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A Crosswalk of Measures and Standards for Eligible Physicians and Other Providers Janet Whitmoyer, RN Health Technology Consultant.

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Presentation on theme: "A Crosswalk of Measures and Standards for Eligible Physicians and Other Providers Janet Whitmoyer, RN Health Technology Consultant."— Presentation transcript:

1 A Crosswalk of Measures and Standards for Eligible Physicians and Other Providers Janet Whitmoyer, RN Health Technology Consultant

2 Ever Get That Sinking Feeling?

3 Congress and federal and state regulators increased their focus on quality health care via several data reporting systems : Medicare Physician Quality Reporting System (PQRS) Patient-Centered Medical Home Program (PCMH) Developed by the National Committee on Quality Assurance (NCQA) Electronic Health Record Meaningful Use (MU) Congress and federal and state regulators increased their focus on quality health care via several data reporting systems : Medicare Physician Quality Reporting System (PQRS) Patient-Centered Medical Home Program (PCMH) Developed by the National Committee on Quality Assurance (NCQA) Electronic Health Record Meaningful Use (MU) Congress and federal and state regulators increased their focus on quality health care via several data reporting systems : Medicare Physician Quality Reporting System (PQRS) Patient-Centered Medical Home Program (PCMH) Developed by the National Committee on Quality Assurance (NCQA) Electronic Health Record Meaningful Use (MU) Congress and federal and state regulators increased their focus on quality health care via several data reporting systems : Medicare Physician Quality Reporting System (PQRS) Patient-Centered Medical Home Program (PCMH) Developed by the National Committee on Quality Assurance (NCQA) Electronic Health Record Meaningful Use (MU) Congress and federal and state regulators increased their focus on quality health care via several data reporting systems : Medicare Physician Quality Reporting System (PQRS) Patient-Centered Medical Home Program (PCMH) Developed by the National Committee on Quality Assurance (NCQA) Electronic Health Record Meaningful Use (MU) The Perfect Storm Congress and federal and state regulators increased their focus on quality health care via several data reporting systems : Medicare Physician Quality Reporting System (PQRS) Patient-Centered Medical Home Program (PCMH) Developed by the National Committee on Quality Assurance (NCQA) Electronic Health Record Meaningful Use (MU)

4 Rip Tide Warning Primary purposes of data reporting: Help inform providers Help improve individual patient care Help identify health care trends and disparities w/in practice populations Reasons for a nationwide S.O.S. Complexities of meeting requirements Financial and reimbursement implications Frustrating and resource-intensive mechanics

5 Help Is On The Way Partnering together to HELP YOU meet data reporting requirements and use your data in a meaningful way to organize care and meet the needs of your patients!

6 Bridge Over Troubled Waters Providers seeking an electronic health record (EHR) incentive payment from either Medicare or Medicaid through adoption of a certified EHR system are required to report on MU health information functionality measures in order to achieve stage 1 objectives Core Measure 10 requires providers to additionally capture and report clinical quality measures using their EHRs

7 Bridge Over Troubled Waters We’ve created a tool that matches these MU and clinical quality measures with related PQRS measures and the 2011 Patient- Centered Medical Home standards This crosswalk will assist you in identifying common measures/standards addressed by each of these programs

8 Charting Your Course When determining which measures to report, providers must consider several factors. What measures are most meaningful to your practice/specialty? Mountain-Pacific assists with data reporting, extraction, workflow analysis and facilitation of information exchange Focus areas are preventive care and screening measures (esp. those aimed at improving cardiac health) What measures are supported by your EHR system? Note: Not all EHR vendors support all 44 clinical quality measures. Are there measures that are meaningful to your practice that meet both MU and PQRS objectives?

9 Smooth Sailing Ahead Electronic health records + Accurate data gathering, reporting and analysis = Better provider-patient partnerships Better health management Better quality of care We hope this crosswalk is helpful in determining how to effectively and efficiently achieve these objectives!

10 Join Mountain-Pacific’s Learning and Action Network! Smooth Sailing Ahead You’ll have the opportunity to work collaboratively with others who are struggling with similar concerns and/or barriers and resolve problems related to providing care!

11 Your Online Headings To Access the Crosswalk: Go to Hover on Health Care Providers so the drop-down menu appears Click on Quality Data Reporting To Join Mountain-Pacific’s Learning & Action Network: Go to Hover on Health Care Providers so the drop-down menu appears Click on Physician Offices

12 What are your questions? Lifeguard Information: Janet Whitmoyer, RN Health Technology Consultant Mountain-Pacific Quality Health This material was developed by Mountain-Pacific Quality Health, the Medicare quality improvement organization for Montana, Wyoming, Hawaii and Alaska, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. Contents presented do not necessarily reflect CMS policy. 10SOW-MPQHF-MT-IH-12-08


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