Outrunning the MIPS Bear – Article (2 of 5)
MIPS: Quality
Ok, gotta outrun Da Bear – let him eat somebody else. Can you say “Darwinism?” It’s a serious ‘survival of the fittest’ approach but hey, right now the bar is low: they’re calling this a ‘transition’ year. Fine, I’ll take it; good year to get started; requirements are going to go up from here so let me get on board, get the good habits established.
As stated in the previous article, there are 4 categories to consider while running away from Da Bear:
Of the 4, Quality represents 50% of my final score, by far the biggest chunk represented by any single category, so, by gum, let’s get this one going. What is the Quality portion of this deal?
Well, straight from the CMS Horse’s mouth/website (qpp.cms.gov), Quality is defined from on high: “Participants must submit data for at least 6 measures for the 12 month performance period.” And further, that: “One of the measures should be an outcome measure; if you have no applicable outcome measure, you can submit a high priority measure instead.”
Ok, thank goodness for CMS stone tablets/websites – what measures should I pick?
I click on a friendly blue button labeled “Explore the measures” and am confronted by, Holy Toledo, 275 Quality Measures. After getting control of my rapid breathing and forcing my eyes to roll back down out of my forehead, I see that I can filter by Specialty Measure Set. After picking Urology as my Specialty the list is magically reduced to 22 measures: whew! And if I further filter by Submission Method, EHR, the list is reduced to 8: All right then! I guess I’ll stop bounding about the room shouting obscenities about CMS and see if I can get my arms around this Quality business of theirs. Government – sheesh.
Eight measures: just 8.
One of those has to be an outcome measure, whatever that is (I’ll deal with that later), OR a high priority measure (whatever that is – worry about that later) instead. A quick scan of the 8 returns no outcome measure, but there is one high priority measure: Documentation of Current Medications. Check: gotta take that one. The 6 I’ll pick:
Measure | CMS ID | NQF | Type | EHR Documentation process |
Documentation of Meds in Current Record | CMS68v7 | 419 | High Priority Measure, Process | Medical record>Medications>Request Med HX or Add Meds |
Tobacco Screening | CMS138v6 | 28 | Process | Medical record>History>Tobacco Assessment |
Bone density eval | CMS645vq1 | NA | Process | Medical record>History>Bone Density |
High BP Screening | CMS22v6 | NA | Process | Medical record>Vital signs>Record |
Diabetes: Medical Attention for Nethropathy | CMS134v6 | 62 | Process | Medical record>History>Nethropathy |
BMI screening | CMS69v6 | 421 | Process | Medical record>Vital signs>Record |
Now all I’ve got to make sure that my staff is documenting these measures where it makes sense, within clinical workflow, so that my clinical quality measures populate!
Done! Check! Quality, step one, is handled. I’m still ahead of Da Bear, and I betcha, I’m willing to bet real money, that already I’m ahead of a lot of folks who haven’t bothered to get this far. Got $5 you want to put down on that bet? Here’s mine…