= AUDIO 8/20/2015. e Clinical Quality Reporting for Hospitals and Providers. An Important Reminder. Mission of OFMQ. Ashley Rhude RHIA, CHTS IM
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1 e Clinical Quality Reporting for Hospitals and Providers Ashley Rhude RHIA, CHTS IM An Important Reminder For audio, you must use your phone: Step 1: Call (866) Step 2: Enter code #. Step 3: Mute your phone!!! = AUDIO Mission of OFMQ OFMQ is a not for profit, consulting company dedicated to advancing healthcare quality. Since 1972, we ve been a trusted resource through collaborative partnerships and hands on support to healthcare communities. 1
2 OFMQ Service Lines Analytics Case Review Education IT Consulting Health Information Technology National Quality Measures Quality Improvement Additional HIT Service Lines Security Risk Assessment Level 1, 2, and 3 Meaningful Use Assistance Meaningful Use Audit Support Risk Management Consulting and Development Staff IT Security Training Website Development & Secure IT Consulting Ashley Rhude, RHIA, CHTS IM AHIMA Approved ICD 10 CM/PCS Trainer Ashley holds a bachelor s degree in Health Information Management, as well as Health Care Administration. She is currently a Health Information Technology (HIT) practice advisor for the Oklahoma Foundation for Medical Quality. In this role, she assists providers, hospitals and nursing homes in the implementation and optimization of Electronic Health Records (EHR). Her specialties include: project coordination with EHR vendors, HIT security and privacy, workflow re design and being an expert in meaningful use. 2
3 Focus of Presentation We will discuss the Clinical Quality Reporting programs for Eligible Providers and Hospitals including: What are the Clinical Quality Measures (CQMs) Reporting options for CQMs How can you report CQMs Timelines for reporting CQMs CQMs for Eligible Providers Eligible Professionals will need to report 9 CQM s CQM s must cover at least 3 of the 6 available National Quality Strategy domains which represent the Department of Health and Human Services priorities for healthcare quality improvement CQMs for Eligible Providers and Guidance/Legislation/EHRIncentivePrograms/Downloads/EPMeasuresTableM ay2015.pdf 3
4 Reporting Options for Providers Options that only apply for the EHR Incentive Program: Option 1: Attest to CQMs through the EHR Registration & Attestation System Option 2: ereport CQMs through Physician Quality Reporting System (PQRS) Portal Options that Align with Other Quality Programs: Option 3: Report individual eligible professionals CQMs through PQRS Portal Option 4: Report group s CQMs through PQRS Portal Option 5: Report group s CQMs through Pioneer ACO participation or Comprehensive Primary Care Initiative participation Individual vs Group Reporting Individual EPs are identified on claims by their individual National Provider Identifier (NPI) and Tax Identification Number (TIN) A group practice under 2015 PQRS is defined as a single Tax Identification Number (TIN) with 2 or more individual EPs who have reassigned their billing rights to the TIN Other Reporting Mechanisms 4
5 Steps for Provider CQM Submission 1. Determine reporting method and which measures apply 2. Verify the EHR system is 2014 Edition certified 3. Document patient information in the EHR system 4. If self reporting: Register for an CMS Enterprise Portal (EIDM) account (only required for PQRS Portal CQM submission) To request an EIDM account: Request the EHR Submitter Role when registering for the EIDM account If you already have an account, you will need to request adding the role to your account 5. If self reporting: Submit 2015 CQM Data Registration & Attestation system PQRS Portal CMS Enterprise Portal Account (EIDM) Registration registration PQRS Timeline Source Initiatives Patient Assessment Instruments/PQRS/Downloads/ _CMS_PQRS_Timeline.pdf 5
6 Penalties for EPs that Do Not Participate in PQRS Performance Year Penalty applied in PQRS Penalty VM Penalty Total Penalty % 1.5% % 2% % 2% % 2% 4% % 2% 4% Hospital CQMs CAH s will need to report 16 CQM s AMI ED IMM STK VTE Sepsis (as of Q discharges) 6
7 Hospital CQMs and Guidance/Legislation/EHRIncentivePrograms/Downloads/eCQM_EH_Table_A pril2014.pdf Reporting Options for Hospitals EHR Reporting Options for Eligible Hospitals in 2014 Include: Option 1: Attest to CQMs through the EHR Registration & Attestation System Option 2: ereport through Hospital Inpatient Quality Reporting (IQR) Hospital IQR Program Requirements Checklist Register with QualityNet Maintain an Active QualityNet Security Administrator (SA) Complete an Notice of Participation (NoP) (for newly reporting hospitals) Submit HCAHPS Data Submit Aggregate Population and Sample Size Counts Submit Clinical Process of Care Measure Data Submit HAI Data, including Influenza Vaccination Coverage Among Healthcare Personnel (HCP) Data Submit Perinatal Care Elective Delivery Measure (PC 01) Data Complete Structural Measures Information Complete the DACA 7
8 Registering with QualityNet Timelines As a Reminder Submission of ecqms does not meet the complete program requirements for the Hospital IQR Program. Hospitals are still required to submit data for the remaining chart abstracted, web based, and claims based measures. 8
9 In Conclusion We Are Here To Help! Call: (877) Visit: Questions? ICD 10 Training in OKC & Tulsa Our workshop provides assistance from AHIMA approved ICD 10 CM trainers to help you learn how to successfully transition from ICD 9 to ICD 10 coding. OKC, August 20 Tulsa, August 26 Choose a date & register at month 9
10 Upcoming WebEx Seminars Wed, Sept 23 12:15pm (Central Time) Meaningful Use Audits for Medicare & Medicaid Register at month Thank you! 10
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