CQM Changes Affecting MicroMD Clients Participating in the Medicare Quality Payment Program or Medicaid Promoting Interoperability
As a reminder, prior to each performance year, it’s critical for ECs to review what’s changed with your payment programs from the prior year. What you may have done last year, may not be an option this year. Sometimes identifying all the annual payment program changes is like nailing Jell-O to a tree. The key is to just do it. It’s the responsibility of program participants to understand the rules and requirements of the programs.
The best offenses and defenses for these situations is to:
- Ensure the practice is armed with the most current requirements for each payment program category item ECs will be tackling; know what changed from year to year
- Execute on a plan to capture the appropriate data needed to meet/exceed measures. Your MicroMD software is based on the current requirements (call us if you’d like training.)
- Train your teams on the current requirements and any changes they will need to make
- Monitor the hard work and coach ECs to make any needed improvements
- Document the hard work ECs have done to maximize program participation
This year our manual highlights some of the changes.
These include:
CMS 69 - Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
- For the following interventions the requirement for the user to select a refusal reason in the diagnostic test has been removed:
- Intervention for Below Normal Follow-up
- Intervention for Above Normal Follow-up
- The following encounter codes have been removed: 97001, 97003, 98960.
- G8417 is no longer valid for Intervention (Above Normal).
- The following codes have been added for Intervention (Above Normal): G0270, G0271, G0447,G0473, 97802, 97803, 99401, 99402, 43659, 43886, 43888.
- The Measured On Date of the most recent BMI should be within 12 months before or on the Service Date of the eligible encounter, instead of 6 months.
CMS 138 - Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
This measure is now divided into three population criteria:
- (Percentage A) Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months;
- (Percentage B) Percentage of patients aged 18 years and older who were screened for tobacco use and identified as a tobacco user who received tobacco cessation intervention; and
- (Percentage C) Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user.
Initial Patient Population (IPP) change
- The code lists for the following types of encounters changed from requiring 1 encounter to requiring 2 encounters:
- Encounter, Performed: Face-to-Face Interaction
- Encounter, Performed: Speech and Hearing Evaluation
CMS 153 - Chlamydia Screening for Women
The initial patient population (IPP) also now includes any patients who have answered “Yes” to the question if they are sexually active in the new field within the Sexual History window. Now when choosing sexual activity from the category drop-down list, a new check box “Patient has had sexual intercourse” is enabled. MicroMD will automatically assign the correct LOINC code(s) to include them in the IPP if this is checked.
CMS 156 - Use of High-Risk Medications in the Elderly
Numerator A
- Now includes medications greater than “or equal to” 90 days
Numerator B
- The numerator for the second performance percentage in MicroMD reflects the number of patients within the denominator who were prescribed high-risk medications, where the Start Date on the medication falls within the measurement period and is also one day after or on the Start Date of a previous medication from the same medication group.
A patient can also count in Numerator B if the cumulative duration on medications in one of the following medication groups is greater than or equal to 90 days:
- Non-benzodiazepine hypnotics
- Anti-infective, other
CMS 159 - Depression Remission at Twelve Months
MicroMD is now also looking at the Behavioral Health Screening under the Behavioral Health section for the PHQ-9 assessment LOINC codes that are setup under the Total Section in the template for the patient to be included in the numerator.
CMS 160 - Depression Utilization of the PHQ-9 Tool
MicroMD is now also looking at the Behavioral Health Screening under the Behavioral Health section for the PHQ-9 assessment LOINC codes that are setup under the Total Section in the template for the patient to be included in the numerator.
For further detailed information about each measure please see the MicroMD EMR Clinical Quality Measure Calculations for Performance Year 2018.
