The delay on a full switchover to the MIPS Value Pathways (MVP) program may relieve anxious partici­pants, but experts say it's merely a reprieve in a Quality Payment Program (QPP) that is slated to undergo funda­mental change in coming years. In 2022, in what may be the final year of traditional MIPS reporting, providers will face thresholds that are higher than ever, and participants who've been breezing through may find rougher going.

Alteon Health, a physician-owned and physician-led acute care medical group based in Germantown, MD, recently became a Qualified Clinical Data Registry (QCDR), a Centers for Medicare & Medicaid Services (CMS)-approved vendor that is in the business of improving healthcare quality. QCDRs may include specialty societies, regional health collaboratives, large health systems, or software vendors working in collaboration with one of these medical entities.¹

by Sramana Mitra 

Sramana Mitra is the founder and CEO of One Million by One Million (1Mby1M), the world’s first and only global virtual incubator/accelerator. Its goal is to help a million entrepreneurs globally reach a million dollars in annual revenue, build a trillion dollars in global GDP, and create 10 million jobs.

by: Sramana Mitra 

Sramana Mitra is the founder and CEO of One Million by One Million (1Mby1M), the world’s first and only global virtual incubator/accelerator. Its goal is to help a million entrepreneurs globally reach a million dollars in annual revenue, build a trillion dollars in global GDP, and create 10 million jobs.

In our recent interview with Lauren Patrick, we discuss her journey into computer science and subsequently healthcare technology. As the founder and CEO of Healthmonix, she is helping practice groups optimize their data and analytics in order to improve their quality of care scores and ultimately, help doctors provide the best care to patients. Our transcript has been edited, but you can listen to the full podcast episode here.

The Centers for Medicare & Medicaid Services (CMS) is providing more detailed guidance for how healthcare providers should report electronic clinical quality measures for telehealth encounters. A total of 39 electronic clinical quality measures (eCQMs) were recently published for the 2021 performance period.¹

The Quality Payment Program (QPP) is slated to retrench slightly due to COVID-19, but take note of several big news items: You’ll find a new reporting scheme for MIPS Alternate Payment Models (APM), a smaller than-expected rise in the overall performance threshold and several telehealth innovations.

by: Roy Edroso 

The first half of 2020 was an extraordinary time for the United States. Quality leaders are beginning to assess how the COVID-19 pandemic response will affect the quality metrics of hospitals for months after the emergency subsides. What will those metrics look like?

They may not look great, and accreditors might be prompted to use a form of “compassionate surveying” when it comes to revelations of noncompliance during this period.

Even after the pandemic winds down, the experience is likely to leave a significant and lasting effect on quality metrics, says Lauren Patrick, founder and president of Healthmonix, a healthcare analytics company based in Malvern, PA.

There are several components to the effect on quality metrics, she says. First, what will the quality metrics show in terms of quality of care? Will quality, measured via the clinical quality measures that are reported, remain at the same level?

“Changes in the performance of clinical quality metrics may be affected in a variety of ways. Chronic care management and preventive care measures may suffer due to missed appointments, clinical transformations, and providers’ focus on immediate issues during the initial period,” Patrick says. “Focus on urgent care, first and foremost, may impact the focus on nonemergent care.”

Metric Effects Uncertain

Secondly, there will be two factors that contribute to a change in the metrics, Patrick says. Depending on how well the quality protocols and standards of care are embedded in a practice at the beginning of the pandemic, there may be a temporary or longer-term decrease in those numbers, she explains.

“A decrease may be due to high-priority urgent care needs that cause a lack of focus on the quality actions that are normally included. A decrease may also be temporarily seen by physicians who are transforming their clinical practices to accommodate new strategies and protocols so swiftly,” Patrick notes. “As physicians quickly move to telehealth or shift roles due to layoffs or urgent care needs, workflows may need to be redesigned to accommodate the changes and ensure that outcomes continue to be achieved and documented.”

Hospital quality leaders already strained by the COVID-19 pandemic welcomed the decision from the Centers for Medicare & Medicaid Services (CMS) to delay reporting deadlines for the Merit-Based Incentive Payment System (MIPS) and not require reporting or use data from the initial pandemic period for Medicare quality reporting and value-based purchasing programs for future payment years.