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Tuesday, December 20, 2016

2015 quality data now available on Physician Compare website

The Centers for Medicare & Medicaid Services (CMS) this week published quality data for 2015 on the Physician Compare website. The data included selected 2015 Physician Quality Reporting System (PQRS) measures, non-PQRS measures, and Consumer Assessment of Healthcare Providers and Systems (CAHPS) measures for both individual physicians and group practices or accountable care organizations (ACOs).

Depending on how the data was reported, the newest batch of information includes the following data from 2015:
     •    90 individual clinician-level PQRS measures collected through claims and registry, and 16 non-PQRS measures collected through Qualified Clinical Data Registries (QCDRs) for approximately 175,000 individual clinicians;
     •    91 group practice-level PQRS measures collected via the web interface and registry and eight CAHPS measures for approximately 2,500 group practices
     •    19 Shared Savings Program and Pioneer ACO measures for approximately 400 ACOs.

The release does not include any measures reported by electronic health record for 2015 because that information continues to be plagued by data integrity issues.

Since starting the Physician Compare website in 2010, CMS has continued to enhance the site to provide data that is both useful to consumers and assists them to make informed health care decisions. CMS also believes transparency motivates better physician performance.

Each measure is scored using a star-rating system with each star representing 20 percent of the total score (e.g., five stars is 100 percent, four stars is 80 percent, etc.)

This information is important to physicians because it reflects on their reputation and may influence potential patients to either seek out or avoid a practice. The CMS plans to eventually add information collected under the Medicare Access and CHIPS Reauthorization Act (MACRA) such as data for each of the four Merit-based Incentive Payment System categories (quality, cost, improvement activities, advancing care information) and final scores. Advanced Alternative Payment Model data will also be available, similar to ACO data now.  Item-level benchmarking will be incorporated into the star rating system.

CMS will host webinars on Feb. 21 and 23 about recent updates to Physician Compare. Additional information regarding these events, including registration information, will be available soon. If you have any questions about Physician Compare or the 2015 performance scores release, contact the CMS Physician Compare contractor at PhysicianCompare@Westat.com.

– Sandy Pogones, MPA, CPHQ, Senior Strategist for Health Care Quality for the American Academy of Family Physicians

Friday, December 16, 2016

Changes to renewing DEA registration for physicians

Update: After this blog item was originally posted, the DEA announced that it had reversed its decisions to eliminate a second registration renewal notice to prescribing physicians and eliminate the grace period for renewals after Jan. 1. Instead, the DEA said it would retain its current policies and procedures for renewing DEA registration although registrants will now receive the second renewal notification at the email address associated with their registration instead of through the mail.

There are many moving parts to practicing as a family physician and one of those is being able to prescribe needed medications for your patients. That depends on having a valid, current registration with the U.S. Drug Enforcement Administration (DEA).

The DEA recently announced significant changes to its registration renewal process. Effective Jan. 1, the DEA is eliminating the informal grace period that the agency had previously allowed for registrants to renew their registrations. The DEA will send only one renewal notice to each registrant’s “mail to” address approximately 65 days before the expiration date; DEA will provide no other reminders to renew the DEA registration.

The DEA also advises that physicians who fail to file a renewal application by midnight Eastern Standard Time of the expiration date will have their DEA number “retired” and have to apply for a new one. The agency also says after the expiration date physicians won’t be able to renew a DEA registration online and the DEA won’t accept paper renewal applications.

– Kent Moore, Senior Strategist for Physician Payment for the American Academy of Family Physicians

Friday, December 2, 2016

University of Colorado clinic wins 2016 FPM Award for Practice Improvement

The University of Colorado School of Medicine Department of Family Medicine has won this year’s Family Practice Management (FPM) Award for Practice Improvement. The department was presented with the award Friday during the Society of Teachers of Family Medicine Conference on Practice Improvement being held in Newport Beach, Calif.

FPM Editorial Advisory Board member John Bachman, MD, presented the award to the department’s medical director, Corey Lyon, DO.

The program was recognized for its success in implementing a team-based model to address access issues, poor outcomes, and burnout. Implementation included increasing provider support with additional medical assistants and support staff, and expanding their roles.

“Culture will eat strategy for breakfast, lunch, dinner, and a midnight snack,” Lyon said. “We had to move beyond the culture of ‘I can’t do that. That’s not how we do it.’”

After one year, monthly visits increased 25.6 percent. Staff costs per visit were unchanged, but monthly charges increased 20 percent. Additionally, provider self-reported burnout was reduced by half.

CMS extends deadline to review value modifier and PQRS results

The Centers for Medicare & Medicaid Services (CMS) has extended until Dec. 7 the deadline for family physicians and others to request an informal review of their value modifier and Physician Quality Reporting System (PQRS) results, which will otherwise impact Medicare physician payments in 2017.

CMS released the 2015 annual Quality and Resource Use Reports (QRURs) on Sept. 26. The 2015 annual QRURs show how physician groups and solo practitioners performed in 2015 on the quality and cost measures used to calculate the 2017 Value Modifier as well as their 2017 Value Modifier payment adjustment.

You can access and review your 2015 annual QRUR now to determine whether you are subject to the 2017 Value Modifier payment adjustment. You will need an Enterprise Identity Management (EIDM) account with the appropriate role to obtain your 2015 annual QRUR. The CMS web site contains instructions for signing up for the appropriate role in EIDM and instructions for accessing the QRUR. Also available on this webpage is a streamlined instructional guide for accessing the QRUR titled “Quick Access Guide for the 2015 Annual QRURs and Tables.”

Physician groups or solo practitioners may request an informal review of perceived errors in their 2017 Value Modifier calculation during the informal review period, which now expires on Dec. 7 at 11:59 p.m. (EST). Additional information about the 2015 Annual QRURs and how to request an informal review is available on CMS’s 2015 QRUR and 2017 Value Modifier webpage.

In 2017, CMS will apply a downward payment adjustment to those who did not satisfactorily report under the Physician Quality Reporting System (PQRS) in 2015.

If you have any questions regarding the status of your 2015 PQRS reporting or are concerned about potentially receiving the PQRS downward payment adjustment in 2017, you can also submit an informal review request for that and ask CMS to investigate your payment adjustment determination. However, again, you must do so by Dec. 7. CMS will be in contact with every individual eligible professional or PQRS group practice that submits a request for an informal review of their 2015 PQRS data and notify them via email of a final decision within 90 days of the original request for an informal review. All CMS decisions will be final, and there will be no further review.

Follow these steps to submit an informal review request:
1.    Go to the Quality Reporting Communication Support Page (CSP).
2.    In the upper left-hand corner of the page, under “Related Links,” select “Communication Support Page.”
3.    Select “Informal Review Request.”
4.    Select “PQRS Informal Review.”
5.    A new page will open.
6.    Enter Billing/Primary Taxpayer Identification Number (TIN), Individual Rendering National Provider Identifier (NPI), OR Practice Site ID # and select “submit.”

Complete the mandatory fields in the online form, including the appropriate justification for the request to be deemed valid. Failure to complete the form in full will result in the inability to have the informal review request analyzed. CMS or the QualityNet Help Desk may contact you for additional information if necessary. Please see the PQRS informal review fact sheet for more information.

Additionally, 2015 PQRS feedback reports can be accessed on the CMS Enterprise Portal using an EIDM account. For details on how to obtain your report, please see the “Quick Reference Guide for Accessing 2015 PQRS Feedback Reports.” For information on understanding your report, please see the “2015 PQRS Feedback Report User Guide.” Both guides are on the PQRS Analysis and Payment webpage on the CMS web site.

For More Help:
•    For additional assistance regarding EIDM or to ask questions about the informal review process, contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715- 6222) from 7:00 a.m. to 7:00 p.m. Central Time, Monday through Friday, or via email at qnetsupport@hcqis.org. To avoid security violations, do not include personal identifying information, such as Social Security Number or TIN, in e-mail inquiries to the QualityNet Help Desk.
•    For additional assistance regarding the QRUR or the Value Modifier, contact the Physician Value Help Desk at pvhelpdesk@cms.hhs.gov or 888-734-6433 (select option 3).

– Kent Moore, Senior Strategist for Physician Payment for the American Academy of Family Physicians

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