CPC+: CPC+ and Quality Payment Program Changes

June 8, 2018

Written by Kristen Schuster, Practice Facilitator

CPC+ practices continue to work hard to improve patient engagement, office workflow and care coordination. To help with these goals, here is a list of helpful changes in 2018.

1. Low Volume Exemption. These values increased significantly! To exceed the thresholds, you need to see at least 200 Medicare patients AND have billed at least $90,000 in allowable Medicare Part

… Read the rest

Steps for Successfully Completing a CPC Audit

January 30, 2018

Written by Kristen Schuster, Practice Facilitator

What can you expect if your practice is selected for a program audit? First, don’t panic. Second, plan for when an audit happens, not if an audit happens. This blog will walk you through how the audit process works and provide helpful tips to successfully pass a program audit.

If your CPC+ practice is chosen for you an audit … Read the rest

Care Delivery and Financial Reporting Extension

January 18, 2018

Written by Kristen Schuster, Practice Facilitator

In response to the overwhelming demand for an extension, the Quarter 4 (Q4) care delivery reporting and financial reporting due date has been extended for all practices. This means that all practices will have until January 26, 2018 to complete both Q4 care delivery reporting and financial reporting. Practices will not need to request an extension in the CPC+ Practice … Read the rest

CPC+ Key Deadlines You Should Know

December 27, 2017

Written by Kristen Schuster, Practice Facilitator

The end of year is approaching and there are deadlines for closing out the CPC+ Program Year 1. Here are some important upcoming deadlines and events.

• 12/25/17 – Portal opens for 4th quarter Care Delivery Report (CDR) and 2018 Forecast submission
• 12/31/17 – Health IT Update due (located in practice portal)
• 01/01/18 – QPP website is available to verify employee

… Read the rest

Deadlines for Risk Stratification, Participation Agreements, and Health IT

November 17, 2017

Written by Kristen Schuster, Practice Facilitator

The Participation Agreement (PA) was sent to practices on October 10, 2017. The PA must be signed by an individual with the authority to legally bind your practice to another entity. The agreement must be signed and sent to CPC+ support no later than December 1st, 2017. If you have questions please contact Kristen Schuster.… Read the rest

Steps to Establish a Primary Care Behaviorist Model

November 10, 2017

Written by Kristen Schuster, Practice Facilitator

The 10/27 blog outlined the care management model of behavioral health integration. This blog is going to establish steps for establishing a primary care behaviorist model. Remember, Track 1 practices, you are not off the hook. Program Year 2 changes were outlined in the 10/20 blog and now Track 1 practices need to choose a BHI model and … Read the rest

Providing Care Management for Mental Illnesses

October 27, 2017

Written by Kristen Schuster, Practice Facilitator

The first year of CPC+ is quickly coming to an end and it is a good time to take a pulse check! Track 2 practices are required to choose a behavioral health integration (BHI) option and need to start implementing this service in to its care. Remember Track 1 practices, you are not off the hook. Program Year 2 changes … Read the rest

Care Delivery Requirements for Program Year 2

October 20, 2017

Written by Kristen Schuster, Practice Facilitator

CMS had several announcements and changes for 2018 during the week of October 16th.
The practice point of contact was sent an important email on October 16th. This email included:

1) The Amended and Restated CPC+ Participation Agreement (PA)
2) Amended and Restated PA Guidance
3) Program Year (PY) 2 Care Delivery Requirement Guidance

If the appropriate person did … Read the rest

How to understand if your organization needs to report MIPS in 2017

October 6, 2017

Written by Kristen Schuster, Practice Facilitator

CMS has released a new website allowing providers to look up their National Provider Identifiers (NPI) status to see if they qualify as an Advanced Alternate Payment Model (Advanced APM). Practices must meet a threshold score during the reporting year for Medicare Part B beneficiaries in order to qualify as an Advanced APM, otherwise … Read the rest

New quality benchmarks for 2017 and much more

September 29, 2017

Written by Kristen Schuster, Practice Facilitator

Fourth quarter is a busy time for the CPC+ program. Centers for Medicare and Medicaid Services (CMS) released new eCQM benchmarks, attribution methodology and new measures for 2018. The changes were made based on feedback from providers. They are intended to help practices retain a greater portion of the incentive payment.

2017 eCQM and CAHPS

• The minimum threshold

… Read the rest

Utilizing the Comprehensive Primary Care Payment (Track 2 Practices)

September 8, 2017

Written by Kristen Schuster, Practice Facilitator

The last blog discussed Track 2 practices changing the Comprehensive Primary Care Payment (CPCP) ration in 2018. This hybrid payment is designed to be used to provide alternate visit types for patients across the practice. Why is it important to provide these services to patients and where does a practice begin? Let’s explore different options for success … Read the rest

Choosing Your Hybrid Payment Selection for 2018

September 1, 2017

Written by Kristen Schuster, Practice Facilitator

It is hard to believe we are already approaching Quarter 3 on the CPC+ timeline. With that comes a decision for Track 2 practices. As a Track 2 participant you selected a hybrid payment ratio. This payment methodology will allow the practice flexibility to deliver care in an appropriate setting and not be tied to the limitations of fee-for-service … Read the rest

Workflow Mapping and How to Improve Efficiency for CPC+

August 11, 2017

Written by Kristen Schuster, Practice Facilitator

Is your practice stuck on where to begin and how to monitor effectiveness of a change strategy in your organization? Change can be difficult, especially when processes have been the same for an extended period. But Mountain-Pacific can help. Below are some useful strategies to help you work through changes in your practice by mapping workflows and … Read the rest

Tracking and Projecting CPC+ Funds

August 4, 2017

Written by Kristen Schuster, Practice Facilitator

Last week, the Centers for Medicare & Medicaid Services (CMS) released the 2017 Financial Reporting Guide. This blog will outline what is expected from your practice for 2017 reporting and 2018 projection of funds. Your practice should reference the full Reporting Guide or the fact sheet located on Comprehensive Primary Care Plus (CPC+) Connect for the outline of what the financial … Read the rest

How to identify high cost specialists and how to create a care coordination agreement

July 28, 2017

Written by Kristen Schuster, Practice Facilitator

The utilization reports are broken down in to several categories for your practice to reference. One of the areas is identifying high cost specialists. Your practice can use this information to create collaboration agreements.

What applies to the specialist in a care coordination agreement?

• Specialist agrees to refer patient back to primary

… Read the rest

Establishing a System to Monitor Patients

July 21, 2017

Written by Kristen Schuster, Practice Facilitator

The utilization report contains information about how your patients are using the system and how much they are costing the system. Now that the data are available, how do you start the process of establishing a transition of care workflow with hospitals? This post will give some quick tips for workflow and care coordination for patients transitioning from the hospital. … Read the rest

CPC+ Second Quarter Reporting due July 14 (Tomorrow!)

July 13, 2017

Written by Kristen Schuster, Practice Facilitator

This post is a refresher from the quarter one Care Delivery Reporting guide. Quarter two will ask about your practice’s progress on more areas for the primary care functions. If you are in the beginning stages of implementing a project or hiring staff, note that in the free text boxes when you can. This shows the Centers for … Read the rest

Regional Feedback Reports Are Here!

May 24, 2017

Written by Kristen Schuster, Practice Facilitator

Thank you to all the Comprehensive Primary Care Plus (CPC+) practices that joined us in Helena or virtually for the first learning session. It was great to meet you and to see the collaboration between the different groups. Remember: You can keep sharing questions and best practices through CPC+ Connect.

The Centers for Medicare & Medicaid Services (CMS) has released the … Read the rest

Practice care delivery report data incorrect? We’re here to help, you can request corrections.

April 24, 2017

Written by Kristen Schuster, Practice Facilitator

Quarter 1 reporting is closed. Congratulations to all who have completed the first reporting requirement! So, what do you do if you missed an answer, fat-fingered a response, or forgot something? Have no fear! Nothing is set in stone and you can request a correction. Here is a timeline for correction requests … Read the rest

Switching EHR Vendors? Pump the breaks and read!

April 7, 2017

Written by Kristen Schuster, Practice Facilitator

Alright, you have decided to finally go for it. Make the BIG switch. We all can agree that not all EHRs are created equal and with the interoperability push hanging over our heads like a cumulonimbus it can make sense to take the plunge. If your organization is switching to align with other practices or because the current … Read the rest

Details for the Upcoming Montana Learning Session

March 28, 2017

Written by Kristen Schuster, Practice Facilitator

Thank you everyone that subscribed to the CPC+ Blog. I’m excited to use this to communicate with everyone about all of the CPC+ details and upcoming events.

The in-person learning session is scheduled for 5/10 from 8:30-4:30PM. The agenda is under development but the event will be a great opportunity to learn and discuss CPC+ practice activities as … Read the rest

First Quarter Reporting due April 14th

March 20, 2017

Written by Kristen Schuster, Practice Facilitator

Well, we all have made it! The end of first quarter but Q1 reporting is quickly approaching. Before we get in to the meat of the post I want to put minds at ease and assure you that you do not need to report eCQMs quarterly. These are reported annually. So, what do practices need to report?

Care delivery reports… Read the rest

How to choose and track eCQMs

March 5, 2017

Written by Kristen Schuster, Practice Facilitator

For the CPC+ program, CMS will only take CQM data that is produced out of your EHR. That is what the “e” on eCQMs stands for. This means your CQMs must be set up and tracked in your EHR. You will NOT be able to use data that is manually chart abstracted or submitted through a registry, as you could … Read the rest

Are You Tracking Your Use of CMF and CPCP Money?

February 28, 2017

Written by Kristen Schuster, Practice Facilitator

CMS is requiring practices to track their use of Care Management Fee (CMF) and Comprehensive Primary Care Payments (CPCPC),(CPCP is for track 2 participants only) reimbursement and to utilize the money for specific practice improvement. It is recommended to create a tracking system for how the money from these two payment models is being used to … Read the rest

Did you get your Quarter 1 Payment

February 20, 2017

Written by Kristen Schuster, Practice Facilitator

Quarter 1 CPC+ payments were issued in two batches. If you have not gotten your Q1 payment, do not panic! The first was delivered at the end of January and the second batch will be delivered at the end of March. The first quarter payment includes the Per Beneficiary per Month (PBPM) Q1 payment and the Per Beneficiary Incentive … Read the rest

EHR Requirements for the 2017 CPC+ Program

February 10, 2017

Written by Kristen Schuster, Practice Facilitator

Electronic Health Records (EHRs) can be versatile tools to create foundation of your quality improvement efforts or they can be a confusing labyrinth. As much as I love David Bowie let’s leave the labyrinth behind. Please review the EHR functionality you will need to meet the requirements for the 2017 CPC+ reporting year.

• Ensure your practice’s EHR version is

… Read the rest

Task Checklist for 2017 reporting year

January 15, 2017

Written by Kristen Schuster, Practice Facilitator

The start of a new program year always has a flood of questions and the fear of missing a deadline. Do not fear! This blog will have you covered for all of the time sensitive CPC+ reporting.
Here is a list of task you may find helpful to navigate through the first year of CPC+. Please let me know if … Read the rest

How to start 2017 right

January 1, 2017

Written by Kristen Schuster, Practice Facilitator

Out with the old and in with the new! As designated providers part ways with PQRS, Medicare Meaningful Use, and the Value-Based Modifier we say hello to CPC+. The first reporting period for CPC+ starts January 1st, 2017.
As the Regional Learning Network for Montana and Hawaii, Mountain Pacific will use this blog to help step you through this first year … Read the rest