Improving Hypertension _ Diabetes Control and Prevention
An e-NEWSLETTER from Quality Insights                                                                                         June 23, 2017

In This Issue

articleIn an article posted on Shots, the online channel for health stories from the NPR Science Desk, author Anna Gorman shines a spotlight on the important role Community Health Workers (CHWs) can play in reaching patients on a level that often times physicians can't.
In this article, Community Health Workers Reach Some Patients That Doctors Can't, Gorman shares the story of Natalie Pedrozza who month after month showed up at the doctor's office with uncontrolled diabetes and high blood pressure. Her medications never seemed to work, and she kept returning to the emergency room in crisis.
According to the article, Walfred Lopez, a Los Angeles County CHW, was determined to figure out why.
Lopez spoke to her in her native Spanish and, little by little, gained her trust. Pedroza, a street vendor living in downtown Los Angeles, shared with him that she was depressed. She didn't have immigration papers, she told him, and her children still lived in Mexico. Then she mentioned something she hadn't told her doctors: she was nearly blind.
Pedroza's physician, Dr. Janina Morrison, was stunned. For years, Morrison said, "People have been changing her medications and changing her insulin doses, not really realizing that she can't read the bottles."

Health officials across the country face a vexing quandary - how do you help the sickest and neediest patients get healthier and prevent their costly visits to emergency rooms? Los Angeles County is testing whether CHWs like Lopez may be one part of the answer. Read more.

get the facts on fats

factsThe American Heart Association (AHA) recommends choosing good (unsaturated) fats, limiting saturated fats, and avoiding trans fats whenever possible. 

Understanding the different types of dietary fats can help consumers make healthier choices. AHA's new Facts on Fat infographic is a great tool to share with your patients.
test your knowledge on realistic a1c targets

questionA 78-year old patient with a 15-year history of type 2 diabetes arrives in your office for a check-up. He suffers from stage 3 chronic kidney disease and lives alone. From previous visits you have learned he has very few support services. What would be a realistic A1C treatment target for this individual? 

   A. A1C 6.0-6.5%
   B. A1C 7.5-8.0%
   C. A1C 8.5-10.0%
   D. A1C 10.5-11%

summer is here - make sure your patients know how to beat the heat

beat the heat infographic heatNow that summer has finally arrived and temperatures are rising across many parts of the country, it is important to remember that extreme heat can put many people at risk for heat-related illness. 

Not everybody has the same level of risk when it comes to heat-related illnesses. Children under four years of age, adults over 65, people who are overweight, and people who are on certain medications are more susceptible. 

For important tips that you can share with patients about preventing heat-related illnesses and how to recognize when someone needs help, visit the Extreme Heat page on the Centers for Disease Control and Prevention (CDC) website. You can also print out and display the Beat the Heat infographic in your office and post it on your practice's website.
five Ways for Healthcare Providers to Get Ready for New Medicare Cards 

fiveMedicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft and protect essential program funding and the private healthcare and financial information of our Medicare beneficiaries.  

CMS will issue new Medicare cards with a new unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI) to replace the existing Social Security-based Health Insurance Claim Number (HICN) both on the cards and in various CMS systems we use now. We'll start mailing new cards to people with Medicare benefits in April 2018. All Medicare cards will be replaced by April 2019.

CMS is committed to helping providers by giving them the tools they need. Read more.  

Join CMS for a Webinar on Proposed Rule for Year 2 of the Quality Payment Program

Monday, June 26, 2017
1:00 p.m. to 2:30 p.m.

webinarJoin the Centers for Medicare & Medicaid Services (CMS) next Monday for a webinar that will provide an overview of the proposed participation requirements for the second year of the Quality Payment Program.

Please note:
  • Space for this webinar is limited. Register now to secure your spot. After you register, you will receive a follow-up e-mail with step-by-step instructions about how to log-in to the webinar.
  • The audio portion of this webinar will be broadcast through the web. You can listen to the presentation through your computer speakers. If you cannot hear audio through your computer speakers, please email the CMSQualityTeam.
  • There will be a Q&A session if time allows. However, CMS must protect the rulemaking process and comply with the Administrative Procedure Act. Participants are invited to share initial comments or questions, but only comments formally submitted through the process outlined by the Federal Register will be taken into consideration by CMS. See the proposed rule for information on how to submit a comment. 
For More Information
CMS encourages participants to review the proposed rulepress release, and  fact sheet prior to the webinar. Additional resources are also available on the  website.

the deadline is fast approaching for Payment Adjustments & Hardship exemptions 

computer icon Hardship Information
deadlineIn the American Recovery and Reinvestment Act of 2009 (ARRA), Congress mandated that payment adjustments should be applied to Medicare eligible professionals, eligible hospitals, and critical access hospitals (CAH) that are not meaningful users of Certified Electronic Health Record (EHR) Technology under the Medicare EHR Incentive Program.

If a provider is eligible to participate in the Medicare EHR Incentive Program as an Eligible Professional (EP), Eligible Hospital, or Critical Access Hospital (CAH) you may be exempt from Medicare penalties if you can show that demonstrating Meaningful Use would result in a significant hardship. To be considered for an exemption (to avoid a payment adjustment) you must complete a Hardship Exception application along with the proof of the hardship. If approved, the hardship exemption is valid for only one payment year and you would need to submit a new application for subsequent years. In no case may a provider be granted an exemption for more than 5 years.

2018 Eligible Professional (EP) Hardship Form
The deadline for Eligible Professionals (EPs) to submit Hardship forms for the 2018 payment adjustment, based on the 2016 EHR reporting period is July 01, 2017.
Payment Adjustments
In the ARRA, Congress mandated that payment adjustments should be applied to Medicare eligible professionals, eligible hospitals, and critical access hospitals (CAH) that are not meaningful users of Certified Electronic Health Record (EHR) Technology under the Medicare EHR Incentive Program.

If a provider is eligible to participate in the Medicare EHR Incentive Program, they must demonstrate meaningful use in either the Medicare EHR Incentive Program or in the Medicaid EHR Incentive Program, to avoid a payment adjustment. Medicaid providers who are only eligible to participate in the Medicaid EHR Incentive Program are not subject to these payment adjustments.  Eligible Professional (EP) Payment Adjustment information can be found here  .
CAPG Educational Series 2017 - Advancing Care Information webinar

Advancing Care Information (ACI) - How to Implement the New Meaningful Use Component of MIPS

webinar icon Friday, July 7, 2017
3:00 p.m. to 4:30 p.m.

ACIwebinarCAPG is pleased to present a new complimentary webinar series for physicians and physician groups participating in the  Quality Payment Program , part of the Medicare Access and CHIP Reauthorization Act (MACRA). 

Through a co-branding agreement with CMS , the sessions combine CMS expertise on the regulation content with CAPG members' knowledge of how clinicians are responding on the ground to the important changes it brings.  Each session will include Q&A time with the presenters. 

CAPG believes the webinars will be a valuable resource to help you successfully participate in MACRA in 2017 and beyond. 

In the upcoming Advancing Care Information - How to Implement the New Meaningful Use Component of MIPS webinar, subject matter experts from CMS will provide an overview of the substantive changes to the program from meaningful use to ACI. Additionally, CMS will answer audience questions on the specific ACI component of the Quality Payment Program.

CAPG will have its members cover key implementation steps for physicians and physician organizations starting on this important transition. Our members will tell the audience about the rationale behind their strategy and any implications this will have on their organization.

  • Ashby Wolfe, MD, Chief Medical Officer, CMS Region IX
  • Elizabeth Holland, Senior Technical Advisor, CMS
  • Larry deGhetaldi, MD, President, Palo Alto Medical Foundation Santa Cruz at Sutter Health
  • Ray Manahan, Senior Director of Government Programs, Providence Health and Services
For more information, please email Dr. Amy Nguyen or call 213.239.5051.
fastfast facts to remember while Preparing for 2017 Medicaid Attestation
  • MAPIR opens for Program Year 2017 Applications on July 3, 2017
  • Your EHR system must be certified to the 2014 edition or a combination of 2014 and 2015
  • There are no alternate exclusions
  • The numerator must have occurred within the EHR reporting period
  • The EHR MU reporting period is a minimum of any continuous 90 days between Jan. 1 and Dec. 31, 2017
  • If you have demonstrated MU in a previous year, the reporting period for CQMs is 1 Calendar Year (1/1/17 - 12/31/17)
  • Avoid your PROMISE account being closed; check your revalidation status, fee assignment and NPI/TIN numbers to ensure everything matches
  • You can access PROMISe information here
  • Visit the Registration and Attestation System page on the CMS website for attestation resources 
  • Make a copy of your applications
contact information

For more details about the Improving Hypertension and Diabetes Care & Prevention project, please contact Rhonda Dodson.
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