Implementation of Quality Measures : Meaningful Measures

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Presentation transcript:

Implementation of Quality Measures : Meaningful Measures Reena Duseja, MD, MS Acting Group Director Quality Measurement and Value Based Incentives Group Centers for Medicare and Medicaid Services April 17, 2018

Disclaimers This presentation was prepared as a tool to assist providers and is not intended to grant rights or impose obligations. Although every reasonable effort has been made to assure the accuracy of the information within these pages, the ultimate responsibility for the correct submission of claims and response to any remittance advice lies with the provider of services. This publication is a general summary that explains certain aspects of the Medicare Program, but is not a legal document. The official Medicare Program provisions are contained in the relevant laws, regulations, and rulings. Medicare policy changes frequently, and links to the source documents have been provided within the document for your reference The Centers for Medicare & Medicaid Services (CMS) employees, agents, and staff make no representation, warranty, or guarantee that this compilation of Medicare information is error-free and will bear no responsibility or liability for the results or consequences of the use of this guide.

Share with the audience Meaningful Measure initiative in CMS Focus on intraoperability Quality Payment Program and opportunities with measure development

A New Approach to Meaningful Outcomes

Meaningful Measures Objectives Meaningful Measures focus everyone’s efforts on the same quality areas and lend specificity, which can help identify measures that:

Meaningful Measures Framework

Meaningful Measures

Strengthen Person & Family Engagement as Partners in their Care (1 of 2)

Strengthen Person & Family Engagement as Partners in their Care (2 of 2)

Promote Effective Communication & Coordination of Care (1 of 2)

Promote Effective Communication & Coordination of Care (2 of 2)

Promote Effective Prevention & Treatment of Chronic Disease (1 of 2)

Promote Effective Prevention & Treatment of Chronic Disease (2 of 2)

The Quality Payment Program Clinicians have two tracks from which to choose: The Merit-based Incentive Payment System (MIPS) If you decide to participate in traditional Medicare, you may earn a performance-based payment adjustment through MIPS. Advanced Alternative Payment Models (APMs) If you decide to take part in an Advanced APM, you may earn a Medicare incentive payment for participating in an innovative payment model. OR

Concluding thoughts Importance of alignment across public of private payers Shifting to data sources that are less burdensome Focusing on meaningful measures as framework for identifying gaps in measurement Partnership with patients and front-line providers on measures that improve care