Author Archives: karen

MIPS Tips (July)

The Merit-based Incentive Payment System (MIPS) 2019 reporting year is approaching the last 90-day reporting period for Promoting Interoperability. Be sure you are staying on track with the changes for 2019 and review the following if applicable to your practice.

12.3 SP3 Upgrades 
Quatris Healthco will announce the release of CPS 12.3 SP3 soon and begin upgrades shortly after that.

2015 CEHRT Compliance for Promoting Interoperability 
Information regarding the 2015 CEHRT Requirements for PI is vital to your success if reporting to the PI category! Because the website is updated frequently, we recommend you review any new information.

  • 2015 CEHRT Requirements on the Quatris Healthco Knowledgebase
    A new resource was added to the Quatris Healthco Knowledgebase and provides step-by-step instructions for providers and practices to take to be fully 2015 CEHRT compliant before starting a 90-day reporting period for the PI category of MIPS. Click HERE to review this new resource! If you do not have access to the Quatris Healthco Knowledgebase REGISTER HERE.

CPS12.3 and 2015 CEHRT Compliance Timing
The timing of your upgrade and the additional 2015 CEHRT requirements that must be in place are dependent upon special statuses and the categories of MIPS that will be reported in 2019.

  • If you are reporting to the Promoting Interoperability category of MIPS then you must have the following completed no later than October 1, 2019:
    • Upgrade to a version of CPS12.3 (preferably 12.3 SP3) 
    • Additional 2015 CEHRT requirements – Azure, API, CCDA 2.1
  • If you are NOT reporting to the Promoting Interoperability category of MIPS but are reporting to the Quality category using athenaPractice and CQR, then you must be upgraded to version of 12.3 (preferably 12.3 SP3) no later than December 31, 2019.
    • The additional 2015 CERHT requirements do not apply for this option as those are only applicable if reporting to the Promoting Interoperability category.
  • To determine if a special status applies to your practice and if you qualify for a Promoting Interoperability Hardship, visit the Exception Applications section of the QPP website. The QPP Participation Look-Up Tool will provide details as to whether or not any special statuses apply at the individual and group levels.

2018 Final Scores Released
On July 3 CMS released the final scores and payment adjustments for the 2018 reporting year via this Quality Payment Program listserv announcement:

“If you submitted 2018 Merit-based Incentive Payment System (MIPS) data, you can now view your performance feedback and MIPS final score on the Quality Payment Program website.”  

You can access your 2018 MIPS performance feedback and final score via this link: cms.gov/login

  • Log-in using your HCQIS Access Roles and Profile (HARP) system credentials (these are the same credentials used to submit your 2018 MIPS data). If you don’t have a HARP account, refer to the QPP Access User Guide to start the process.
  • To learn more about performance feedback, view these frequently asked questions (FAQs). The FAQ’s highlight what is performance feedback, who receives the feedback, and how to access it on the Quality Payment Program website.

Targeted Review period opened with the release of the 2018 final scores and payment adjustments. Information was provided via the July 3rd Quality Payment Program listserv announcement:

“The MIPS payment adjustment you will receive in 2020 is based on your final score. A positive, negative, or neutral payment adjustment will be applied to the Medicare paid amount for covered professional services furnished by a MIPS eligible clinician in 2020.”

MIPS eligible clinicians, groups, and virtual groups (along with their designated support staff or authorized third-party intermediary), including APM participants, may request CMS to review the calculation of their 2020 MIPS payment adjustment factor(s) through a process called targeted review. 

When to Request a Targeted Review
If you believe an error has been made in your 2020 MIPS payment adjustment factor(s) calculation, you can request a targeted review until September 30, 2019. The following are examples of circumstances in which you may wish to request a targeted review: 

  • Errors or data quality issues for the measures and activities you submitted.
  • Eligibility and special status issues (e.g., you fall below the low-volume threshold and should not have received a payment adjustment).
  • Erroneously excluded from the APM participation list and not being scored under the APM scoring standard.
  • Performance categories were not automatically reweighted even though you qualify for automatic reweighting due to extreme and uncontrollable circumstances.

How to Request a Targeted Review
You can access your MIPS final score and performance feedback and request a targeted review by:

  • Visiting the Quality Payment Program website
  • Logging in using your HCQIS Access Roles and Profile System (HARP) credentials (these are the same credentials that allowed you to submit your MIPS data.) Refer to the QPP Access Guide for additional details.

When evaluating a targeted review request, CMS may require documentation to support the request. If your targeted review request is approved, CMS may update your final score and the associated payment adjustment (if applicable), as soon as technically feasible. Note: targeted review decisions are final and not eligible for further review.

For information about how to request a targeted review, refer to the 2018 Targeted Review Fact Sheet and the 2018 Targeted Review FAQs.

Questions?
If you have questions about your performance feedback or MIPS final score, contact the Quality Payment Program via phone 1-866-288-8292/TTY: 1-877-715-6222 or email: QPP@cms.hhs.gov”.  

MIPS Consulting
Quatris Healthco offers quality consulting services to our all of our customers. For information contact mkeller@qhco.com.

*Note: The content of this email may not apply to your practice. Contact your EMR vendor on processes for support and quality reporting programs.

A Simple Review of Life in the Cloud in The Healthcare Industry

Cloud computing has become commonplace in medical practices, and we continue to see an uptick of practices year-over-year choosing to move to the Cloud. Gone are the days of maintaining in-house servers, having to schedule upgrades at inconvenient times, and purchasing new hardware. Today’s medical practices are also realizing that using a Cloud service can eliminate many of the IT (repair/replacement or additional storage costs) and business (budget predictability of operational costs) headaches experienced in years past.  

In our world, using a Cloud service allows you to take your Practice Solution/Electronic Medical Records and move it from your local server to a Cloud-based solution. You no longer need an on-base server to store your documents, secure your database, and facilitate your connection to athenaPractice. You log into a website that launches a remote desktop connection which gives you scanning, indexing, billing, portals and hospital connections all in one spot.

Key Considerations For Life in The Cloud

Know the Team

It’s important to know upfront that your Cloud provider has the resources to manage your migration to the Cloud and throughout the life of the relationship. The Cloud team you rely on, in addition to yourself, should include a Project Manager, a local IT contact, a Cloud Migration Technician, and an Interface Technician. These vital resources must work together to ensure a successful transition.

Local IT Involvement

If your practice utilizes a local IT company, their involvement is pivotal at first, then minimal afterward. Moving to a Cloud-based solution requires initial setup of printers, scanners, and other onsite hardware to be able to communicate to the data center. Once it is set, it is typically easy to leave and forget it.

Typical steps to migration may include:

  1. Kickoff meeting to discuss hosting changes and set a target date.
  2. Technical discussion with current IT resources.  
  3. Review of 3rd party applications/interfaces/vendors that may need to be transitioned.
  4. Local setup of scanners/cameras/printers to allow the transition to hosting.
  5. Onsite Cloud Assessment: Test migration to test reporting, printing, scanning, and other applications.
  6. Production Migration (overnight and/or weekend).
  7. Dedicated support bridge morning after migration for any questions/concerns.

Necessary Downtime

Downtime is strictly up to the practice. Determine if migration technicians work only during the work week or can they handle migrations over the weekend. If your practice doesn’t have any weekend or late hours, downtime may be minimal.

Post-Go-Live Date

Be sure your vendor has an entire team dedicated to maintaining and supporting the Cloud solution. This team should have the technicians that work on servers, upgrades, and even a tier group that will answer support calls.

For more information on cloud services, watch our webinar on moving your practice to the cloud.

Keeping your Patient and Financial Data Safe from Ransomware in the Healthcare Industry

There has been a global uptick and a wide variety of incidences in 2019 related to ransomware in the healthcare industry. Ransomware attacks are becoming more sophisticated and are not just targeting hardware and software vulnerabilities. Criminals are leveraging social engineering to find opportunities to exploit businesses. 

Medical practices today must diligently protect their patient and financial data and take the necessary actions to make sure the software systems are up-to-date and not susceptible to malicious software.

What is Healthcare Ransomware?

Ransomware is malicious software designed to block access to a computer system and has the potential to affect any site that has not protected itself from these kinds of vulnerabilities or exploits. Exploits typically use vulnerabilities in popular platform software such as Microsoft Windows, web browsers, and Microsoft Office to infect devices. Software updates patch vulnerabilities, so they aren’t available to exploit.

What Should You Do About Ransomware?

To help prevent these types of cyber-attacks and to take measures to protect your practices patient and financial data, secure your backups offsite and upgrade your Microsoft software products and other susceptible software platforms as soon as possible. Note: ransomware is not an athenaPractice product issue.

General recommendations and supporting documentation:

  1. Utilize an offsite backup schedule for database backups at a minimum. (offsite backups have proven to be the most effective method for recovering data).
  2. Make sure your security and firewall applications are up-to-date.
  3. Follow ransomware best practices per this Microsoft webpage.
  4. Regularly and promptly patch all systems in your environment with the latest operating system and application security patches. New vulnerabilities are often quickly exploited by attackers after they are discovered.
  5. Periodically scan your systems with a vulnerability scanner to discover missing security patches and end-of-life software.
  6. Disable Remote Desktop Protocol in all cases where it’s not necessary.
  7. Never open Remote Desktop Protocol to the public Internet. Limit the use of Remote Desktop Protocol to users behind a firewall or connecting through a VPN.
  8. Enable Network Level Authentication on Windows Servers that require the use of the Remote Desktop Protocol.

Don’t let key infrastructure and applications go unprotected. Your EMR/PM vendor can help you remain at optimal performance and security.

Refer to these additional resources to learn more:
Microsoft: About Ransomware
Preventing Ransomware

MIPS Tips (June)

The Merit-based Incentive Payment System (MIPS) 2019 reporting year is now past the half-way point in the reporting year. Be sure you are staying on track with all the changes for 2019.

Category Corner (MIPS performance categories) 
Eligible clinicians must report active engagement in the Improvement Activity(s) selected for a minimum of a 90-day reporting period and be able to support their active engagement in the activity(s) for the full 90-days. In the event of an audit, remember these important tips:

  • Select your Improvement Activity(s) early – A full list of activities can be found in CQR and on the QPP website in the Resource Library.
  • Select your 90-day reporting period – This can be any 90-days within the reporting year as this no longer needs to align with the PI component of MIPS. PI bonus points are no longer being given for selecting Improvement Activities that require CEHRT.
  • Create and save supporting documentation – While supporting documentation is not required at the time of attestation, in the event of an audit they will ask for proof of the eligible clinician (group) being actively engaged in the activity that was reported.
  • The best way to prove active engagement for a full 90-day reporting period is to have at least one example for each month of the 90-day reporting period.

Program Perks (new and important updates from CMS on the Quality Payment Program) 
On June 20th via the QPP Listserv, The Centers for Medicare & Medicaid Services (CMS) announced the following:

  • Merit-based Incentive Payment System (MIPS) Data Validation and Audit to begin June 2019 for Performance Years 2017 and 2018 
    • CMS has contracted with Guidehouse to conduct data validation and audits of a select number of Merit-based Incentive Payment System (MIPS) eligible clinicians. Data validation and audits are processes that will help ensure MIPS is operating with accurate and useful data. MIPS eligible clinicians, groups and virtual groups are required by regulation to comply with data sharing requests, providing all data as requested by CMS.
    • If you are selected for data validation and/or audit, you will receive a request for information from Guidehouse via email or certified mail. You have forty-five calendar days from the date of the notice to provide the requested information.
      • If you do not provide the requested information, CMS may take further action, to include the possibility that you will be selected for future audits. To avoid this, CMS is in the process of developing resources to support clinicians selected to participate.

Measurement Metrics (how to improve your scores)
The 2015 CEHRT Requirements for the PI category can be found on the Quatris Healthco Knowledgebase. View the step-by-step instructions to be fully 2015 CEHRT compliant before starting a 90-day reporting period. If you are a Quatris Healthco customer and do not have access to the Quatris Healthco Knowledgebase, click here to register.

Athenahealth recently hosted a webinar and reviewed the setup and workflow for the Receiving and Incorporating Health Information measure. Click here to view the webinar and click here to view the slides.

  • The key to understanding this measure is how the denominator is calculated. It requires two indicators for a patient to be included in the denominator count.
    • Indicator 1: The patient must be a new patient to the provider or if the patient is established the checkbox for “Encounter is Transition of Care” must be checked on the office visit document.
    • Indicator 2: The patient must have an imported CCDA on their chart.
      • If either of these is not present on the chart, then the patient will not be included in the measure.

Toolbox Tactics (how to use the Quality Reporting tool to manage and monitor your progress)

  • CQR Version 1.6.10 Release
    • Click here to view the recorded webinar outlining the upgrade features.
    • Click here to download the new Quality Reporting Guide. 
  • CPC+ 2019 Patient Roster Report
    • Quatris Healthco has proactively uploaded this report for customers that participate in CPC+. If you have any questions regarding this report, log a case at support@qhco.com.

MIPS Consulting
Quatris Healthco offers quality consulting services to all of our customers. For information contact mkeller@qhco.com.

*Note: The content of this email may not apply to your practice. Contact your EMR vendor on processes for support and quality reporting programs.

Is it time for a HealthCheck?

In today’s busy medical practices, it’s hard to find time to step back and assess whether workflows and processes are functioning at peak performance. System reports, various backlogs, and other indicators might point to areas needing help, but too often, we can’t find the time to turn the problems into actionable solutions!

Wouldn’t it be ideal to work with a trusted partner that is familiar with your practice and able to conduct a athenaPractice assessment or tune-up per se of your system? We know medical practices invest a lot of money in their “systems” and getting the most from their investment is paramount.

Quatris Healthco realizes the importance of offering customers this type of value-added assessment, and we call it: HealthCheck. HealthCheck is an ideal way to optimize practice workflows and allow athenaPractice to do the heavy lifting. The tune-up technicians (our experts) provide hands-on help in all things athenaPractice for both new and established users. When you participate in a HealthCheck, you receive a full evaluation that you can use to improve workflows, develop better processes and utilize the athenaPractice tools to make sure you are getting the most out of your athenaPractice investment.

A HealthCheck will ensure that you’re on the way to greater automation with a cleaned-up A/R, better cash flow and return on investment, and more efficient athenaPractice users.

Five Signs That It’s Time for a athenaPractice HealthCheck

  1. Your clinic has new administrative, clinical or billing staff
  2. It’s been more than two years since you implemented athenaPractice
  3. Your athenaPractice workflows feel burdensome and clunky
  4. You have concerns about your A/R and/or claims processes
  5. Clinic staff uses workarounds outside athenaPractice

A HealthCheck gives you the information you need to identify the root of the problem and find a solution to take your team’s use of athenaPractice to the next level.

MIPS Tips (May)

The Merit-based Incentive Payment System (MIPS) 2019 reporting year is in full swing, and we are about to reach the half-way mark in the reporting year. Be sure you are staying on track with all the changes for 2019?

Category Corner (MIPS performance categories) 
The Cost category of MIPS remains somewhat of an unknown since we are not able to track this in CQR as it is entirely claims based. Here are examples of what providers can do to control costs and accurately reflect the patient population being treated? 

  • Controlling Cost
    • Reduce ordering duplicative tests
    • Minimize ER visits and hospitalizations (when possible)
    • Implement a good referral network with open communication and information sharing on tests and procedures that have already been ordered and performed.
  • Patient Population
    • Did you know that your ICD-10 coding contributes to your Cost category score? There are Hierarchical Condition Categories (HCC-chronic conditions used to create a risk adjustment methodology) categories of codes that put patients in a higher risk category and level of complexity (typically patients with diseases in these categories “cost” more to care for). When providers include these codes on their claims during the reporting year, this is taken into consideration in determining the Cost category score. Examples of HCC categories:
      • Diabetes – DM with complications
      • Vascular – Peripheral vascular disease (PVD)
      • Psychiatric – Major depression disorder
      • Kidney – Chronic kidney disease, stage 4
      • Substance Abuse – Alcohol/Opioid dependence
    • Risk Adjustment Factor (RAF) – Assessing the acuity of illness based on reported ICD-10 codes and demographics.

The Bottom Line – If the patient has a chronic condition that is contributing/impacting the treatment decisions being made in the care of the patient, they should be reported on the claim to provide an accurate reflection of the patient population being treated.  

Program Perks (new and important updates from CMS on the Quality Payment Program) 
Now that we have passed the 2018 attestation period and are in the middle of the 2019 reporting year, there has not been a lot of “chatter” coming from QPP. Now would be a great time, if you have not already done so, to make sure that you are signed up for the QPP Listserv and take advantage of the available resources.

  • QPP Listserv – To sign up for the QPP Listserv click HERE > scroll to the bottom > enter your e-mail in the “Subscribe to Updates” section > click Subscribe.  
  • QPP Resource Library – QPP offers an extensive resource library with links to Fact Sheets, FAQs, Webinars, and more!  

Measurement Metrics (how to improve your scores)
2015 CEHRT Requirements for Promoting InteroperabilityTo report for the PI category of MIPS, eligible clinicians/groups are REQUIRED to upgrade to all components of 2015 CEHRT. These include CPS 12.3/CEMR 9.12 – Azure AD, API and CCDA 2.1

  • A new resource has recently been added to the Quatris Healthco Knowledgebase website that provides step-by-step instructions providers/practices must take to be fully 2015 CEHRT compliant before starting a 90-day reporting period for the PI category of MIPS. Click HERE to review this new resource! (if you do not have access to the Quatris Healthco Knowledgebase REGISTER HERE)

Supporting Electronic Referral Loops Measures – It is important that providers are sending and receiving Transition of Care documents electronically with providers that they are referring to and receiving referrals from. Below are a few recommendations for obtaining and updating secure electronic addresses:

  • Outgoing referrals – Review the list of providers routinely being referred to. If there is not a secure electronic address use the “Map Service Providers” option in the ezAccess Patient Portal to see if there is one listed in this directory or reach out to the practice and ask for the secure electronic address.  
    • Incoming Referrals – Consider drafting a standard letter to send to those providers that are referring to you and let them know that you are actively participating in MIPS. Request that they send a Transition of Care document electronically when they refer a patient to your practice and include your secure electronic address.  

Toolbox Tactics (how to use the Quality Reporting tool to manage and monitor your progress)
2019 QSS Enrollment is now OPEN.

  • MIPS QSS (2019 MIPS QSS Enrollment Webinar)
    • Enrollment is open from May 20, 2019, to March 2, 2020
    • Submission authorization is from January 24 to March 16, 2020
    • MIPS submission by athenahealth to CMS using the EHR reporting method is $400/provider* for all reporting options (individual, group, any performance category)
    • A $200 per practice QSS assistance fee will be quoted if assistance beyond the self-service tools are required for QSS set-up, enrollment, authorization, etc.
    • CPC+ QSS (2019 CPC+ QSS Enrollment Webinar)
      • Enrollment is open from May 20, 2019, to Feb 2, 2020
      • Submission authorization is from January 13 to February 14, 2020
      • CPC+ submission by athenahealth to CMS using the EHR reporting method is $500/provider
      • A $200 per practice QSS assistance fee will be quoted if assistance beyond the self-service tools are required for QSS set-up, enrollment, authorization, etc.
    • Audit Assistance – Did you know that a MIPS audit can happen up to six years after attestation? Did you also know that Level 3 MIPS Consulting customers receive an audit tool kit to proactively prepare for an audit and assistance in the event of audit as part of their package? If you are not a MIPS Consulting customer, it is important to note that if you are audited Quatris Healthco does provide documentation on best practices to assist you in responding to an audit, but if you need further assistance, this is a billable service.

MIPS Consulting
Quatris Healthco offers quality consulting services to all of our customers. For information contact mkeller@qhco.com.

*Note: The content of this email may not apply to your practice. Contact your EMR vendor on processes for support and quality reporting programs.