Imagination at work

QSS Enrollment: PQRS 2016

June 20, 2016

Quality Reporting Preparation Series

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QSS Enrollment: PQRS 2016

Presenter Agenda

• Physician Quality Reporting Service (PQRS) 2016

• Quality Submission Services (QSS)

• The Enrollment Process

• Updating Providers

• GPRO

• Electronic Signatures

• QSS Order

• QSS Support

• Q&A

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Laura Wagner, PMP, MBA

Senior Project Manager GE Healthcare

Time investment: 60 minutes

Please enter your questions into the Q&A dialog box, NOT the chat window. Set to “All Panelists”. We will record today’s session and post it to the Centricity™ Practice Solution Community and Centricity EMR Community NOTE:

Physician Quality Reporting System PQRS 2016

PQRS 2016: A quality reporting program that encourages eligible professionals (EPs)

and group practices to report information on the quality of care 1.

5 https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/index.html

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• Payment adjustments applied in 2018—total risk of 6% for not reporting

• For not reporting: 2% negative adjustment for PQRS

• Based on performance: Value based modifier (range of -4 to +4%)

• Reporting Period: January 1, 2016 – December 31, 2016

• Submission Period: January 4, 2017 – February 28, 2017

• Includes only Clinical Quality Measures (CQMs)

• PQRS submission may include the CQM component of the MU incentive program, but the EP or

GPRO will need to meet the other MU objectives via manual attestation

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PQRS 2016: EHR Reporting Method

Participant Measure Requirement

Minimum Domains

Additional Requirements

Individual Eligible Professional (EP)

Minimum of 9 3 -If the EP’s CEHRT does not contain patient data for at least 9 measures across at least 3 domains, then the EP must report the measures for which there is Medicare patient data. -An EP must report on at least 1 measure containing Medicare patient data.

GPRO 2-99 EPs Minimum of 9 3 -If the PQRS group practice CEHRT does not contain patient data for at least 9 measures across at least 3 domains, then the group practice must report the measures for which there is Medicare patient data. -A group practice must report on at least 1 measure containing Medicare patient data.

GPRO 2-99 EPs + CAHPS (optional)

Minimum of 6 2 -If less than 6 measures apply to the group practice, the group practice must report up to 5 measures. -A group practice would be required to report on at least 1 measure for which there is Medicare patient data.

GPRO 100+ EPs + CAHPS (mandatory)

Minimum of 6 2 -If less than 6 measures apply to the group practice, the group practice must report up to 5 measures. -A group practice would be required to report on at least 1 measure for which there is Medicare patient data.

GE is not a CAHPS certified CMS vendor. If an EP or group practice satisfactorily reports for 2016 PQRS and selects the CQM electronic reporting option during MU Attes tation, it will also satisfy the CQM component of the MU incentive program; however, EPs and PQRS group practices will still be required to meet the other Meaning ful Use objectives through the Medicare EHR Incentive Program Registration and Attestation System.

Investigate and Choose Your PQRS Submission Method

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• Choose to report as individual providers or group practice option.

• If GPRO, you would have needed to register with CMS by June 30th.

• Individual EPs do not need to sign up or pre-register with CMS.

• To learn more about PQRS and different reporting methods, reference our

PQRS FAQ located in the new QSS Checklist tool (slide 13).

• If choosing GE QSS, the remaining slides will provide more detail.

Quality Report Guide https://engage.gehealthcare.com/docs/DOC-200668

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Quality Submission Services (QSS)

The QSS Program

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• If you enroll with QSS, GE Healthcare will submit PQRS data directly to CMS on your behalf for provider(s) or group practice (s) that you authorize.

• Electronic Health Record (EHR) reporting option for both Eligible Professionals and Group Practices registered as GPRO.

• A bookmark feature allows the ability to look up the participating provider’s or GPRO’s PQRS results historically on the CQR Dashboard, including the patient lists associated with each measure.

• A confirmation email with proof of submission “batch id” from CMS will be

provided for your records.

QSS Program Details • MQIC membership required

• Cost for this service:

» $275 per each individual EP

» $275 per each EP in the GPRO

• If a TIN is associated with an Accountable Care Organization (ACO), CMS will expect PQRS submissions to be generated by the ACO and will reject any submissions from QSS

• PQRS submission data is auto-archived

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**Please note this checklist is posted on the Quality Reporting Community and may be updated periodically. These tasks assume participation with QSS.

The QSS Enrollment Process

Install CQR, Monitor Measures and Assign/Confirm SOPs

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• Contract with GE Healthcare or your Value Added Reseller, if CQR is not installed.

• Regularly refresh calculations in CQR and work with providers to help improve results for the CQMs.

• Assign or confirm Source of Payment codes for all insurance carriers (QSS

Checklist has link for SOP FAQs).

Join the MQIC consortium (if you are not currently a member)

MQIC Tab: Member View

MQIC Tab: Non-Member View

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• A new MQIC Agreement is not required each year.

• Read our Medical Quality Improvement Consortium (MQIC) FAQ and Agreement.

CPS: https://engage.gehealthcare.com/docs/DOC-175590 CEMR: https://engage.gehealthcare.com/docs/DOC-175601

• Sign agreement and deliver to GE Healthcare per instructions in FAQ.

Select to Enroll in QSS in CQR starting on July 29th, 2016

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• Select the MQIC tab

• Only available to the Quality Champion or Admin role

• Select Program: PQRS 2016

• Select ‘Enroll’

• Monitor Enrollment Status

Complete Organization, Contact, Provider Information

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Description Comments

Organization Information

CQR Registration Name Organization Name Address

Prepopulates Add any additional name your organization uses, especially if you have abbreviated the org name in CQR registration Prepopulates

Primary Contact Information

Name, Phone, Email NOTE: The QSS Agreement will be emailed to this address.

Individual Provider Information

Estimated # of individual providers

Include providers participating individually only. Do not include providers participating via GPRO.

GPRO Yes, my organization intends to report via GPRO

Check box enables GPRO enrollment. It required registration with CMS by June 30, 2016

Provider Total Total # of Providers Estimated (EP+GPRO)

Adds the number of individual and GPRO providers. Auto-populates to provide a total number of participating providers

Completion of enrollment triggers the sales order to be sent to contact. Sign and return to sales.

Submit QSS Agreement

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One QSS Agreement per organization per each participating year

QSS Agreement is sent to the email address of the person designated as the primary contact

Workflow:

• Select ‘Send Agreement’ • Watch for the agreement in your email • Follow the DocuSign workflow to review, sign and submit the agreement. In approximately

3 hours, your enrollment status should state “Enrolled” and your list of providers will be available to work with.

NOTE: Sign & submit the QSS Agreement to complete the enrollment process

Update Provider Information

Steps for Providers who participated in QSS 2015 Program

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• Validate the providers NPI (imported from EMR into CQR) and TIN (manually entered)

• If consent form was already signed electronically, no further action required for that provider

Steps for Providers who did not Participate in QSS 2015 Program

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Provider List:

Allows provider selection

Identifies provider status

• Missing NPI • Missing TIN • Consent Form status

A provider with no ‘red warning message’ next to their name has met all prerequisites for authorization. Once a provider ’s information is complete and consent form is signed, Consent Form Received should

show to the right of the provider ’s name. The ‘Authorize’ Button is inactive until January

Workflow:

• Select providers that you want to take action on

• Select ‘Update Selected Providers’

Update Provider Tables

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Features Include:

• Inline editing of NPI, TIN, Email Address

• Column headers sort ascending & descending

• Search on Provider Name, NPI, TIN, Email, Consent Status

• Bulk update of Tax IDs

• Send provider consent form (form gets sent to

email address from screen to right)

Note:

The ‘Update Provider’ table in the MQIC tab and in Configuration are linked. Changes made to one, will be reflected in the other.

Update Provider: MQIC Tab

Update Provider: Config > Organization Structure

Bulk Update of Tax IDs

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Steps:

• Use the checkbox to select providers

• Select ‘Update Tax ID’

• Enter Tax ID Number

• Select ‘Update’

Sending a provider consent form

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Consent Form Tips:

• Provider consent form gets sent to email

address from screen to right.

• The online form vendor, Docusign, uses an

electronic signature consisting of the provider’s

initials.

• Initials format: The first letter in the first and last name fields in the CQR provider name fields

plus the first letter follow a space. For instance, Joe Jones M.D., where first name is Joe and

last name is Jones M.D., Docusign would use the initials of JJM. For any provider that would

not agree to such initials should have their credentials removed from their last name field in

CQR prior to requesting a Consent Form.

Sending a provider consent form

An NPI, TIN and Email address must be entered to ‘Send’ a provider consent form.

Best Practice:

• Alert your providers to expect an email from GE & DocuSign.

• Send the consent form directly to the provider’s email address.

You can multi-select providers and send multiple consent forms at once, using the ‘Send Consent’ button if each email address is unique.

Do not use the same email address for every provider and bulk send.

A consent form cannot be sent to a provider with a status of pending, completed, or blank.

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Provider Consent Status

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Consent Form Status

Description

Completed Provider has signed the consent form

Pending The consent form has been emailed but has not been signed & submitted

Rejected Provider declined signing the consent form

Undeliverable The request could not reach the intended recipient mailbox (email

address is not valid)

Blank An NPI, TIN and email address are required to send a consent form. If any one of the three are missing, the consent form field is blank.

QSS Enrollment: Group Practice Reporting (GPRO)

Enrollment: Group Practice (GPRO)

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Note: To participate in PQRS as a GPRO, group practices must have registered w/ CMS before the June 30, 2016

deadline. If you did not register previously with CMS for GPRO reporting, you cannot enroll in GPRO with GE now,

however your providers can still participate in GE’s QSS program as individual providers.

• Select the checkbox to enroll your practice for GPRO submission (Yes, my organization previously

registered as a group practice with CMS, and intends to report via GPRO)

• Validate and enter the group’s Tax ID

• Enter the GPRO Registration ID received from CMS @ registration

• Enter the estimated number of providers in the GPRO

• If your organization has more than one GPRO, select ‘Add’ to enter another GPRO

• The ‘Total # of Providers Estimated’ will populate when you select ‘Save’

• If your practice is only enrolling as a GPRO, the green box (Individual Providers) on the left of the screenshot would be 0

GPRO View in the Provider Tree

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A GPRO practice includes any provider with the same GPRO Tax ID number provided at QSS enrollment Each GPRO will display as GPRO_TIN_123456789 In the MQIC tab > Provider Tree, providers included in the GPRO will display under the GPRO practice The only way to add or remove a provider from a GPRO, is to edit the Tax ID number in the ‘Update Provider table or in Config > Org Structure > Edit Provider

ALWAYS RECALCULATE when providers are added or removed from a GPRO

GPRO in the Provider Tree

GPRO Enrollment

GPRO View in the Dashboard

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• A GPRO practice includes any provider with the same GPRO Tax ID number provided at QSS enrollment

• Each GPRO Practice will display as

GPRO_TIN_123456789 • The GPRO will display in both the Practice and

Provider dropdown • Providers that display in the GPRO Practice’s Provider

dropdown are included in the GPRO • Edit a provider’s TIN to add or remove the provider

from a GPRO

GPRO Enrollment

GPRO in the Dashboard

GPRO Workflow

• Enroll your group practice (GPRO) with GE

• Validate your GPRO appears in the dashboard

• Verify that the correct providers are included in the

GPRO

• Select clinical quality measures for the GPRO

• Recalculate the GPRO

• View GPRO measure results

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Electronic Signatures

DocuSign After a document is sent….

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• Monitor your email

• The QSS Agreement is sent to the primary contact

• Look for these subject lines in your email:

• Select ‘Review Document’

NOTE: QSS.Program@GE.com is an unmonitored email box.

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• Agree to use electronic records and signatures

• Select ‘Continue’

• ‘Other Actions’ provide additional options

Finish Later Decline to Sign Assign to Someone Else

DocuSign Workflow

Electronic Signature: QSS Agreement

Enter a title Select ‘Sign’

Review Select ‘Adopt and Sign’

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REMEMBER TO SELECT TO SEND THE COMPLETED DOCUMENT

Electronic Signature: Provider Consent Form

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Review Select ‘Adopt and Sign’

REMEMBER TO SELECT TO SEND THE COMPLETED DOCUMENT

Review Select ‘Sign’

**Reference Slide 26 for Initials Format

After signing a document electronically

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• Look for these confirmation messages & emails

• Options:

• Print the document

• Download the document

• Document will be automatically emailed as an

attachment

QSS Order

QSS Order QSS Fees:

• $275 per individual provider.

• $275 for each provider in the GPRO.

GE Direct customers:

• The sales team will provide a QSS order after completing the enrollment and QSS Agreement form.

• Sign and return the order within one week of receipt .

• The QSS order is based on the estimated number of providers that will be authorized.

• The QSS invoice is based on the actual number of providers authorized (Sent Q2 2017).

VAR customers:

• Contact your VAR for your billing process.

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QSS Support

Access GE Healthcare 2016 QSS Resources

Centricity Support: 888-436-8491 (Option 2, Option 3)

Quality Reporting Community

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Quality Reporting Community

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Scroll Down

Centricity customers can register for access to the Service Portal at: http://gehealthcare.com/registerserviceportal

PQRS Resources: Quality Reporting Community

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CPS: https://engage.gehealthcare.com/community/en/cps/quality-reporting-community

CEMR: https://engage.gehealthcare.com/community/en/emr/quality-reporting-community

Choose the blue “Follow” button in the upper right-hand corner of the community to receive automatic update notifications as resources are posted.

How to get more information on the QSS Program?

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Follow the Quality Reporting Community for program details.

• Quality Reporting Community

Checklist

FAQs and Quality Reporting Guide

Discussion Board

• Listserv

• Webinars

• Value Added Reseller (VAR)

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CMS PQRS Hotline: 866-288-8912

Quality Net Helpdesk menu. Follow the prompts.

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In Closing

Manage your QSS enrollment • QSS Checklist Link: https://engage.gehealthcare.com/docs/DOC-

214070

• Continue pre-work in parallel with enrollment

• Be mindful of program timelines

• QSS Enrollment: July 29, 2016 to January 13, 2017

• Monitor your provider’s consent form status

• Educate providers about the new electronic consent form process before sending any consent forms electronically

• Validate each provider’s NPI, TIN, and email address

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Prepare for Measure Selection & Authorization

• January 4- February 3, 2017

• Confirm each provider has a unique NPI/TIN combination and a consent form submitted

• Monitor each provider’s performance and focus on identifying

measures for submission

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Questions? Please enter questions via the Q&A dialog box. This session was recorded and will be posted to the Service Portal.