HC Webinars: Hello, everyone. Thanks for joining us today. My name is Laura Martin, and I will be your host for today's webinar.
HC Webinars: The presentation we will be covering for you today is empowering Acos.
HC Webinars: leveraging quality management tools for MIPS, and beyond
HC Webinars: presented by Shannon Campbell, senior manager of the Regulatory measures program here at health, catalyst
HC Webinars: and Hayes. Will Morrison, measurable product manager with health catalyst.
HC Webinars: Before we begin, I want to couple. Cover a couple of housekeeping items.
HC Webinars: All attendees have been placed on mute, and cameras are off to eliminate background, noise and distractions.
HC Webinars: Please use the QA. Panel to ask questions and interact with our speakers throughout the presentation.
HC Webinars: The slides and the recording of this presentation will be emailed tomorrow as well as published on our website.
HC Webinars: And as a reminder, ceus are not provided for today's webinar.
HC Webinars: That is all I have for now, so I will hand it over to our presenters. Janet and Hazel.
Shannon Campbell: Thank you, Laura. My name is Shannon Campbell, and I've spent the last 17 years or so managing compliance and Cms quality, reporting across healthcare settings, including clinics, hospitals.
Shannon Campbell: Ascs and regional healthcare system.
Shannon Campbell: And while I wouldn't quite call it a hobby, I thoroughly enjoy reading the Cms. Rules, so I feel that this position is perfect for me.
Shannon Campbell: I love this work, and I love helping providers make the most of their efforts within the regulatory guidelines, so they can reap the full rewards available to them.
Shannon Campbell: We'll get started before we dive into the regulatory aspects.
Shannon Campbell: of the Aco. Quality measures.
Shannon Campbell: sorry I wasn't prepared to cover the agenda.
Shannon Campbell: I'll cover the agenda during today's slide presentation. You'll learn the regulatory requirements for Acos how to avoid common pitfalls for Acos
Shannon Campbell: and use the measurable tool for MIPS and beyond.
Shannon Campbell: I'll be covering the regulatory requirements for Acos, and before we dive into the regulatory aspects of the Aco quality measures. We have a poll question, and we'd like to get an idea of how actively you currently monitor your quality performance throughout the year.
Shannon Campbell: Do you monitor it annually?
Shannon Campbell: Quarterly
Shannon Campbell: monthly? Or is your monitoring more active or continuous?
Shannon Campbell: We'll leave this open for a few seconds, so everyone can participate.
Shannon Campbell: Got about a 3rd of our responses.
Shannon Campbell: and the responses are just trickling in, so maybe give it another 5 seconds. 10. I'll Laura. I'll let you choose.
Shannon Campbell: Looks like, there's some easy division, and that's great that a 3rd of quarterly, a 3rd monthly, a 3rd actively or continuously, roughly, they're about 30% to 34%.
Shannon Campbell: That's great
Shannon Campbell: with that idea of monitoring quality performance in mind. Let's dig into the intention of the quality payment program and why the MIPS measures are important.
Shannon Campbell: The Qpp measures
Shannon Campbell: are often categorized as
Shannon Campbell: needless, burdensome tasks that cms forces on healthcare organizations, but they should be seen in a different light, one that benefits the organizations. Instead.
Shannon Campbell: the measures focus on established, evidence-based clinical practices which represent the basic care patients should receive.
Shannon Campbell: These practices are standards that are likely already being followed by Qpp participants.
Shannon Campbell: Why not capitalize on quality practices? You're already following
Shannon Campbell: measures should be viewed as opportunities to fund even more quality improvement.
Shannon Campbell: We look at it like a layer cake.
Shannon Campbell: Consider the foundational layer is the accurate capture of E. Hr. Data.
Shannon Campbell: accurate documentation by healthcare providers and the accurate mining of that data
Shannon Campbell: by submitting these data to Cms in the form of QP. Measures.
Shannon Campbell: Success in these established clinical practices can maximize incentive payments.
Shannon Campbell: reimbursement
Shannon Campbell: to drive continuous improvement leading to better quality, improve patient outcomes and cost reduction.
Shannon Campbell: This will improve measure results further, seeking the cycle by increasing revenue and driving continuous improvement to support the quality improvement efforts implemented in clinics
Shannon Campbell: to achieve healthcare excellence.
Shannon Campbell: Some Qpp participants simply make the annual measure submission to Cms and nothing more. While that's technically allowed, it doesn't meet the intention of the program. And it's not a a wise use of the resources invested into the Ehr and the data collection.
Shannon Campbell: It also leaves unclaimed incentive dollars on the table. And most importantly, it risks patient care
Shannon Campbell: instead, participants
Shannon Campbell: should monitor their data during the performance period so they can identify gaps and close them before the end of the performance period. This way they can improve the quality of care their patients receive and have more control over their performance scores over previous years, and as a result.
Shannon Campbell: the financial incentives.
Shannon Campbell: So as Acos, you'd be best served by embracing a culture that aligns with the quality payment program one in which you actively monitor your Acos performance and the quality measures providing clinicians the opportunity to close performance gaps.
Shannon Campbell: Not only will this make you more agile in the field C of Cms quality reporting
Shannon Campbell: and better equipped to adjust to changes that Cms makes to the program, but it'll also improve your quality scores and maximize the financial incentives awarded to your Aco.
Shannon Campbell: also, the data sharing aspect of Qpp measures inherently supports the Aco's goal to share in the accountability of the care of patients
Shannon Campbell: where one clinician may not meet a measure, another clinician may close the gap during a subsequent visit.
Shannon Campbell: not only improving the measure performance.
Shannon Campbell: improving the patient's care
Shannon Campbell: at this point.
Shannon Campbell: Have a second poll question
Shannon Campbell: to ask how actively you manage your performance in quality measures.
Shannon Campbell: Responses are
Shannon Campbell: the options are, we do not have any care. Gap closure processes. We just submit the data through Cms
Shannon Campbell: notify member organizations about care gaps.
Shannon Campbell: We identify patterns in care gaps and provide member organizations with insights for improvement.
Shannon Campbell: We actively work with member organizations to improve their processes, related to care gaps
Shannon Campbell: or other.
Shannon Campbell: We have about a quarter
Shannon Campbell: responses so far, but they're still flowing in pretty quickly. So I say, we leave it open for a few more seconds here.
Shannon Campbell: And then, as soon as I said that, it began to trickle. So Alura maybe give it. Yeah, there we go. Thank you.
Shannon Campbell: Okay, so great, 45% actively work with member organizations to improve their processes related to care gaps. It's great. Second, even better. Second, we we identify patterns and care gaps and provide member organizations with insights for improvement. That is wonderful. Thank you very much for that.
Shannon Campbell: Prior to the calendar year 2021 physician fee schedule, MSP. Acos submitted their required data, their quality data, anyway, through the 10 measures collected via the Cms. Web interface method with this method Cms
Shannon Campbell: sent the Aco a list of patients for which the Aco then submitted the 10 measure values
Shannon Campbell: the patient list came from Cms. So the measures only applied to Medicare patients.
Shannon Campbell: The calendar year 2021 physician fee schedule, however, aligned the shared savings program with MIPS reporting
Shannon Campbell: which meant the Mss. Pacos would have to transition from the web interface to the Apm. Performance pathway or the Ap. P. By submitting 3 specific myth measures.
Shannon Campbell: diabetes HBA, one C poor control
Shannon Campbell: screening for depression and follow up plan
Shannon Campbell: controlling high blood pressure.
Shannon Campbell: A vast departure from the Mss. Paco measures in the Cms. Web interface is that the mids Ap. Measures, whether CQM. Or ECQM.
Shannon Campbell: Require that all patients, regardless of payer.
Shannon Campbell: be included in the measure population. This means that the measures have to include Medicare patients
Shannon Campbell: as well as patients with commercial payers, and even self pays
Shannon Campbell: all patients
Shannon Campbell: regardless of pair.
Shannon Campbell: The reason for this
Shannon Campbell: is that Cms. Doesn't want Msf Pacos to focus only on Medicare patients, but to apply best practice and quality monitoring to all the patients that they treat
Shannon Campbell: this calendar. Year 2021
Shannon Campbell: Pss. Rule also announced the sun setting of the Cms. Web interface as of the 2022 performance period.
Shannon Campbell: Subsequent Pfs rule, though delayed the termination of the web interface
Shannon Campbell: until the end of the 2024 performance period.
Shannon Campbell: giving MSS. Pacos 3 additional years to transition to the All patient, all payer requirement
Shannon Campbell: in the rules. Since then Cms. Has received feedback, leading them to
Shannon Campbell: announce
Shannon Campbell: in the calendar year 2024 Pfs. Rule
Shannon Campbell: the creation of a new transitional data collection method, Medicare, Cqm. Which is an option available only to MSS. Pacos.
Shannon Campbell: These measures are calculated the same way as the traditional Cqms. You see listed here, except they don't require all pay or all patient data.
Shannon Campbell: They only require data to be reported for all medicare patients
Shannon Campbell: keep in mind that this requirement isn't for all Medicare patients
Shannon Campbell: attributed to the Mss. Paco. It means all patients who have medicare part B and receive care from a provider in the aco.
Shannon Campbell: These Medicare Tqms are intended to be transitional, meaning that Cms. Will remove them at some point in the future. But they haven't announced when
Shannon Campbell: the goal of the Medicare Cqm's is to transition Msf. Paco to the all pay or all patient version of these measures.
Shannon Campbell: Cms. Can provide a quarterly cumulative list of Medicare Cqn. Patients. Your Aco. Is required to report.
Shannon Campbell: but we haven't seen that this Medicare, Cqm. Option will be very helpful to any of our Acos. The resources needed to pull the list of patients from the Quarterly Cms. Report and aggregate those results into the submission tool are better served, being applied to the ultimate goal of pulling all patients regardless payer.
Shannon Campbell: and therefore setting up the Aco for success with the traditional Cqm. It's kinda like, why bother using training wheels if you can ride a 2 wheeler without them.
Shannon Campbell: So, to summarize the Mss. Paco options for submitting quality data to Cms.
Shannon Campbell: The last year the Cms web interface method will be available. Is the current 2024 performance year.
Shannon Campbell: as of the 2025 performance period MSS. Pacos
Shannon Campbell: must submit quality data via CQM.
Shannon Campbell: The Ecqms. Or the New Medicare, Cqm.
Shannon Campbell: Those will be your only options for this, for the foreseeable future
Shannon Campbell: addition to the all patient, all payer requirement.
Shannon Campbell: the shift
Shannon Campbell: of Mss. Pacos to the app measure. Submission brought up another topic needing clarification
Shannon Campbell: data completeness.
Shannon Campbell: Cms requires
Shannon Campbell: a measure, level data completeness threshold of 75% for the
Shannon Campbell: 2024 quality measures which includes the 3 Mspac aco measures. You see here, it doesn't mean that
Shannon Campbell: has to submit 75% of the data required for the measures.
Shannon Campbell: The Aco is expected to submit 100% of the data.
Shannon Campbell: 100% of its participants
Shannon Campbell: to feed the measure populations and the measured denominator
Shannon Campbell: data. Completeness applies to the numerator action.
Shannon Campbell: and each measure must meet the 75% threshold.
Shannon Campbell: This means that 75% of the denominator cases
Shannon Campbell: must have a quality action. Whether that's performance met, performance not met, or in the case of depression screening here.
Shannon Campbell: denominator exception.
Shannon Campbell: If the data completeness threshold isn't met for a measure, no points will be awarded to the Aco for that measure.
Shannon Campbell: So here we see the data completeness, calculation
Shannon Campbell: from the measure, specifications for the depression screening measure, which is number 1, 34.
Shannon Campbell: You can see that the the data completeness rate is calculated by starting with the eligible population in the denominator, which in this example is 80 patients.
Shannon Campbell: Again, this is calculated from the entirety for 100% of the Acos data.
Shannon Campbell: Looking at the numerator for the data completeness rate.
Shannon Campbell: You see in this example that 40 patients have enumerator action of performance met.
Shannon Campbell: 10 patients have a denominator exception, and 20 patients have enumerator action of performance not met totalling 70.
Shannon Campbell: This means that 70 of the 80 patients in the denominator have a numerator action or complete data.
Shannon Campbell: 10 have incomplete data.
Shannon Campbell: 70 out of 80 patients
Shannon Campbell: with complete data
Shannon Campbell: results in a data completeness rate of 87.5%, which exceeds the 75% threshold.
Shannon Campbell: As for the performance categories in waiting, the Qvp has 4 performance categories for which data is traditionally submitted.
Shannon Campbell: quality cost improving activities and promoting interoperability.
Shannon Campbell: Given the nature of an accountable care organization as part of the Ap. P. The Aco. As an Apm. Entity isn't scored on the cost performance category and is automatically await awarded
Shannon Campbell: 100% of the improvement activities activities which is weighted at 20% of the Aco's final score. So that accounts for cost
Shannon Campbell: and improvement activities
Shannon Campbell: for the Ms. Paco
Shannon Campbell: performance improvement category.
Shannon Campbell: Excuse me, the promoting interoperability category is weighted at 30% of the Acos final score and oh, new to the 2024 performance period. Acos had the option to report this category at the Apm. Entity level. They previously dependent on the clinicians or groups to submit that data
Shannon Campbell: also, speaking of changes, Qps or qualified participants and partial Qps. Participating in an aco were previously exempt from the promoting interoperability category.
Shannon Campbell: The calendar year 2024 Pfs. Rule adopted a change
Shannon Campbell: such that as of the 2025 performance period.
Shannon Campbell: all MSS. Paco participants, including the Qps and partial Qps
Shannon Campbell: included in the promoting interoperability data reporting requirements.
Shannon Campbell: So if the Aco submits Pi data at the Aco level, Qps and partial Qps must be included. If the Aco doesn't submit pi data at the Aco level, the Qps and partial Qps will need to submit their data
Shannon Campbell: at one of the other submission levels
Shannon Campbell: for the quality performance category, which is 50% of the Aco's final score.
Shannon Campbell: Mss. Pacos are required to submit either the
Shannon Campbell: 10 web interface measures, or the 3 Cqm. Medicare, Cqm. Or Ecqm. Measures.
Shannon Campbell: in addition to
Shannon Campbell: the traditional caps, permits survey measure, and the 2 administrative claims measures.
Shannon Campbell: I see we have a question that came in in regards to the hardship, exemption.
Shannon Campbell: exception for small practices for pi, for 2025
Shannon Campbell: you still have to apply for the exception, there is no automatic. I don't believe
Shannon Campbell: there's an automatic exception, but that would need to be. Yeah, there might be an automatic
Shannon Campbell: regret answering that one live.
Shannon Campbell: But I think you still have to apply for the hardship, hardship, exception. I hope, Susie, that that answers your question. I'm sorry.
Shannon Campbell: Aco. Clinicians
Shannon Campbell: may submit data separately from the Aco, and they have a choice of submission and participation methods.
Shannon Campbell: If submitting via the Ap. P. As an individual or part of a group.
Shannon Campbell: The categories and weights mirror those of the aco.
Shannon Campbell: if submitting via traditional maps, which is the self chosen quality measures, and such
Shannon Campbell: all 4 categories must be submitted, and the weights of those categories differ from the Ap. Submission.
Shannon Campbell: This traditional MIPS option also includes the subgroup
Shannon Campbell: type, but a subgroup is only allowed to submit an Mvp. Which has to be registered with Cms. Before December second of this year
Shannon Campbell: Aco clinicians, submitting outside of the Aco. Won't receive the automatic 100% for the improvement activities category. But they do enjoy a reduced reporting burden for improvement activities. Their Ia score will be at least 50%.
Shannon Campbell: If the clinician attests to an improvement activity
Shannon Campbell: or submits data for quality and promoting interoperability.
Shannon Campbell: whatever submission or participation option is chosen, the highest submitted score will be attributed to the clinician.
Shannon Campbell: We'll now review some common questions or concerns we hear from Ms. Pacos that I haven't already covered
Shannon Campbell: the data. Completeness. Requirement is a new concept for some MS. Pacos. So a common question we get is.
Shannon Campbell: what's its intention?
Shannon Campbell: Right? So the data completeness threshold was adopted at the inception of the Cqm. Measures in 2020. Excuse me 2017.
Shannon Campbell: The threshold was initially adopted at 50%, which matched the legacy. PQRS. Requirement.
Shannon Campbell: though Cms initially proposed 90%. So you can see how far discrepant it was from the 90 they proposed
Shannon Campbell: every year or so since then the threshold has increased, bringing it to the current. 75% we discussed earlier for the 2024 performance period
Shannon Campbell: Cms. Intends to continue increasing the threshold over the coming years to bring it as close to 100% as possible. The intention is that every visit
Shannon Campbell: or event or patient in a measures denominator should have a quality action documented. Whether that action is performance met, not met, or there's a denominator exception, the goal is to get as complete and accurate a picture of the submitter's performance
Shannon Campbell: as possible, with all data points documented and accounted for.
Shannon Campbell: the data. Completeness.
Shannon Campbell: Requirement also supports the prevention of cherry picking. Cherry picking is a the selective removal of unfavorable data to skew a participant's true performance.
Shannon Campbell: and is an act explicitly forbidden by cms.
Shannon Campbell: So this
Shannon Campbell: data completeness threshold, by the way, only applies to Cqm's and Medicare Cqms. Due to the manual aspect of their collection.
Shannon Campbell: The the Ec. Qms. Inherently have a 100% data completeness rate because their data are collected electronically without manual manipulation.
Shannon Campbell: Another question that is sometimes asked is if the Msf incentive to report Ecqm or Cqm.
Shannon Campbell: Also applies to Medicare, Cqm.
Shannon Campbell: It does not.
Shannon Campbell: Cms has explained that because Medicare Cqms only include medicare beneficiaries rather than all payers, all patients type of reporting. They aren't eligible
Shannon Campbell: for the incentive.
Shannon Campbell: Now I will pass it off to Hazel to cover the use of measurable for acos.
Shannon Campbell: Hazel.
Hazel Morrison: Beautiful. Thank you, Shannon.
Hazel Morrison: So welcome everybody. I'm Hazel Morrison. I use Adam pronouns, and I'm the product manager for the measures. Portfolio of applications at health catalyst.
Hazel Morrison: I've been in the qualified but registry space for about 5 years now.
Hazel Morrison: and before that I worked at a pharmacy benefits manager on the payer side. I also began my career at epic. So I've seen measures from a lot of different angles.
Hazel Morrison: and today I'll be walking through. How different features in our measurable application, support our Aco customers. So to start us off, I'd love to get a sense of how many of you are familiar with measurable already.
Hazel Morrison: Your options are. I've never seen a measurable dashboard, which, if that's the case, that's wonderful. You'll get a little intro today. You've seen a demo, but you've never used measurable.
Hazel Morrison: You use measurable to track performance, and you use measurable today to track performance and to submit.
Hazel Morrison: So I see people are still seem to be answering. I'll give everyone another 5 seconds or so
Hazel Morrison: great. So it looks like we have a lot of new faces, a lot of people who are new to measurable. So I'm really excited to share that with you today.
Hazel Morrison: So as an intro really building off of what Shannon said earlier. We want to support you in meeting your regulatory requirements, but we also want to go beyond that.
Hazel Morrison: We want you to use your performance
Hazel Morrison: and monitor it continuously and and really dig into the insights that will help you and your member organizations perform those important improvement activities and ultimately receive better compensation. So it's kind of a seamless process that should be happening continuously over time. I was really pleased to see earlier in this presentation with one of our 1st polls. But many of you are doing that already. So we wanna continue to support that you and that
Hazel Morrison: and I'll be sharing some different features in our application that support each of these activities. So if we could go to the next slide, please.
Hazel Morrison: so as an overview of the measurable dashboard. It's broken down into 5 main screens. Starting off with the program level that gives you an overall picture of your performance. For the whole organization or program.
Hazel Morrison: Then, moving on to the group and provider level, you can drill down and see how your groups and providers are performing relative to each other which in an aco context, can provide a lot of valuable insights.
Hazel Morrison: Further insights can be gleaned from the next screen. Which is a summary or index of patients who fall into the different populations for the different measures. This is a really rich source of information, and it's an area where I really encourage our customers to spend a lot of time. So you can see the list of patients who are in different options or populations. Even within a measure, you can say, Okay, well, who met
Hazel Morrison: the numerator requirements for this reason versus this reason, who was a gap for this reason versus this other reason. And that can help, you know, spur a lot of ideas for process improvements for your member organizations. Finally, you can drill down even further at the individual patient level and get actionable information about how each patient met the requirements or did not for each measure. You can see the individual records that were used to make those calculations.
Hazel Morrison: And that can help inform a lot of care. Gap closure processes.
Hazel Morrison: Could we? Yeah. Next slide, please. Okay. So our next poll is what are your submission plans for performance year 2024. The 1st option is, we don't plan to submit the Aco level.
Hazel Morrison: The second option is we plan to submit using traditional Cqms.
Hazel Morrison: 3, rd we plan to submit using Medicare Cqms.
Hazel Morrison: 4, th we plan to submit using Ecqms. And then, finally, we plan to submit via the Cms web interface.
Hazel Morrison: And of course, as Shannon mentioned, this is the last year that the web interface is going to be available. So I'm interested to see how that all
Hazel Morrison: pans out for this group.
Hazel Morrison: still seeing some movement here. So I think we'll give another 5 seconds or so
Hazel Morrison: perfect.
Hazel Morrison: Alright. So I'm seeing A lot of folks who are not planning on submitting at the Aco level, and a lot of people using the Cms web interface, some using traditional Cqms. So I'll be happy to cover all of the options that we support and maybe that can spur some ideas for what you might want to do in future years
Hazel Morrison: on this next screen. Here you can see what it looks like to track your performance on an Msp program. So we do support traditional Cqms. Medicare, Cqms and Ecqms.
Hazel Morrison: As Shannon mentioned the data pipeline for Medicare Cqms can sometimes be a little tricky to set up, but the application absolutely supports it from a technical perspective. And that's a determination you can make as to whether that implementation work is valuable or whether you would just like to use the traditional Cqms
Hazel Morrison: on the screen. You can see your performance. You can see your estimated points based on that performance, as I'm sure all of you know. Your overall numerator and denominator is part of the picture, but it's not exactly how those points are determined. So we actually use the desiles provided by Cms to estimate how many points you can expect for each measure.
Hazel Morrison: If we could have the next slide here. Great. And then, if you're using traditional Cqms or Medicare Cqms, you can submit through our qualified registry. So able health has been a qualified registry since 2,017. And this we have an Api connection to Cms that allows us to submit
Hazel Morrison: on your behalf without you having to leave the dashboard. So you can use the actions, menu, to open up that submission, Wizard, and then you'll be guided through a step by step process to fill out all the configuration elements and attestations that are needed for your submission.
Hazel Morrison: Then you can sign off on the submission with an electronic signature. And of course, you know, just like any other qualified registry would tell you ultimately you the Aco or your member health organizations, if they're submitting at that level, are kind of legally responsible for the completeness and accuracy of the data behind the submission. So you'll sign off of that during the submission process.
Hazel Morrison: And then, because we have an Api connection, you'll get immediate feedback. About the success of the submission and the message that was received by Cms. And then you'll be able to download all the documentation related to that submission
Hazel Morrison: next slide. Please thank you for those of you who are interested in using Ecqms. As I mentioned, we support those as well. All of the Ecqms in our library are certified.
Hazel Morrison: And
Hazel Morrison: The submission process is a little bit different. The Api that all qualified registries use does not permit for Ecqm submissions. So what we recommend instead is to export your da 3 files which contain the results of these measures. And once you've exported those files, you can download them, using a secure link that will be emailed to you.
Hazel Morrison: You'll need to log into the Qpp Web portal using your harp account, and then you can go ahead and upload those Qrda 3 files
Hazel Morrison: keep in mind. This is different from the Cms web interface. The Cms web interface process is a different portal. Different process, and a different way of thinking about the measures. But this is how you you would use our dashboard to facilitate Ecumm submission.
Hazel Morrison: And if you're interested in submitting pi measures as well, promoting interoperability on top of your Ecqms. You can certainly mix and match we support a submission of the pi measures only, and then you can separately go through the web portal and submit your Ecqms that way.
Hazel Morrison: Great. So what does promoting interoperability look like that's our screen here. This allows you to perform the self attestations. For example, if you know you're doing that security risk analysis, you can check that off
Hazel Morrison: and then we also provide a space for you to enter in the numerator and denominator for your e-prescribing measures.
Hazel Morrison: And make choices about your health information, exchange measures.
Hazel Morrison: So this is self attestation, and then that will be included in your
Hazel Morrison: submission. Wizard Api submission. If you choose to use that
Hazel Morrison: on our next slide, Shannon will show you how we represent improvement activities and costs for our Aco groups.
Hazel Morrison: So if if your dashboard is set up for Aco level reporting, you'll see that improvement activities will automatically receive full credit in 2024, and that cost is automatically waited at 0 for Acos.
Hazel Morrison: So, pulling together all that information, we estimate a composite score for you with the appropriate waiting, and with all the information we've calculated, and all the information you've entered. That modeled composite score which you see on the left is our best estimate of what Cms may give you. It's certainly not a guarantee right? Cms has been known to change benchmarks. And you know
Hazel Morrison: they ultimately are responsible for calculating that score, but based on the information we have. We hope that this provides you with a way of anticipating what your likely score might be, and help you make those decisions about improvements that you may want to engage in before submitting.
Hazel Morrison: So again, just trying to help with that kind of proactive approach to improving your performance.
Hazel Morrison: So with that, here's some wonderful resources. If you want to learn more, the slides for this presentation will be available online, and so that these will be clickable links, those external resources. But just wanted to highlight those here.
Hazel Morrison: And at this point I will open it up to questions.
Hazel Morrison: So I do see one question here for you, Shannon. Can. Groups and providers within an aco also do their own submissions. If an aco is submitted on their behalf.
Shannon Campbell: They can. The clinicians and groups and subgroups, for that matter, may choose to submit any number of
Shannon Campbell: measures appropriate to that submission method, and the highest score attributed to that particular provider will be attributed to them. So you can submit
Shannon Campbell: 3 4 different ways, and the highest will be the one that gets awarded to that particular provider.
Hazel Morrison: Great answer. Thanks, Shannon, and I'll add to that. We facilitate that in the dashboard you can certainly do submissions at different levels.
Hazel Morrison: You know the Aco level, the group level provider level and then you can track and see your progress on. On each of those submissions. We do have many customers who do
Hazel Morrison: multiple types of submissions in the same submission here. And that, you know, really can benefit you with that higher score. As Shannon said.
Hazel Morrison: okay, I see another question, how does your product support Ecqms when an Aco has numerous emrs?
Hazel Morrison: That's a great question. And that is the benefit of the health catalyst platform. Right? Our absolute bread and butter is pulling together multiple data sources, standardizing normalizing that data and then providing that in a cohesive way to our measures engine. So most of our customers have multiple emrs that are sending us data.
Hazel Morrison: And most of our customers are also pulling in data from other sources besides, just the clinical data from the Emrs. So that's something that we not only support but encourage
Hazel Morrison: great question.
Hazel Morrison: Okay, so here is another question about Ecqms and Cqms
Hazel Morrison: asking in in this Aco, there's both paper practices and Emrs. So
Hazel Morrison: could this Aco. Submit both Cqms and Ecqms. Or
Hazel Morrison: will they be penalized for the paper practices? If they decide on Cqm. Or on Ecqms. I see.
Shannon Campbell: So on this one.
Shannon Campbell: That's a little difficult. Because if you're gonna report via Ecqm.
Shannon Campbell: the implication is, you have full electronic access. So to your point, Crystal. You can have the papers
Shannon Campbell: electronic access, right? That defeats the purpose. Now it's when it comes to
Shannon Campbell: penalizing.
Shannon Campbell: I i i don't think there's a penalty involved in it. But you're not really meeting the intention of the Ecqm. So if you can't
Shannon Campbell: fully get all the electronic data, the expectation is that the Aco will submit to Cms
Shannon Campbell: all of the possible data. And if that can't be done electronically, I don't think electronic Cqm's are going to be
Shannon Campbell: right choice for you. It Cqms. May be the best choice at that point.
Shannon Campbell: I hope that helps you. Sorry.
Shannon Campbell: See? A question popped in of what are the Ecqm requirements for calendar year 2024.
Shannon Campbell: Not sure exactly what the question is intending or the context of it. There is no requirement to submit an ECQM.
Shannon Campbell: But if you choose to submit your Ap. P. 3 measures the depression
Shannon Campbell: HBA, one C, and controlled blood pressure.
Shannon Campbell: If you choose to submit via that method, you have the choice of ECQM. S.
Shannon Campbell: You can also choose to submit by Cq. End
Shannon Campbell: either met or or you can choose to submit a measure via ECQM. And other measures via Cqm.
Shannon Campbell: You can maximize your scores, let's say your Ec. Qm. Score is higher for one particular measure, because keep in mind the benchmarks are going to be different for each of the measures right and our our tool allows you to analyze which is the most advantageous for your particular organization. So, although you're
Shannon Campbell: Cqm score, you know you, you may see that you have a higher numerator. It depends on the benchmark. If the Ecqm's benchmark is that significantly lower than the Cqm. It may be advantageous to submit the ECQM. Version of that particular measure.
Shannon Campbell: So requirement.
Shannon Campbell: there is no requirement. Necessarily, there are specification requirements. But I don't think that's what you're speaking to. So I hope that answers your question as well. That least elucidates it otherwise. Feel free to
Shannon Campbell: elucidate the the question a bit more. And and if I didn't get the detail that you were looking for, thank you.
Hazel Morrison: Okay, I'm seeing another question here about what data sources we recommend to ensure that we're capturing all payers and all patients.
Shannon Campbell: Well, in order to capture the all patients and all payers. Aspect of these particular measures which is required of both the Cqm. And the Ecqm.
Shannon Campbell: We need to make sure that we get as close to the service as possible, because that's the driver of these measures right? The Cpt's the Hick picks the diagnoses.
Shannon Campbell: the different criteria date of service that go into the charge
Shannon Campbell: so as close to the
Shannon Campbell: coding is possible. That could be your billing data. It could be your dropped charges.
Shannon Campbell: You do want to make sure that you steer clear of
Shannon Campbell: what's commonly called claims data. Now, what what I would call claims data from a Cms perspective is the data that goes on the claim.
Shannon Campbell: I have
Shannon Campbell: experience definitions of claims, data meaning the data that you get back from the payers
Shannon Campbell: that are related to the claim. So the payer's response to the claim that's too far down the charge line.
Shannon Campbell: So in that case, if you're using returned claims or acted upon claims from payers, it's too far down the charge line because you miss out on self pays. You also miss out on claims data pertaining to payers that you may never have billed before. Say, a patient from an outside State visits you well, their their payer may be in another state. You've never billed them before, but they still need to be in your population, so we want to stay as close as possible
Shannon Campbell: to the actual charge as it's entered into. Your Emr, that
Shannon Campbell: more solidly gets us all your patients, whether they're medicare, commercial or self pay, and all your patients, and or, excuse me, your payers, including those you may never have billed before. All patients all pays as close to the service charge dropping as possible is how we're going to achieve that. All patient, all pay data.
Shannon Campbell: Do we have any more questions that have trickled in.
Hazel Morrison: One more question here about the cert id you know, which, of course, is required for submission. The question is, how did they find the cert id how do they get that information and ensure that's included in the submission.
Shannon Campbell: Oh, that's a good question. Yeah. So your cert id is going to be custom for your particular certified Ehr technology? Right? So you, it depends on the particular products that you have pieced together to satisfy your needs for that promoting interoperability requirement.
Shannon Campbell: Therefore, the cert id is going to be unique to your particular, you know.
Shannon Campbell: Mixing and matching of products, if you will right. So
Shannon Campbell: your particular
Shannon Campbell: vendor, your Ehr vendor, will be of help
Shannon Campbell: by providing the different components that you have purchased to piecemeal together your Ehr. Each of those different products and their modules or versions of the particular EHR
Shannon Campbell: can be entered into a chapel site. That's that's managed by Cms. And I would see where they bring together all the products, and as you enter your products and the modules that you use to make up your certified Ehr technology.
Shannon Campbell: They all are joined together to create a cert. ID
Shannon Campbell: in that chapel site, and you can simply Google, CHPL.
Shannon Campbell: Chapel, C. Hpl.
Shannon Campbell: You can go to that site, enter in your products. You can filter by vendor you can filter by version, you can then filter by the particular certification year that they have for your particular need. So you can customize your build of your certified Ehr technology, and by entering all of that build, then chapel will spit out a cert id for you to use in your promoting interoperability, attestation.
HC Webinars: Any other questions, Hazel, that you see.
Hazel Morrison: I don't see anymore. I think. Yes, we may be coming to the end of the questions from the audience.
HC Webinars: Perfect. Okay, thank you.
HC Webinars: Thank you. Shannon and Hazel. This great presentation for any other questions that we did not get to. We will get to those, we will get those answered offline and post them to our website. So continue to use that. QA. Panel. If you do have questions. We wanna thank all of you for joining us today, and we hope you enjoyed the presentation. I am launching a poll asking if you would like to learn more about health, catalyst products and services.
HC Webinars: This poll should only take you about 2 min as a reminder. The on demand. Webinar recording and sites will be shared with you tomorrow. You can always reach out to us through email or our website. If you have further questions or comments
HC Webinars: for anyone still filling out the poll. I'm gonna continue to leave it active for a couple of more minutes to give you time to complete it. Otherwise, on behalf of all of us here at health. Catalyst. Thank you again for joining us today and have a great rest of your day.
Shannon Campbell: Thank you.
Hazel Morrison: Thank you.