Quality Insights News 

The Centers for Medicare & Medicaid Services (CMS) is accepting recommendations from stakeholders for potential consideration of new specialty measure sets and/or revisions to existing specialty measure sets for program year 2019 of the Merit-based Incentive Payment System (MIPS) program. 

CMS Launches New Data Submission System on QPP.CMS.GOV for Clinicians in the Quality Payment Program
On Tuesday, January 2, 2018, the Centers for Medicare & Medicaid Services (CMS) launched a new data submission system for clinicians participating in the Quality Payment Program. Clinicians can now submit all of their 2017 Merit-based Incentive Payment System (MIPS) data through one platform on the qpp.cms.gov website. 

The Centers for Medicare & Medicaid Services (CMS) is offering online, self-paced courses about the Quality Payment Program through the MLN Learning Management System. There are now seven courses available.

As proposed in the 2018 Quality Payment Program proposed rule, solo practitioners and groups can choose to participate in the Merit-based Incentive Payment System (MIPS) as a virtual group for the 2018 performance period.

Visit CMS.gov to View New and Existing Quality Payment Program Resources

On November 2nd, the Centers for Medicare & Medicaid Services (CMS) issued the final rule with comment for the second year of the Quality Payment Program (calendar year 2018), as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as well as an interim final rule with comment.

On November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) issued the final rule with comment for the second year of the Quality Payment Program (calendar year 2018), as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as well as an interim final rule with comment.

Quality Insights has received funding from the Centers for Medicare & Medicaid Services (CMS) to help emergency medical service (EMS) providers offer expanded care to people with Medicare who live in West Virginia. The goal of this collaboration is to lessen unnecessary hospital admissions and emergency department visits while enhancing access to quality care for the state’s most vulnerable and rural residents.  

November is National Diabetes Month and Quality Insights Quality Innovation Network’s Everyone with Diabetes Counts (EDC) program is working with community partners and health care providers to improve health outcomes and quality of life among people with diabetes in its five-state network. The theme for this year includes a focus on the connection between kidney health and diabetes. 

2016 Physician Quality Reporting System (PQRS) feedback reports and 2016 Annual Quality and Resource Use Reports (QRURs) were released on September 18, 2017. The PQRS feedback reports show your program year 2016 PQRS reporting results, including if you are subject to the 2018 PQRS downward payment adjustment. 

This October, Quality Insights, as a partner in the advancement of health information technology to help improve healthcare —is a Proud Partner in National Health IT Week.

It’s not too late to participate in the first year of the Merit-based Incentive Payment System (MIPS)—one of the two tracks in the Quality Payment Program. The transition year of MIPS has been underway since January 1, 2017 and runs until December 31, 2017.

The Quality Payment Program Hardship Exception Application for 2017 is now available on the Quality Payment Program website.

August is National Immunization Awareness Month

Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft and protect essential program funding and the private healthcare and financial information of our Medicare beneficiaries.  

Proposed rule aims to simplify reporting requirements and offer support for doctors and clinicians in 2018.

Quality Insights is proud to announce that it is featured in the Centers for Medicare & Medicaid Services’ (CMS’) newly released 2016 QIO Program Progress Report. Quality Insights is one of 14 QIN-QIOs that contributed to the Program’s success in improving the quality of care for Medicare beneficiaries throughout the United States.

LoveYourFeetLogoThe Everyone with Diabetes Counts (EDC) national "Love Your Feet" campaign kicked off in April and will continue through September 30, 2017.

Lower extremity amputation rates related to diabetes have been gradually increasing each year since 2009, says a new report from the Centers for Medicare & Medicaid Services’ (CMS) Quality Innovation Network National Coordinating Center (QIN NCC). 

Celebrate National Nurses Week and National Nursing Home Week this month

Quality Innovation Networks (QIN), which are comprised of regionally-focused Quality Improvement Organizations (QIO) across the country, have reached their target of enrolling 2,336 nursing homes in the Center for Disease Control’s (CDC) National Healthcare Safety Network (NHSN). The NHSN is the most widely used healthcare-associated infection (HAI) tracking system in the US. It is currently used by most hospitals and dialysis facilities, but not yet extensively used by nursing homes.

Explaining complex healthcare topics to Medicare beneficiaries and their families can be challenging. As a result, Quality Insights identified an opportunity to use an online video platform to create short, educational and engaging messages. These animated videos provide patients, their families and caregivers with a better understanding of these important and complex topics.

April is National Minority Health Month

March 28 is American Diabetes Alert Day

One in three American adults — about 80 million people — has high blood pressure, putting them at increased risk for heart attack, heart failure, stroke, kidney failure and other health problems. To combat this major health threat, the American Heart Association (AHA) and the American Medical Association (AMA) launched the Target: Blood Pressure nationwide initiative to help healthcare providers and patients achieve better blood pressure control at the best levels to improve health. Quality Insights is partnering with them to introduce this program to physician practices in our five-state network.

Adverse drug events fell by 67,000 between 2010 and 2013 as the result of the federal “meaningful use” program that offered financial incentives to hospitals for using certified electronic health records, according to a new AHRQ study. 

February is American Heart Month

On December 13, 2016, Quality Insights received an award for its work in reducing unnecessary hospital readmissions and hospital-acquired infections over the past five years. The award was presented at the Centers for Medicare & Medicaid Services (CMS) annual Quality Conference in Baltimore, Maryland. 

December 4-10 is National Influenza Vaccination Week

December 4-10 is National Handwashing Awareness Week

Learn how to manage your diabetes at a free class near you

Network will collaborate to reduce opioid misuse and increase Medicare Annual Wellness Visits for patients in DE, LA, NJ, PA and WV

Today, the Department of Health & Human Services (HHS) finalized a landmark new payment system for Medicare clinicians that will continue the Administration's progress in reforming how the health care system pays for care.

The Centers for Medicare & Medicaid Services (CMS) is sponsoring hospital interviews to develop an understanding of how the Hospital Value Based Program (HVBP) is being implemented in hospitals and unintended consequences that may be associated with implementation. Oklahoma Foundation for Medical Quality (OFMQ) is the contractor for this task to administer the interviews on behalf of CMS.

Beginning October 1, 2016, the CMS Quality Improvement Organization (QIO) Program will incorporate a key component of the Partnership for Patients in order to sustain and expand national progress toward better patient care, smarter health care spending and healthier people.

September is Healthy Aging Month

Over the last few years there have been a notable amount of reports of diabetes ketoacidosis (DKA) to the U.S. Food and Drug Administration (FDA) involving  a popular new class of type 2 diabetes drugs- the sodium-glucose cotransporter 2 (SGLT2) inhibitors.

The submission deadline for hospitals participating in the Hospital Inpatient Quality Reporting (IQR) Program to enter Quarter 1 (Q1) 2016 Perinatal Care Elective Delivery Measure (PC-01) data is Friday, August 26, 2016, at 11:59 p.m. PT. However, due to recent flooding in parts of Louisiana, those hospitals that were affected by the natural disaster can apply for an extension of this deadline.

This summer, Quality Insights Quality Innovation Network reminds people who have diabetes to take extra care. While the summer heat can make many of us uncomfortable, those with diabetes have a higher risk of heat-related complications.

Save the date – webinar series will kick off Tuesday, August 9

The Centers for Medicare & Medicaid Services (CMS) Home Health Quality Initiative (HHQI) Special Innovation Project (SIP) recently united stakeholders in creating an updated diabetes educational resource geared toward advancing better health, smarter spending, and healthier people.  

The Centers for Medicare & Medicaid Services (CMS) announced on Wednesday, July 6, 2016 that it is streamlining electronic health record (EHR) reporting requirements for eligible professionals and hospitals in the Medicare EHR Incentive Program.

A success story out of New Jersey in relation to Quality Insights Quality Innovation Network's Reducing Adverse Drug Events project was featured in the July 2016 issue of QIO News. QIO News is a publication dedicated to highlighting news, successes and best practices from the Quality Innovation Network-Quality Improvement Organizations (QIN-QIO) in the United States.

Secondhand smoke causes cancer and other diseases in non-smokers

In watching coverage of the recent flooding in West Virginia, you’ve probably heard discussion of tetanus vaccines and other health concerns. It’s a sobering reminder that we all should be up-to-date on needed vaccines.

On June 1, 2016, Sven Berg, MD, MPH, CPE, FAAP, Chief Medical Officer for Quality Insights Quality Innovation Network and Keith T. Kanel, MD, MHCM, FACP, Chief Medical Officer for Pittsburgh Regional Health Initiative (PRHI), served on a panel of experts that discussed successful partnerships at the annual meeting for the American Health Quality Association (AHQA) in Baltimore, Maryland.

Statistics show that 76 percent of hospital readmissions can be prevented

The Centers for Medicare & Medicaid Services’ (CMS) recently released the 2015 Quality Improvement Organization (QIO) Program Progress Report, which highlights how Quality Innovation Network-QIOs (QIN-QIOs) nationwide are bringing together local providers, partners and other stakeholders to achieve bold goals in health care quality improvement. 

April is National Minority Health Month

Thanks to tools provided by the Affordable Care Act, an estimated 30 percent of Medicare payments are now tied to alternative payment models that reward the quality of care over quantity of services provided to beneficiaries, HHS announced today.  Today’s announcement means that over 10 million Medicare patients are getting improved quality of care by having more time with their doctors and better coordinated care – nearly a year ahead of schedule.

Patient Safety & Quality Healthcare (PSQG) recently posted an article about nominations for a Sherman Award in Patient Engagement: “EngagingPatients.org, an online community dedicated to sharing best practices in patient and family engagement, is now accepting nominations for the 2016 John Q. Sherman Award for Excellence in Patient Engagement.

On December 28, 2015, President Obama signed into law the Patient Access and Medicare Protection Act. The law states that the Center for Medicare and Medicaid Services (CMS) will approve hardship exception applications submitted by eligible professionals, hospitals, and critical access hospitals that did not meet Meaningful Use in 2015.

The Centers for Medicare and Medicaid Services has issued a Notice of Proposed Rulemaking to revise the discharge planning requirements that Hospitals, including Long-Term Care Hospitals and Inpatient Rehabilitation Facilities, Critical Access Hospitals, and Home Health Agencies must meet in order to participate in the Medicare and Medicaid programs.

Dates: The call for Public Comment period opens on November 2 and closes on November 16, 2015

On September 28, 2015, CMS made available the 2014 Supplemental Quality and Resource Use Reports (QRURs) to every medical group practice and solo practitioner nationwide. Medical group practices and solo practitioners are identified in the Supplemental QRURs by their Taxpayer Identification Number (TIN). The Supplemental QRURs are also available for medical group practices and solo practitioners that participated in the Medicare Shared Savings Program, the Pioneer ACO Model, or the Comprehensive Primary Care initiative in 2014, in addition to those consisting of non-physician eligible professional (EPs).  

This October 5 - 9, Quality Insights is proud to support National Health IT Week.  National Health IT Week is the premier event offering all healthcare stakeholders an opportunity to unite under one banner, expressing the benefits that health information technology (IT) brings to U.S. healthcare. “One Voice, One Vision.”

On September 11, 2015, CMS began distributing letters to Physician Quality Reporting System (PQRS) individual eligible professionals (EPs), EPs providing services at a Critical Access Hospital (CAH) billing under method II, and group practices regarding the 2016 PQRS negative payment adjustment. The letter indicates that either an individual EP, EPs providing services at a CAH billing under method II, or the group practices that registered for the 2014 PQRS group practice reporting option (GPRO) did not satisfactorily report 2014 PQRS quality measures in order to avoid the 2016 negative PQRS payment adjustment and, therefore, all of their 2016 Medicare Part B Physician Fee Schedule (MPFS) payment will be subject to a 2.0 percent reduction.

In 2016, CMS will apply a negative payment adjustment to individual eligible professionals (EPs), Comprehensive Primary Care (CPC) practice sites and group practices participating in the Physician Quality Reporting System (PQRS) group practice reporting option (GPRO) (including Accountable Care Organizations [ACOs]) that did not satisfactorily report PQRS in 2014. Individuals and groups that receive the 2016 negative payment adjustment will not receive a 2014 PQRS incentive payment.

More than 1,900 providers and 300 community partners are collaborating for better health, better care and lower costs.

CMS may begin using PECOS account information for upcoming communications

The Centers for Medicare & Medicaid Services (CMS) will host a series of webinars to discuss The QIO Program in Action: National Benefits, Local Support

Secondhand smoke causes cancer and other diseases in non-smokers

As of August 1, 2015 the calls to any of Quality Insights' toll-free numbers for appeals and quality of care (QOC) concerns will no longer be forwarded to the Beneficiary & Family Centered Care-Quality Improvement Organizations (BFCC-QIO).  Additionally, the toll-free numbers that were in effect prior to August 1, 2014 for appeals/QOC concerns, will no longer work starting August 1, 2015.   

A video recording of the "PQRS/Value-Based Provider Modifier: What Medicare Professionals Need to Know in 2015" presentation has been posted to the CMS MLN Connects® page on YouTube.  This presentation is the same as the webinars that were delivered on March 31, 2015 and April 7, 2015.

In recognition of National Nursing Home Week, May 10-16, QIO News is helping highlight how the QIO Program and its national and community partners are striving to instill quality performance and improvement practices in nursing homes across the country.

As part of its efforts during National High Blood Pressure Education Month, the American Medical Group Foundation (AMGF) hosts the Measure Up/Pressure Down® National Day of Action: Roll Up Your Sleeves annually in May.

According to a 2015 White House Conference on Aging blog post, there is research to support that delivering formal services and supports in home and community-based programs can improve the quality of care individuals receive as well as reduce health care costs.

The Centers for Medicare & Medicaid Services will host a Special Open Door Forum on the Home Health Electronic Clinical Template and the Home Health Paper Clinical Template. The conference call will be held on Tuesday, April 28, 2015 from 1:30 - 2:30 p.m. ET

QIOs are leading the way in partnering with others to improve healthcare quality. Learn more about the impact of these local, state and national partnerships in the latest QIO Program Progress Report.

In a recent National Association for Homecare & Hospice (NAHC) Report, the organization strongly recommended that home health agencies partner with Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) to improve cardiac health and reduce healthcare disparities. NAHC also emphasized that QIN-QIO efforts align with the goals of the proposed Conditions of Participation and offer a key opportunity for home health agencies to build a foundation for developing an ongoing, data-driven, agency-wide quality improvement program, while enhancing the process for care planning, delivery, and coordination of services.

Welcome to Collaborative I of the 11th Statement of Work.

The negative update of 21 percent under current law for the Medicare Physician Fee Schedule is scheduled to take effect on April 1, 2015. Medicare Physician Fee Schedule claims for services rendered on or before March 31, 2015, are unaffected by the payment cut and will be processed and paid under normal procedures and time frames.

As announced in December, 2014, the Centers for Medicare & Medicaid Services (CMS) is planning to add a “star” rating to Home Health Compare (HHC) that will be a summary of some of the current measures of home health care provider performance that the site already offers. CMS shared its plans for implementation of the HHC Star Ratings at Special Open Door Forums in December 2014 and February 2015, and solicited comments and suggestions from stakeholders.  The recordings and transcripts from those calls are posted on the CMS Special Open Door Forums page. An updated Frequently Asked Questions (FAQ) document, which addresses the issues raised in the comments received, is being posted on the Home Health Star Ratings web page.

The Philadelphia Regional Office of CMS will be hosting a new webinar on Tuesday, March 31, 2015 at 12:00 Noon EDT to provide an overview of the requirements of the 2015 Physician Quality Reporting System (PQRS) and the Value-based Payment Modifier (VM).  

Want to boost your revenue while providing better care to your Medicare patients?

More than 400 individuals took part in viewing the first in a series of three free webinars focused on the topic of Alzheimer’s Disease and Related Dementias (ADRD) on March 11. The webinar series is a partnership between Quality Insights Quality Innovation Network and the West Virginia Geriatric Education Center.

March 24 is American Diabetes Alert Day

The Physician Quality Reporting System (PQRS) is a program that promotes the reporting of quality information by eligible professionals (EPs) and group practices. Participation in PQRS is at the individual National Provider Identifier (NPI) level within a Tax Identification Number (TIN). EPs who worked for more than one organization during the 2013 PQRS program year (January 1, 2013 through December 31, 2013) had to meet the payment adjustment reporting requirements for each TIN under which he or she worked to avoid the 2015 PQRS payment adjustment for each TIN, or for each specific TIN/NPI combination. Beginning January 1, 2015, EPs who did not meet the PQRS reporting requirements during the 2013 program year will receive the negative 1.5 percent adjustment to all of their Part B Medicare Physician Fee Schedule (MPFS) reimbursements.

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that the submission deadlines for the PQRS reporting methods below have been extended.  All other submission timeframes for other PQRS reporting methods remain the same.

Eligible professionals now have until 11:59 pm ET on March 20, 2015, to attest to meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program 2014 reporting year. 

The Everyone with Diabetes Counts (EDC) project was featured in a recent episode of "This Week in East Brunswick," a local weekly news program of EBTV, the municipal access television station for the Township of East Brunswick, New Jersey. EBTV is a department of the East Brunswick Public Library.

The Centers for Medicare & Medicaid Services (CMS) intends to engage in rulemaking this spring to help ensure providers continue to meet meaningful use requirements.

A new white paper estimates the amount of time spent and costs associated with clarifying medication discrepancies and omissions during transitions between hospitals and nursing homes.

Providers participating in the 2014 PQRS program may be eligible to report their quality data one time only to earn credit for multiple Medicare quality reporting programs.

Diabetes is one of the top public health threats in the U.S. today, impacting nearly 30 million children and adults with the disease and 86 million who have pre-diabetes, according to the American Diabetes Association. Multiple health organizations are encouraging individuals and health care providers to raise awareness and learn more about diabetes throughout the month of November.

Beckey Cochran, Director for the West Virginia Medical Institute's (WVMI) Quality Insights Quality Innovation Network, received a Partnership Appreciation Award from the American Cancer Society (ACS) – South Atlantic Division for collaborative efforts between WVMI and the ACS over the past two years.

The National Partnership to Improve Dementia Care, a public-private coalition, today established a new national goal of reducing the use of antipsychotic medications in long-stay nursing home residents by 25 percent by the end of 2015, and 30 percent by the end of 2016. The coalition includes the Centers for Medicare & Medicaid Services (CMS), consumers, advocacy organizations, providers and professional associations.

The Kicking Off a New Season for Health Care Quality: Teaming Up for Care Coordination and Medication Safety webinar is scheduled for Wednesday, September 24 from 2:00 to 3:00 p.m. ET/1:00 to 2:00 p.m. CT. Register today

The Centers for Medicare & Medicaid Services (CMS) has awarded a new five-state Quality Innovation Network-Quality Improvement Organization (QIN-QIO) to a partnership led by the West Virginia Medical Institute (WVMI) d/b/a Quality Insights.