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Welcome to the MHQP & HealthForce MN Quality Brownbag Room Monthly Noon Brownbag Fourth Thursday Every Month. July 22 nd PQRI Physician Quality Reporting Initiative. Welcome to the New Classroom ! https://umconnect.umn.edu/hcq/ Glad you were able to find it. Questions?

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Presentation Transcript
Questions contact skip valusek mhqp education chair skipvalusek comcast

Welcome to the MHQP & HealthForce MN Quality Brownbag Room

Monthly Noon Brownbag Fourth Thursday Every Month

July 22nd

PQRI

Physician Quality Reporting Initiative

Welcome to the New Classroom !

https://umconnect.umn.edu/hcq/

Glad you were able to find it.

Questions?

Contact: Skip Valusek

MHQP Education Chair

skipvalusek@comcast.net

Slides are posted at:

http://www.healthforceminnesota.org/pages/Programs/courses.html


Register your attendance

Hopefully you provided your name & organization when you signed in.

If so:

Just say Hi in the Chat Pod and we’ll capture your name and organization in the log.

If not:

identify yourself and organization in the Chat Pod to the

left of your screen.

Register your Attendance


Poll who is attending this session

Rural / Outstate ? signed in.

Metropolitan area ?

Organization that has (or serves) both ?

Poll: Who is Attending this Session ?

6

7

3


Poll who is attending organization type

Healthcare system signed in.

Hospital

Clinic or Clinic System

Long term care

Healthplan

Homecare / Hospice

A Quality Support Organization

Other ? (e.g. MCM )

Poll: Who is attending: Organization Type ?

4

3

3

0

0

1

3

2


Poll how many total participating in your room

1 signed in.

2

3

4

5

6

7

>7

Poll: How many total participating in your room ?

15

1

1

0

0

0

0

0


Poll what do you hope to gain by participating

I am a healthcare quality professional and am interested in additional education.

I am a healthcare professional interested in developing quality skills as a core competency.

I am a healthcare professional interested in learning more about healthcare quality.

Poll: What do you hope to gain by participating?

12

2

2


What is pqri the neophyte s perspective
What is PQRI: additional education. The neophyte’s perspective:

  • Physician Quality Reporting Initiative

  • Began in 2007 – now with over 200 measures from which to choose

  • Pick and report on 3 measures for any provider to get an additional 2% CMS payment (2% for all CMS submissions for that provider !!)

  • Payment is NOT based on performance – paid for reporting information only

  • Used to be a “clinics” initiative - The growth of hospitalist practices has changed the picture.

  • Future remains a bit unclear. Will continue for 2011, but unsure how will eventually fit with Meaningful Use/ARRA


What is pqri the registrar s perspective
What is PQRI ? additional education. The registrar’s perspective:

  • Brenda Paul

    • State Quality Measurement Program Development Project Manager at Minnesota Community Measurement (MNCM)

    • Brenda’s background:

      • Health Services Research background

      • Started with MNCM in 2009

      • In addition to supporting PQRI, also develops new measures for clinical quality reporting


Pqri registry based submission
PQRI: Registry Based Submission additional education.

  • Partnership between MNCM and the Wisconsin Collaborative for Health Care Quality (WCHQ)

    • Submitting PQRI data together as a registry since 2008

    • 19 Quality measures for 2010, Measure Areas include:

      • Diabetes, Ischemic Vascular Disease, Tobacco Use And Cessation, Prevention Screening and Preventive Care, Chronic Kidney Disease, Health Information Technology, Perioperative Care

      • E-prescribing incentive program

  • An alternative to claims-based PQRI submission

    • In 2008, 96% of providers using registry received an incentive payment.

    • Approximately 50% of providers using the claims-based method received an incentive payment in 2008.


How it works
How it works additional education.

  • Register: each provider must sign-up and submit data for 3 measures to be eligible for incentive payment (e-prescribing is a separate program).

  • Upload full population data to secure ftp site

    • Clinical file

    • Patient file

    • Encounter file

  • Submission to CMS

    • MNCM calculates all measures and submits the files to CMS on your behalf in February.

    • Incentive payments are typically awarded in the fall of the same year you submit the data.


Program highlights
Program Highlights additional education.

  • Rewarding

    • The average incentive payment in 2008 was slightly more than $1,000/provider (MNCM’s charges $120/provider).

    • Eligible professionals can earn a 2% incentive payment for all Medicare FFS covered patients seen during the reporting period.

    • Earn an additional 2% for participating in the e-prescribing program

  • Efficient

    • No need to attach G-codes to PQRI data

    • Combine MNCM’s Direct Data Submission with PQRI data submission by submitting full population data


Best practices for participating programs
Best Practices for Participating Programs additional education.

To maximize your efficiency you might want to consider the following tips:

  • If you are unsure about pulling data or are only confident with certain data points, start small – select the minimum number of measures (three) and choose ones for which you have the most robust data

  • Appoint one person to work with this data – since full population data files are big, think about testing the data with a few dates of service so you can see how it goes before trying to pull a full year

  • Take advantage of MN Community Measurement’s systems! You can pull and submit data for the first part of the year as soon as you sign up – don’t wait until January to try it! Pull and send the first 3 quarters of 2010 before the year ends. That way in January, you’ll only need to change the dates on your query and pull three months of data!


Future of pqri
Future of PQRI ? additional education.

  • Incentive payments reduced over time (providers may be penalized for not reporting in the future)

  • Changes to the PQRI rule coming in late July

  • Meaningful Use rule may affect PQRI’s future

  • Untapped dollars – providers across MN may be missing out on free money by not participating!

  • Challenges of the program: Working with the IACS reimbursement system can be difficult / Not easy to do without an EHR.


Contact information
Contact Information additional education.

If you are interested in participating or want more information about submitting PQRI data via the Registry Based System please contact Brenda Paul (paul@mncm.org) or Nathan Hunkins (hunkins@mncm.org) at MN Community Measurement


Direct reporting perspective i e you are a registry
Direct Reporting Perspective additional education. (i.e. you are a registry)

  • Linda Walling MD

    HealthEast Medical Director: Clinical Informatics

    HealthEast Clinics

  • HealthEast is a PQRI   registry

    • Submitted 2009 data directly to CMS

    • 2008 data - submitted through another registry

      • Cost consumed 1/3 of our payout

      • Cost about equal to work involved in certification

        to be a registry  

    • As long as you successfully submit, the cost is minimal for ongoing years.


Direct reporting continued
Direct Reporting (continued) additional education.

  •  We also qualify to report on the e-prescribing initiative

    • Registry reporting option for 2010

    • Potential payout doubled for 2010 registry work

    • The claims-based submission for 2009 was very labor intensive and was discontinued

  • We feel that being a registry positions us very well for Meaningful Use

    • The first year is by attestation- numerator and denominator for the quality submissions-

    • After that , it is electronic  submissions


  • Direct reporting continued1
    Direct Reporting (continued) additional education.

    • Quality measurement team collects data from EHR

    • Measures submitted are same as those that we are required to submit to MNCM

    • Public reporting has put spotlight on outcomes and helped focus necessary resources to improve infrastructure to improve outcomes. Optimal diabetes care was 9% in 2006. Was 26% in 2009 using same criteria.


    Poll for clinics are you participating in pqri
    Poll: For Clinics additional education. Are you participating in PQRI ?

    0

    0

    1

    0

    0

    3

    0

    • Yes, we have from the beginning through MCM

    • Yes, we have from the beginning through another registry

    • Yes we are now through MCM

    • Yes we are now through another registry

    • Yes we are now as our own registry

    • No, but we plan on it asap

    • No and we won’t until it has a penalty cost.


    Poll for hospitals are you participating in pqri
    Poll: For Hospitals additional education. Are you participating in PQRI ?

    0

    0

    0

    1

    1

    3

    0

    • Yes, we have from the beginning through MCM

    • Yes, we have from the beginning through another registry

    • Yes we are now through MCM

    • Yes we are now through another registry

    • Yes we are now as our own registry

    • No, but we plan on it asap

    • No and we won’t until it has a penalty cost.


    Poll for those not participating why not
    Poll: For those not participating, why not ? additional education.

    2

    1

    0

    0

    0

    • We don’t have an EHR so reporting is too hard.

    • We have an EHR but PQRI hasn’t made it onto the project inventory.

    • PQRI is a work in progress; submitting in 2010 ??

    • Heard it was a lot of effort so haven’t pursued it.

    • Other (specifics in chat box please)


    Questions
    Questions ? additional education.


    Questions contact skip valusek mhqp education chair skipvalusek comcast

    Welcome to the MHQP & HealthForce MN Quality Brownbag Room additional education.

    Monthly Noon Brownbag Fourth Thursday Every Month

    August 26

    On the CUSP: STOP BSI

    Rachel Blake

    MHA + Panel

    Questions?

    Contact: Skip Valusek

    MHQP Education Chair

    skipvalusek@comcast.net

    Slides are posted at:

    http://www.healthforceminnesota.org/pages/Programs/courses.html