MSSP Quality Measure Performance Improvement Comparison EOY 2016 Present Discrete Fields from EHR Medicare Population

Transcription

1 MSSP Quality Measure Performance Improvement Comparison EOY 2016 Present Discrete Fields from EHR Medicare Population 1

2 Practice Performance Comparison: Preventive Health *Medicare Population using Discrete Fields from ecw and NextGen Fall Risk Screening Depression Screening Influenza Immunization Pneumococcal Immunization Sajjad Aziz, MD 46.3% 64.5% 48.8% 68.5% 58.1% 79.5% 75.5% 84.7% Syed Haque, MD 69.3% 25.6% 81.9% 19.9% 43.8% 45.1% 74.5% 74.4% Primary Medical Services, PC, Dr. Zaidi 61.8% 47.0% 61.2% 50.0% 44.0% 31.2% 58.7% 63.2% X Cel Primary Care 78.0% 85.6% 0.0% 22.2% 41.6% 49.6% 74.5% 93.8% MHP Internal Medicine Associates Middletown Valley Family Medicine 80.5% 69.0% 62.3% 55.4% 52.0% 68.2% 67.4% 69.9% 66.5% 68.1% 47.6% 65.4% 55.0% 69.0% 86.6% 89.7% Parkview Medical Group 48.1% 64.1% 24.7% 73.1% 24.0% 50.2% 72.0% 79.0% Sibte Kazmi, MD LLC 52.1% 22.2% 8.9% 1.5% 26.3% 59.5% 32.4% 78.3% Union Bridge Family Practice 78.9% 71.1% 59.9% 67.2% 37.1% 64.2% 83.7% 85.9% 2

3 Performance Comparison: Preventive Health *Medicare Population using Discrete Fields from ecw and NextGen Practice BMI Screening w/ Follow-up Tobacco Screening w/ Follow-up Colorectal Cancer Screening Breast Cancer Screening Sajjad Aziz, MD 45.3% 44.9% 95.1% 96.3% 0% 4.2% 6.4% 17.8% Syed Haque, MD 79.5% 63.0% 89.6% 89.8% 22.0% 18.0% 8.6% 1.3% Primary Medical Services, PC, Dr. Zaidi 63.5% 59.8% 89.7% 89.4% 2.7% 7.4% 53.7% 27.8% X Cel Primary Care 45.4% 46.2% 81.8% 92.1% 4.2% 0.8% 5.9% 6.8% MHP Internal Medicine Associates Middletown Valley Family Medicine Parkview Medical Group 73.3% 82.3% 96.1% 96.1% 67.3% 49.6% 67.2% 36.4% 42.2% 43.9% 91.1% 96.5% 40.0% 45.4% 55.0% 41.8% 57.6% 78.8% 94.4% 98.9% 41.2% 18.6% 51.1% 16.6% Sibte Kazmi, MD LLC 34.8% 58.9% 82.1% 99.0% 1.6% 40.0% 35.6% 59.6% Union Bridge Family Practice 88.3% 87.1% 80.7% 90.0% 14.8% 18.1% 21.6% 20.9% 3

4 Practice Performance Comparison: At-Risk Population *Medicare Population using Discrete Fields from ecw and NextGen Diabetes Composite HbA1c<=9 Diabetes Composite Retinal Exam MH: Depression Remission at Twelve Months Sajjad Aziz, MD 29.5% 31.3% 0.0% 80.0% *Not Reportable 0% Syed Haque, MD 39.4% 8.0% 67.6% 18.0% *Not Reportable *Not Reportable Primary Medical Svsc, Dr. Zaidi 67.0% 44.9% 32.1% 24.7% 0% 0% X Cel Primary Care 7.6% 42.4% 19.1% 22.6% *Not Reportable *Not Reportable MHP Internal Medicine Assoc 74.5% 77.7% 17.4% 5.3% 0% 0% Middletown Valley Family Medicine 74.0% 73.2% 32.7% 33.2% 0% 0% Parkview Medical Group 67.4% 71.7% 6.2% 3.7% 6.6% 5.5% Sibte Kazmi, MD 70.1% 56.7% 6.6% 32.7% *Not Reportable *Not Reportable Union Bridge Family Practice 73.5% 70.7% 6.1% 16.2% *Not Reportable 0% 4

5 Practice Performance Comparison: At-Risk Population *Medicare Population using Discrete Fields from ecw and NextGen Statin Therapy for Cardiovascular Disease HTN: Controlling High Blood Pressure IVD: Use of Aspirin or other Antithrombotic Sajjad Aziz, MD 78.2% 82.1% 71.3% 79.2% 83.0% 85.5% Syed Haque, MD 61.1% 61.6% 62.7% 60.3% 87.4% 85.4% Primary Medical Services, PC, Dr. Zaidi 84.3% 83.3% 56.9% 87.1% 91.6% 88.2% X Cel Primary Care 82.4% 83.3% 50.0% 72.0% 74.1% 86.7% MHP Internal Medicine Associates 78.0% 81.3% 74.0% 79.7% 80.5% 92.1% Middletown Valley Family Medicine 84.6% 82.1% 66.2% 75.3% 84.7% 91.2% Parkview Medical Group 83.6% 84.2% 75.3% 81.7% 75.5% 86.1% Sibte Kazmi, MD LLC 64.2% 82.1% 62.1% 71.3% 83.0% 82.1% Union Bridge Family Practice 90.4% 89.7% 64.9% 63.4% 77.1% 85.4% 5

6 Importance of HCC Risk Coding and Risk Adjustment Factor 6

7 What is HCC? HCC payments are risk-adjusted based on patient complexity, allowing for increased payments for high-risk patients. Accurate HCC coding information helps create a more complete picture of a patient population complexity, improves the value of individual patients problem list, and enables better chronic disease management. The HCC model has expanded to assist with reimbursement for both Accountable Care Organizations (ACOs) and other shared savings programs. As reimbursement models continue to evolve it is increasingly important to have an effective HCC strategy. The strategy must include documentation capture of the patient's diagnoses. 7

8 HCC Reimbursement Examples Community non-dual aged (RAF)

9 Morbid Obesity Morbid obesity (BMI > 40) is considered a high risk factor and increases your overall risk score when coded appropriately. Use E66.01 as your code (HCC 22) In addition, coding the level of BMI may also contribute to your RAF score (Z68.4_ ; HCC 22): BMI Z68.41 BMI Z68.42 BMI Z68.43 BMI Z68.44 BMI > 70.0 Z

10 10

11 Coding Tip: Risk / HCC Score Why is this important? Higher ACO Risk score increases Potential Shared Saving For Specialists, helps with Episode of Care cost comparisons between providers for MIPs and commercial contracts Will be increasingly important for the future 11

12 MIPS Advancing Care Information Reminder: Providers must report independently; however, FIHN scored in aggregate 12

13 ACI Progress Status Many practices have not yet reported current ACI Security Risk Analysis to be scheduled Several practices are not meeting required measures for minimum base score Suggest using practice scorecard to assess current status Certified letter sent to practices requiring that all ACI Required Base Score Measures are completed and that a higher score will be required in future years 13

14 14

15 15

16 Holly Hills Social November 7, 2017, 6:00-8:00 p.m. RSVP to 16

17 Next Meeting January 25, :00 p.m. 8:00 p.m. 17