2014 GPRO Web Reporting Tool Kick-off Webinar

Allscripts Clinical Quality Solution
2014 GPRO Web Reporting Tool
Kick-off Webinar
August/September 2014
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Agenda
2014 PQRS Reporting Options & Considerations
• 2014 PQRS Reporting Options
• Factors to Consider
GPRO Web Interface: Process Overview
• GPRO Web Reporting Dynamics
• GPRO Web CMS Measures
• CMS GPRO Web Interface
CQS GPRO Web Interface Reporting Tool
GPRO Web Interface: Client Resource Planning
GPRO Web Interface: Schedule
• Tentative Release Timeline
• Self-nomination
• Next Steps
• Resource Materials
Questions
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2014 PQRS Reporting Options &
Considerations
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2014 PQRS Reporting Options
1. GPRO Web Interface with CQS
– Using the CQS GPRO Web Reporting Tool, supported by TeamPraxis
– Included with your PCC Contract; no additional fees
– TINs with 25+ providers can report via GPRO Web Interface
2. Allscripts Data Submission Vendor (DSV)
– Service provided by Allscripts, using Allscripts Analytics Platform
– Individual or Group (GPRO) reporting for 61 CQMs
• Any size group (2+ EPs) or Individual EPs can report via DSV
– Requires additional subscription, separate from CQS, MU Stage 2 package
– Contact your Allscripts Outcome Executive for more info
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Factors to Consider
• Number of TINs
– Each TIN must report separately
– If multiple TINs self-nominate for GPRO Web reporting, then each
TIN has a separate (duplicative) reporting process
• CAHPS Survey
– Patient experience survey required for TINs with 100+ EPs,
(optional for 25-99 EPs or any size group reporting via DSV)
– Results will likely be part of quality tiering scores
• Additional resources required for GPRO-W reporting
• Additional cost of Allscripts DSV subscriptions
• Measure Scores and Quality Tiering
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2014 PQRS Reporting Considerations
• Reported Measure Scores matter
• Quality Tiering
– Quality Tiering for 2016 is mandatory and will be applied to
all applicable TINs
– Every TIN with 10+ NPIs will have 2016 claims adjusted
based on the Quality
• Tiering process
– TINs with 100+ EPs, these adjustments may be positive, (i.e., a
bonus), neutral (no change), or negative (i.e., a penalty).
– TINs w/ 10-99 EPs, adjustments can only be positive or neutral
– Note: CMS expects most groups (all sizes) to have a neutral
(0%) adjustment for 2016
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Quality Tiering
• 10-99 EPs
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Quality Tiering
• 100+ EPs
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2014 PQRS Reporting Considerations
• TINs with 1 EP
– Provider only need to satisfy PQRS
• 0.5% inventive for successful reporting, -2.0% penalty for not reporting
– Provider/TIN is not subject to Value Based Payment Modifier this year
• But likely will be next year
– Provider/TIN has one Allscripts option:
1. Report as an individual via Allscripts DSV
– No Self-Nomination required
– Separate from CQS & MU Stage 2 Package, subject to additional fee
– Contact your Allscripts Outcomes Executive
• OR, provider can report via another outside service
– Could be done via Claims, Registry or an EHR DSV (like Allscripts)
– No Self-Nomination is required
– Note: TeamPraxis does not support any option for individual providers
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2014 PQRS Reporting Considerations
• TINS with 2-9 EPs
– Providers only need to satisfy PQRS
• 0.5% inventive for successful reporting, -2.0% penalty for not reporting
– Providers/TIN not subject to Value Based Payment Modifier this year
– Providers/TIN has two Allscripts options:
1. TIN reports as a Group via Allscripts DSV
– Self-Nomination is required
– Separate from CQS & MU Stage 2 Package, subject to additional fee
2.
Providers report as individual EPs via Allscripts DSV
– No Self-Nomination required
– Separate from CQS & MU Stage 2 Package, subject to additional fee
• OR, providers can report via another outside service
– Could be via Claims (individual only), Registry, or EHR DSV
– GPRO reporting requires Self-Nomination
– Note: TeamPraxis does not support any options for TINs of this size
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2014 PQRS Reporting Considerations
• TINs with 10-24 EPs
– TIN must satisfy PQRS and Value Based Payment Modifier
• PQRS: 0.5% incentive, -2.0% penalty for not reporting
• Value Based Modifier: Quality Tiering (+,0), -2.0% penalty for not reporting
– TIN has two Allscripts options:
1. TIN reports as a Group via Allscripts DSV
– Self-Nomination is required
– Separate from CQS & MU Stage 2 Package, subject to additional fee
2.
EPs report as individuals via Allscripts DSV (not recommended)
– No Self-Nomination required, 50%+ EPs must report successfully
– Separate from CQS & MU Stage 2 Package, subject to additional fee
• OR, providers can report via another outside service
– Could be via Claims (individual only), Registry, or EHR DSV
– GPRO reporting recommended, requires Self-Nomination
– Note: TeamPraxis does not support any options for TINs of this size
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2014 PQRS Reporting Considerations
• TINs with 25-99 EPs
– TIN must satisfy PQRS and Value Based Payment Modifier
• PQRS: 0.5% incentive, -2.0% penalty for not reporting
• Value Based Modifier: Quality Tiering (+,0), -2.0% penalty for not reporting
– TIN has three Allscripts/CQS options:
1. TIN reports as a Group via GPRO Web Interface (CQS/TeamPraxis)
– Self-Nomination is required
2.
TIN reports as a Group via Allscripts DSV
– Self-Nomination is required
– Separate from CQS & MU Stage 2 Package, subject to additional fee
3.
EPs report as individuals via Allscripts DSV (not recommended)
– No Self-Nomination required, 50%+ EPs must report successfully
– Separate from CQS & MU Stage 2 Package, subject to additional fee
• OR, providers can report via another outside service
– Could be via Claims (individual only), Registry, or EHR DSV
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2014 PQRS Reporting Considerations
• TINs with 100+ EPs
– TIN must satisfy PQRS and Value Based Payment Modifier
• PQRS: 0.5% incentive, -2.0% penalty for not reporting
• Value Based Modifier: Quality Tiering (+,–,0), -2.0% penalty for not reporting
– TIN has three Allscripts/CQS options:
1. TIN reports as a Group via GPRO Web Interface (CQS/TeamPraxis)
– Self-Nomination is required
2.
TIN reports as a Group via Allscripts DSV
– Self-Nomination is required
– Separate from CQS & MU Stage 2 Package, subject to additional fee
3.
EPs report as individuals via Allscripts DSV (not recommended)
– No Self-Nomination required, 50%+ EPs must report successfully
– Separate from CQS & MU Stage 2 Package, subject to additional fee
• OR, providers can report via another outside service
– Could be via Claims (individual only), Registry, or EHR DSV
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GPRO Web Interface:
Process Overview
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GPRO Web Reporting Dynamics
• Unique and different reporting method
– No measure selection, assigned patient sample
• Client ownership of reporting process
– Clients facilitate self-reporting to CMS; CQS tool assists
– Clients must follow CMS instructions to complete reporting
process; TeamPraxis does not participate
• Reporting Process entails two elements:
1. Patient identification (matching)
2. Data reporting (filling & updating)
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GPRO Web Reporting CMS Measures
• 22 measures from 5 disease modules & 2 patient care modules
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–
–
–
–
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CAD (2 measures)
Diabetes (6 measures)
Heart Failure (1measure)
Hypertension (1 measure)
Ischemic Vascular Disease (2 measures)
Care Coordination/Patient Safety (2 measures)
• Includes Medication Reconciliation
– Med Reconciliation must be entered manually into the CMS GPRO Web Interface
– Preventive Care (8 measures)
• Yes/No, Dates, Values, Exclusions
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CMS GPRO Web Interface (2013)
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CMS GPRO Web Interface (2013)
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GPRO Web Reporting CMS Measures
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CQS GPRO Web Reporting Tool
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GPRO Web Reporting Tool
• Two Steps
1. Patient Matching
• Produces report of patients, including No or Multiple Matches
2. Data Fill & Update
• Single job
• Original XML will be updated and saved; tool does not
generate a new XML
• Tool can be used reiteratively
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GPRO Web Reporting Tool Process
Upload Updated
XML file to
CMS Web Portal
CMS
Web Portal
CQS Tool:
1. Patient
Matching
- Download
Review data
XML file
in the CMS
from CMS
Web Portal,
Web Portal
make changes - Open XML in
as needed
CQS Tool
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- Run Patient
Matching Step
- Review Patient
Match Reports;
- Make changes
and re-run
(if needed)
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CQS Tool:
2. Data Fill &
Update
Run Data Fill &
Update Step
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GPRO Web Reporting Tool:
Client Resource Planning
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GPRO Web Reporting: Resource Planning
• Allocate at least 1-2 resources
– IT resource with access to CQS server
– Resource(s) to validate data CQS fills in the GPRO Web Portal
– Manually fill in Medication Reconciliation measure
– Manually fill in any missing data
• Execute GPRO Web Reporting Tool module or configure a user
to execute
– GPRO Web Reporting Tool resides on your CQS Production server
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GPRO Web Reporting Tool:
Schedule
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Tentative Release Timeline
• Webinar #2 – October/November
• Likely end-of-year CQS Upgrade – December/January
• All organizations to receive access to CMS Portal in
~January 2015; given 8 weeks to complete reporting
• CQS Web Reporting Tool GA: Monday of 2nd week
– Tool must be piloted with live CMS data during first week
– You may start manual data entry, (i.e. Medication Reconciliation)
during the first week
Note: timeline subject to change if CMS changes its timeline
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Self-Nomination
• Self-Nomination is required for any GPRO Reporting
• Self-Nomination Deadline: September 30
• TINs must report via the reporting method for which it
Self-Nominated
• TINs must Self-Nominate for GPRO Web Interface in order to
report via CQS GPRO Web Reporting Tool
• TINs that Self-Nominate for DSV must utilize Allscripts DSV
• TINs that Self-Nominate for Registry must find an outside vendor
• Changes can be made to Self-Nominations until Sept. 30
• Self-Nomination requires a CMS IACS account
• More information: www.cms.gov/Medicare/Medicare-Fee-for-ServicePayment/PhysicianFeedbackProgram/Self-Nomination-Registration.html
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Next Steps
• Obtain an IACS account ASAP
• Self-nominate with CMS by September 30
– For each TIN that wishes to report as a GPRO
– Multiple TINs must self-nominate and report separately
• Once you Self-Nominate, please let us know how
you intend to report
– Even if you won’t report via GPRO Web Interface
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Resource Materials
• CQS GPRO Web Reporting Tool website
• CMS GPRO Web Interface website
http://www.cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/PQRS/GPRO_Web_Interface.html
• CMS IACS Account Presentation for GPRO Web
www.cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/PQRS/Downloads/2014-PQRS-and-ACO-GPRO_IACS_Portal_Training.pdf
• To apply for a CMS IACS account
– https://applications.coms.hhs.gov/
• CMS QualityNet Help Desk
– E-mail: [email protected]
– Phone: (866) 288-8912
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Questions?
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