January 2019
KAMMCO Develops New Tool to Assist Healthcare Providers Combating Opioid Epidemic
Physicians, hospitals, and behavioral health providers participating in the Carolina eHealth Network health information exchange will appreciate access to a new analytic dashboard—Opioid/Controlled Substances. Developed by physicians in response to the widespread opioid crisis in this country, the new tool supplements the currently available Prescription Drug Monitoring Program (PDMP). 

The tool builds upon a more comprehensive set of data than the PDMP, which only utilizes filled prescription data. The new dashboard provides participating clinicians with the list of opioids/controlled substances prescribed or administered to a clinician’s patients even before a prescription is filled at the pharmacy and even if the patient received prescriptions in multiple locations or states.

The tool utilizes data available through the physician-led Carolina eHealth Network health information exchange as a part of the KAMMCO network which includes the states of Kansas, Georgia, South Carolina, Connecticut, Missouri, New Jersey, and Louisiana and used by prescribing providers and their delegates. 
CONNECT
To develop this advanced analytics tool, KAMMCO worked with leading Kansas physicians to assess how health information exchange data could better inform physicians regarding their patients’ history of opioid/controlled substance use. The tool helps physicians to identify their patient population who received at least one prescription/administration of opioids/controlled substances and isolate patients who received overlapping opioid medications. Dashboard functionality also allows breakouts by facility and date range of opioid prescriptions, overlapping prescriptions over 12 months, and top five opioid medications prescribed/administered to their patients. 

Carolina eHealth Network provides physicians with access to aggregated clinical data from the health information exchange through secure web-based dashboards. Additional analytic dashboards available to participating physicians include: High Risk Patients, 30-Day Readmissions, Disease Registries, Health Care Utilization, Behavioral Health, Preventive Care Quality Reporting and Polychronic Conditions. 
ECRI Institute Opens Access to Clinical Practice Guidelines
ECRI Institute has launched the ECRI Guidelines Trust, a portal to expertly vetted, evidence-based guideline briefs and scorecards. The healthcare community has free access to the website, which will grow over time as more trustworthy clinical guidelines become available.   

ECRI Institute developed the new resource in response to pleas from healthcare professionals after substantial federal funding cuts forced the Agency for Healthcare Research and Quality (AHRQ) to shut down the National Guideline Clearinghouse (NGC). ECRI had developed and maintained the NGC website for 20 years. 

"Trustworthy clinical practice guidelines are essential to medical professionals who need to deliver safe and effective patient care. Since ECRI Institute's mission is to advance effective, evidence-based healthcare globally, we are taking the lead to provide free access to trusted guideline resources," said Marcus Schabacker, MD, president and CEO, ECRI Institute. For information and to register for ECRI Guidelines Trust, visit www.ecri.org/components/GuidelinesTrust/Pages/default.aspx .
CMS Streamlines Systems for QPP Data Submission and Access
If your organization participates in the Quality Payment Program (QPP) or you are a representative of an Alternative Payment Model (APM) reporting data to the Centers for Medicare & Medicaid Services (CMS) through the  QPP Website (such as a Medicare Shared Savings Program Accountable Care Organization (ACO)), you can sign in to the  QPP Website to view, submit, and manage your data. As of December 19, 2018, CMS updated and streamlined its systems to deliver better service.

CMS is transitioning from the Enterprise Identity Data Management System (EIDM) to the HCQIS Access Roles and Profile System (HARP). This system is used to create identity management accounts and request access to the QPP website. Now, all users and organizations they represent for reporting quality data will manage access and view their MIPS feedback directly through the  QPP Website .

This transition does not impact the ability to access legacy program reports, such as the Quality and Resource Use Reports (QRURs) or Physician Quality Reporting System (PQRS) Feedback Reports, available on the  CMS Enterprise Portal .

For those who already have an EIDM account with a role for QPP, transition to HARP will be automatic. No additional action is required. Use of an existing EIDM user ID and password to sign in to the QPP website will access the same organization(s).

Moving forward, everyone will manage user ID, password, and access to organizations through the QPP website, instead of EIDM. If you need to manage your password, you can do so through HARP, and a link on the  QPP sign in page . You can also request authorization to connect to different organizations by signing in to the QPP website. For more information on this process, refer to the Connect to an Organization guide in the  QPP Access User Guide .

For those who don’t have an EIDM account that lets you sign in to the QPP website, you’ll need to register for a HARP account. For a step-by-step guide to signing up for a HARP account, refer to the Register for a HARP Account guide in the  QPP Access User Guide .

If you currently have a Security Official role for your organization(s), you will now approve requests by signing in to the  QPP Website . This will allow security officials to manage all QPP activities through one, easy-to-use portal. Like staff users, Security Officials can use their existing EIDM user ID and password to sign in to the QPP website—there is no need to create a new account. Learn more about the steps a Security Official needs to take to approve requests through the QPP website in the Security Officials: Manage Access guide in the  QPP Access User Guide .

For More Information download the  QPP Access User Guide . Or contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222).
CMS 2019 Quality Payment Program Final Rule Highlights
The Centers for Medicare and Medicaid Services (CMS) recently issued its policies for Year 3 (2019) of the Quality Payment Program via the Medicare Physician Fee Schedule (PFS)  Final Rule . The provisions in the rule build on the foundation established in the first two years of the program, and are reflective of the feedback received from many stakeholders.

Year 3 Final Rule Policy Highlights

In Year 3 of the Quality Payment Program, CMS continues to use the framework established by the Patients Over Paperwork initiative: implement meaningful measures, promote interoperability, support small and rural practices, reduce clinician burden, and improve patient outcomes.

Key policies for Year 3 include:

  • Expanding the definition of a Merit-based Incentive Payment System (MIPS)-eligible clinicians to include new clinician types, including physical therapists, occupational therapists, speech-language pathologists, audiologists, clinical psychologists, and registered dietitians or nutrition professionals.
  • Adding a third element (Number of Covered Professional Services) to the low-volume threshold determination and providing an opt-in policy that offers eligible clinicians who meet or exceed one or two, but not all, elements of the low-volume threshold the ability to participate in MIPS.
  • Applying facility-based scoring automatically for eligible facility-based clinicians without data submission requirements for individual clinicians and using group data submissions in the MIPS Promoting Interoperability or improvement activities categories to identify groups for facility-based scoring determinations.
  • Modifying the MIPS Promoting Interoperability (formerly Advancing Care Information) performance category to support greater electronic health record (EHR) interoperability and patient access, while aligning with the recent changes to the Promoting Interoperability Program requirements for hospitals.
  • Moving clinicians to a smaller set of objectives and measures with scoring based on performance for the Promoting Interoperability performance category.
  • Allowing small practices to submit quality data for covered professional services through the Medicare Part B claims submission type for the Quality performance category.
  • Streamlining the definition of a MIPS comparable measure in both the Advanced Alternative Payment Models (APMs) criteria and Other Payer Advanced APM criteria to reduce the confusion and burden amongst payers and eligible clinicians submitting payment arrangement information to CMS.
  • Updating the MIPS APM measure sets that apply for purposes of the APM scoring standard.
  • Updating the Advanced APM and Other Payer Advanced APM Certified EHR Technology (CEHRT) threshold so that these must require that at least 75% of eligible clinicians use CEHRT. For Other Payer Advanced APMs, as of January 1, 2020, the number of eligible clinicians participating in the other payer arrangement who are using CEHRT must also be 75%.
  • Extending the 8% revenue-based nominal amount standard for Advanced APMs and Other Payer Advanced APMs through performance year 2024.
  • Finalizing proposals to implement the Medicare Advantage Qualifying Payment Arrangement Incentive Demonstration in 2018 under the authority in section 402(b) of the Social Security Amendments of 1967 (as amended).

Help and Support

CMS will continue to provide no-cost technical assistance to help individual clinicians, groups, and virtual groups participate in the Quality Payment Program. To learn more about technical assistance options, visit the Quality Payment Program  website .

Or contact the Quality Payment Program via:


For more information about the Quality Payment Program, please visit: QPP.CMS.GOV .
Russell Calicutt
Executive Director
Carolina eHealth Network
855.719.4181