Wednesday, June 08, 2016

#CM4H16 Aligning Quality Measures

Panel: How Michigan is Working to Align Quality Measures

Moderator: Rick Wilkening, Director of Major Accounts & Emerging Solutions, MiHIN

Efforts in Michigan to address the quickly-evolving quality measure reporting space have developed rapidly in the past few years. Learn about these efforts and how they tie together to ease reporting and alignment of quality measures, and how new models are being developed to maximize the effectiveness of quality measures.

Quality Measures and Meaningful Use – Jason Werner, Manager, Medicaid EHR Incentive Program, Michigan Department of Health and Human Services

Michigan’s Payer-Provider Quality Collaborative (PPQC) – Joe Neller, Director, Integrated Physician Advocacy, Michigan State Medical Society

Quality Measures in a Multi-Payer Environment – Ellen Bunting, Manager, Michigan Data Collaborative

Quality Measures and Meaningful Use – Jason Werner

Medicaid EHR Incentive Program

  • The program is not dead or going away.
  • eMIPP accepting 2016 registrations
  • Rolling out stage 3 of Meaningful Use (MU) in 2017
  • Dual Eligible (MIPS/Medicaid EHR) providers will have to register separately.

5,900 MI providers distributed $153M of incentives (9,704 payments)
117 MI Hospitals distributed $157M (299 Payments)

Quality Measure collection:

  • Direct Data Entry
  • PDF Upload
  • QRDA Category III file upload
  • QRDA Category File upload via HIE/Direct by June 1, 2016 – Via MiHIN.

QRDA Cat 1 = Individual Patient quality Report.

QRDA Cat 3 = Aggregate quality data.

MI focuses on Cat 3.

MiHIN MiDiGate

Eligible entities and providers create QRDA XML file.
Submitted to MiHIN. cat3

MiHIN validates for quality isees.

Valid QRDA
Check NPI

Then shared to PQRS and other State data warehouses.

Provides a REPORT ONCE benefit and front-end validation.

Michigan’s Payer-Provider Quality Collaborative (PPQC) – Joe Neller

Collaborating to support Physician Organization (PO) practices.

Surveyed PO leaders to identify quality outcome measures.

Resulted in 35-45 common measures.

Physician Payer Quality Collaborative (PPQC)

Health Plan Survey:

Found 9 common measures.
7 of 9 are national overlapping measures.

Outcome was 24 common measures across most health plans. 18 of the 24 are from CQMs for Meaningful Use.

Quality Measures in a Multi-Payer Environment – Ellen Bunting

MI Primary Care Transformation Project
Quality Improvement Goals and Measurement
Aligning HEDIS Measures in a multi-payer environment
Changing the perspective in a multi-payer environment

350 Practices / 1,800 Physicians in a PCMH model.

PCMH Key Elements:
– Access to Primary Care
– Acute Care
– Prevention
– Chronic Care

Use Data for learning, finding variations, identify best performers and use that information to model based on best performers.

Success factors:
– Use all data available across all providers and payers
– Linking Patient’s data (common key Service)
– Identify denominator by population regardless of payer

[category News, Health]
[tag health, cloud, ONC, opendata, hdpalooza, blue button, CM4H16]

Mark Scrimshire
Health & Cloud Technology Consultant

Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
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I am currently HHS Entrepreneur-in-Residence and CMS BlueButton Innovator working on an assignment to update BlueButton for Medicare Beneficiaries.

The views expressed on this blog are my own.

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