Optimizing the Quality Payment Program

January 14, 2020

Written by Amber Rogers

We get it. You have a busy practice with a thousand things you would like to improve. And adding maximizing the Medicare Quality Payment Program (QPP) might not hit your priority list until it is absolutely required.

In the spirit of kicking off the new year right, it’s in your best interest to get an early start on QPP. Why? Because it can help optimize your score and engage your practice in improving quality care throughout the year. Health care is a team sport, and improvement relies on ongoing efforts of the entire team.

Selecting the Right Quality Measures

Ask yourself and your staff these questions:

• Who are the patients you serve? Are there certain populations or health conditions that are more prevalent? What health outcomes would you like your patients to achieve?
• Do you have other state or federal programs in which you are also participating? Identify all programs early and align measures to decrease workload.
• What are you or your staff passionate about in health care? Find meaning in your work. Making a difference is a great motivator. Your physician or staff lead champion can work on an identified improvement project to get buy-in.

Once Your Measures Are Selected

Many think, “I have my measures, so now I can just run a report and work on it sporadically throughout the year, right?” The answer is no.

Follow these steps to keep on track and ensure your quality improvement efforts are not going to waste.

1. Understand the measure specification guide in detail. When you run your data report, do the number of patients falling into the numerator and denominator make sense?
2. Are all staff or clinicians documenting clinic process in different ways?
3. Do a deep dive on documentation process with a small sample size of 15-20 patients. What variations are you seeing? Do your results match the electronic health record (EHR) report?
4. Review the documentation guidelines from your EHR vendor and discuss with them your sample size results compared to the standard report. There may be a missing Logical Observation Identifiers Names and Codes (LOINC) code that needs to be added to a field to improve data capture.

Discuss your findings with staff and invite them to be a part of your quality improvement journey.  Including others will increase staff engagement, provide additional workflow suggestions and lighten your workload. Nominate a staff member to find a related Improvement Activity on the QPP.cms.gov site to further align your efforts.

Congratulations, you now have the start of a Plan-Do-Study-Act (PDSA) cycle!

Other Resource Links

Mountain-Pacific Quality Health’s QPP Resources Webpage

Centers for Medicare & Medicaid Services (CMS) QPP Resource Library

See all Previous MIPS blogs

---

 

Subscribe to the Merit-Based Incentive Payment System (MIPS) Blog
Subscribe

 

---