Do Your Providers Know What Their MIPS Scores Mean?
CMS’s Quality Payment Program (QPP) is in its second year. With inclusion of the Merit-Based Incentive Payment System (MIPS) as part of QPP, eligible providers submit their data to CMS in the first quarter of 2019 for their 2018 performance, which will impact 2020 Medicare reimbursement. Many providers are unaware of their eligibility status. Meanwhile, others simply do not understand how their performance translates into MIPS points, and how those points will impact future reimbursement. 

In addition to staying on top of the rules and changes to scoring for QPP, KHIN can help with interpreting provider performance.

Providers need a minimum score of 15 under MIPS to avoid a negative adjustment in 2020, when there is a range of -5 to +5 adjustments given to reimbursement.

The analytics dashboard tool from KHIN can help you track your quality measures, which make up 50 percent of the MIPS score in 2018. KHIN can also look closely at how percentiles align with established benchmarks. Using the MIPS calculator, KHIN can project how performance translates into points, which then will allow us to look at whether your Medicare reimbursement adjustment would be positive, negative or neutral.
HIE usage helps with several of the Clinical Improvement Activities, which account for 15% of the MIPS score in 2018. KHIN can assist with selecting these measures, and proper documentation.

While 2018 reporting will occur in January, February and March, the final rule for 2019 (year 3) will likely be released in October. Changes considered to the program each year include expanding the definition of MIPS eligible clinicians to include new clinician types, changing the volume threshold for eligibility, and reweighing the percentages of each of the four categories that impact the MIPS score. A proposed rule for year 3 was released earlier this year, but is subject to change as feedback is gathered. KHIN will communicate to membership more about the 2019 final rule upon its release. 

To schedule an analytics dashboard demonstration contact Susan Penka today at spenka@kammco.com.
New Military Health System Collaboration with KHIN Delivers Critical Health Information Across the Globe
On August 30, the Military Health System (MHS) added the Kansas Health Information Network (KHIN) to its increasing health information exchange efforts. Military hospitals and clinics now can quickly and securely access patients’ personal health information 24/7 from KHIN, the Kansas physician-led health information exchange.

“The 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 health information exchanges (HIEs), records are available from the private sector if the HIE is onboarded to the MHS. Having access to records from patients that are part of KHIN will assist MHS providers with clinical decisions.”

Laura McCrary, Ed.D, KHIN Executive Director said, “KHIN holds patient information for more than 6.4 million patients, nearly 10,000 providers and has been servicing the State of Kansas for nearly a decade. Being able to deliver lab results or health history for a serviceman across the globe is a privilege. We are proud the MHS can query our HIE and effectively use the clinical data they access.”
Healthcare Needs to Catch-up; It's Time to #killthefax
In medical facilities throughout the country, physi­cians, nurses, and staff are placing medical records in a tray, dialing a number, pressing send to fax private health information across town, across the state, or around the world. According to one private firm’s estimate, 75 percent of all healthcare communications are sent by fax. Isn’t it time we change this picture and #killthefax?

While industries such as banking, insurance, and education consider faxing a nearly antiquated form of communication, many in healthcare have not tran­sitioned to the digital transfer of information. The fax’s endurance may be a symptom of regulations, technological limitations, or simply tradition. The lack of privacy for personal health information, the un­certainty and unreliability on the part of the end user, half-printed and missing pages, are all critical reasons to #killthefax.

In August, the Centers for Medicare and Medicaid Services (CMS) announced their goal to eliminate fax machines from physician offices by 2020. CMS Administrator Seema Verma noted that healthcare is stuck in a 1990s time warp — it is possible to keep patient data secure while sharing it with them. Verma challenged developers to help make doctors’ offices a fax free zone by 2020. 

Recently released research dubbed, ‘Faxploit’, demon­strates how cyber criminals can now infiltrate a cor­porate network by exploiting all-in-one-printer-fax machines. The only thing required to carry out the attack is a fax number. Another reason to #killthefax.

Interoperability remains the key in accomplishing the #killthefax initiative. 

Participation in a health information exchange, such as Kansas Health Information Network (KHIN), will not only help #killthefax in Kansas but also allows healthcare providers to quickly access their patients’ data across disparate healthcare systems, reducing treatment delays and enhancing clinical decision making. The HIE supports patient care coordination and transitions of care by allowing healthcare professionals to access their patients’ most recent test results, procedures, diagnoses, and medica­tions in a secure environment.
To learn more about KHIN #killthefax initiative visit www.khinonline.org/killthefax .
State Medical Societies Collaborate to Impact Healthcare Disparities
Seven state medical societies, including the Kansas Medical Society (KMS), announced the creation of the Health Equity Network for Change (HENC) in September. The organization is focused on improving the health status of medically underserved populations, utilizing health information exchange data and powerful analytic tools provided by KAMMCO. Medical societies in Georgia, South Carolina, Connecticut, New Jersey, Missouri, and Louisiana have engaged KAMMCO to build physician-led exchanges. 

HENC chairman M. Natalie Achong, MD, MHL, FACOG, representing the Connecticut State Medical Society, shared, “Physicians across the nation are increasingly concerned about health disparities. To address this, HENC brings leading physicians together to examine trends in health disparity data. This will allow HENC to make data-driven recommendations for the establishment of population health priorities at regional, state and national levels aimed at improving health outcomes.”

“KMS is pleased to collaborate in this new initiative with the state’s physician-led health information exchange, KHIN,” said Jon Rosell, KMS Executive Director. “By working together to address universal healthcare issues such as healthcare disparities and population health, we can broaden our impact across the country.”

Laura McCrary, Ed.D, Senior Vice President of KAMMCO added, “Health information exchange data is an enormously valuable, rich set of clinical data aggregated across all exchange participating healthcare providers within a region, state or nation. This data provides key insights into healthcare patterns and utilization previously not available from static, outdated or geographically limited clinical data sets.” 

HENC has tapped leading physicians with expertise in health disparities to include: Tracie Collins, MD, MPH, MHCDS, representing the Kansas Medical Society. Dr. Collins is board certified in General Internal Medicine and Vascular Medicine, practicing at the Robert J. Dole VA Medical Center in Wichita, Kan., and serves as Chair of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita.

Physicians representing the other states include: Amin Yehya, MD, representing the Medical Association of Georgia; Donnie Batie, MD, ABFM, representing the Louisiana State Medical Society; Kirsten Dunn, MD, FACP, representing the Missouri State Medical Association; Soumen Samaddar, MD, representing the Medical Society of New Jersey; and, Gerald Wilson, MD, representing the South Carolina Medical Association. 
KHIN: Online Learning Center Member Resource
Visit the Kansas Health Information Network Online Learning Center to access KHIN’s latest video clips and learn more about the analytic dashboards, patient portal and provider portal. Each video clip provides a brief introductory overview of the feature’s functionality.


For additional member resources, visit the website www.khinonline.org .
Physicians Encouraged to Re-check 2017 MIPS Scores: Targeted Review Deadline Extended
In mid-September, CMS announced they identified errors in the scoring logic for the 2017 MIPS Performance scores. Solutions to correct the errors have been implemented. Physicians are encouraged to check and/or re-check their 2017 MIPS Performance scores for accuracy and updates.

As a result, CMS is extending the targeted review deadline from October 1 to October 15. The scoring logic affects:

  • Practices granted ACI exemptions and Extreme and Uncontrollable Circumstances hardship exception. The performance scores for many of those practices did not take the exemptions into account.
  • The awarding of Improvement Activity credit for successful participation in the Improvement Activities (IA) Burden Reduction Study. Practices participating in the study were not given the appropriate IA credit.
  • The addition of the All-Cause Readmission (ACR) measure to the MIPS final score.

When CMS corrected the scoring logic, the scores for impacted clinicians were affected. In addition, because the MACRA legislation must remain budget neutral, clinicians who were not directly affected by the logic changes may see corrections to their 2019 MIPS adjustments.

Physicians should log into their Enterprise Identity Data Management (EIDM) account to review revised 2017 MIPS scores by the October 15, 2018 deadline to submit any appeals to CMS. If a physician does not have an EIDM account, they can  click here  to create one. Physicians can call CMS at 866.288.8292 with questions.

KHIN QCDR Update
KHIN’s Doctors Quality Reporting Network has been approved by the Centers for Medicare & Medicaid Services as a Qualified Clinical Data Registry (QCDR) for 2018. In our second year of reporting, the technology used will have a standard data capture and interoperable exchange of information including enhanced patient safety, usability, privacy and security. Our vendor, Diameter Health just recently received the 2015 Drummond ONC Certification.  

The Doctors Quality Reporting Network will be National Committee for Quality Assurance (NCQA) certified to report on 36 electronic clinical quality measures (eCQM) for 2018. KHIN expects to have all 36 measures certified by the end of November. This is the same timeframe that NCQA worked with in 2017. 

In addition to being certified to report on the 36 eCQMs, we provide feedback to QCDR members via dashboards for eight of the available eCQMs, as well as provide quarterly electronic reports generated across all the available eCQMs. 

To learn more about the Doctors Quality Reporting Network, contact Josh Mosier, KHIN Client Services Manager, at 785.231.1341 or email jmosier@khinonline.org.
New MIPS Resources are Now Available in the Quality Payment Program Resource Library
CMS has posted the following new Merit-based Incentive Payment System (MIPS) resources on CMS.gov :

  • 2019 Virtual Groups Toolkit: Includes an overview fact sheet, which details what virtual groups are and how to participate in a virtual group in 2019; an election process fact sheet that describes the process for forming a virtual group; a sample virtual group election submission email; and a virtual group agreement template.




  • MIPS Data Validation Criteria: Includes an overview fact sheet and the 2018 criteria used to audit and validate data submitted in the Quality, Improvement Activities, and Promoting Interoperability performance categories.


For More Information
Come See Us!
October 2 - 3, 2018
Kansas Public Health Association
2018 Conference
Hyatt Regency
Wichita, KS



Josh Mosier
Manager of Client Services
785.231.1341