.gov/ehrincentiveprograms/ Medicare & Medicaid EHR Incentive Program Meaningful Use Stage 1 Requirements Summary 2010 What are the Requirements of Stage 1 Meaningful Use? Basic Overview of Stage 1 Meaningful Use: Reporting period

More information

PROGRAM ASSISTANCE LETTER

PROGRAM ASSISTANCE LETTER PROGRAM ASSISTANCE LETTER DOCUMENT NUMBER: PAL 2012-03 DATE: April 11, 2012 DOCUMENT TITLE: Approved Uniform Data System Changes for 2012 TO: Health Center Program Grantees Primary Care Associations Primary

More information

Clinical HEDIS Medicare Stars Quick Reference Guide

Clinical HEDIS Medicare Stars Quick Reference Guide Clinical HEDIS Medicare Stars Quick Reference Guide MEASURE Adult BMI Assessment (ABA) Breast Cancer Screening (BCS) SPECIFICATIONS The percentage of members 18 74 years of age who had an outpatient visit

More information