As the holiday season is upon us, we find ourselves reflecting on the past year and appreciating all the special relationships that have been fostered. We hope that 2018 has been just as memorable for you, your colleagues, and your loved ones. 

Thank you for giving us the opportunity to serve you. We look forward to working with you in the years to come.

Happy Holidays,
Your Health e Paradigm Team
KAMMCO Develops New Tool to Assist Health Care Providers Combatting Opioid Epidemic
Physicians, hospitals, and behavioral health providers participating in the Health e Paradigm 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 Health e Paradigm 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. 
How Patients Benefit
from Health e Pardigm
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. 

Health e Paradigm 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 Patients. 
Seven Health Information Exchanges Connect to Military Health System to Include Health e Paradigm
This Fall, the Military Health System (MHS) added critical medical information from seven physician-led health information exchanges (HIEs) across the nation. This was facilitated by the Kansas Health Information Network (KHIN), KAMMCO, and the eHealth Exchange. Laura McCrary, Ed.D, Executive Director of KHIN, comments on the significance, “This represents the growing capabilities of HIEs to share records in all locations from which a patient has received care.”

With this new development, medical records can be shared across the world as military personnel and their families transition between multiple locations, stateside or overseas. Military hospitals and clinics now can quickly and securely access patients’ personal health information 24/7 and have access from the physician-led HIEs in Kansas, Connecticut, New Jersey, South Carolina, Georgia, Missouri, and Louisiana.   

“MHS cares for 9.4 million beneficiaries, delivering care globally in military hospitals and clinics and providing coordinated, integrated care through civilian networks,” said Kimberly Heermann-Do, Health Information Exchange Office Lead in the EHR Modernization Program Management Office. Heermann-Do added, “Through HIEs, records are available securely from the private sector if the HIE is onboarded to the MHS. Having access to records for patients across the KAMMCO Network will assist MHS providers with clinical decisions.”

Health e Paradigm is a physician-led health information network endorsed by the Medical Association of Georgia (MAG) and delivered in partnership with KAMMCO. Health e Paradigm offers a suite of health information technology tools to help health professionals share patient information while employing powerful analytic reports designed to help improve clinical outcomes, reduce inefficiencies, and positively impact patient safety.
Adventist Health System Joins KAMMCO Network and Health e Paradigm
Adventist Health System is the newest addition to the list of health care participants now sending and receiving patient data through the KAMMCO health information exchange network. The faith-based, not-for-profit Adventist Health System has more than 80,000 skilled and compassionate caregivers in physician practices, hospitals, outpatient clinics, skilled nursing facilities, home health agencies, and hospice centers across 10 states including Kansas, Colorado, Texas, Florida, Minnesota, Kentucky, Tennessee, North Carolina, and Georgia. 

Adventist joined Health e Paradigm through the KAMMCO Network.
New Health e Paradigm Advisory Committee Member
Health e Paradigm welcomed Garland Ashley Register, Jr., MD, to its advisory committee in October. Dr. Register is a graduate of Mercer University School of Medicine, Macon, Ga., and did his residency at the University of Kansas School of Medicine, Wichita, Kan. He is on the staff at Grady General Hospital, Cairo. He is a member of the Medical Association of Georgia, serving as a member of the Board of Directors and as 2 nd District President. Dr. Register also serves on the clinical faculty of the Mercer University School of Medicine and the Florida State University Medical School, Tallahassee, Fla.  
#FightFlu: National Influenza Vaccination Week, December 2-8
To encourage influenza vaccination and emphasize the seriousness of the flu, the Centers for Disease Control and Prevention (CDC) and its partners promote the week of December 2-8 as National Influenza Vaccination Week. Started in 2005, the week-long promotion highlights the importance of continuing flu vaccinations through the holiday season and beyond.

Most people who get the flu will recover in a few days to less than two weeks, but some will develop serious complications. During the 2017-2018 flu season, the CDC estimates there were: 

  • 49 million flu illnesses - more than the combined populations of Texas and Florida;
  • 960,000 flu hospitalizations - more than the number of staffed hospital beds in the United States; and
  • 79,000 deaths - more than the average number of people who attend the Super Bowl each year.
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 health care 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 health care 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 Releases Final Rule for the 2019 Quality Payment Program
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 clinician 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 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, and 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).

For More Information
To learn more about the PFS Final Rule and the Year 3 Quality Payment Program policies, review the following resources:
  • Executive Summary - provides a high-level summary of the Quality Payment Program Year 3 final rule policies.
  • Fact Sheet - offers an overview of the policies for Year 3 (2019) and compares these policies to the current Year 2 (2018) requirements.

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:

Phone 1-866-288-8292 (TTY: 1-877-715-6222)

For more information about the Quality Payment Program, please visit: QPP.CMS.GOV
New QPP CME Modules, Infographics, and Scoring Guide Now Available
CMS has posted three new continuing medical education (CME) modules on the Merit-based Incentive Payment System (MIPS) performance categories and MIPS Alternative Payment Models (APMs). The courses may be accessed by logging into one’s  Medicare Learning Network account or creating one here.

The new CME modules include:
  • 2018 Improvement Activities Performance Category CME Module

  • 2018 Cost Performance Category CME Module

  • 2018 MIPS APM CME Module

Questions?
Contact the Quality Payment Program at QPP@cms.hhs.gov or 1-866-288-8292 (TTY: 1-877-715-6222).
Come and See Us!
January 16, 2019
NFMGMA - January Event
The Metropolitan Club
Alpharetta, GA.



Ryan Larosa
Health e Paradigm
Director
678.303.9290