pcmh 2014 tips for the final weeks dg 08.17.17 - … pcmh 2014 – tips for the final weeks ......

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NCQAPCMH2014–TipsfortheFinalWeeks

KentuckyPrimaryCareAssociaEonAugust17,2017

SummaryofTips–ForTodayl  NCQAPMCH2014RecogniEon

l  Updated11.21.2016

l  Submitby9.30.17

l  Commonmistakes

l  Tipstobesuccessful

l  Afewdetailsabout2017standards

CompleEon-CheckStepsl  DoyouhavetheapplicaEonandISSpurchasedfromNCQA?

l  Ifnot,youcannotproceedwith2014

l  ApplicaEon(submitnow)l  ViaNCQARecogniEonPortal

l  InteracEveSurveySysteml  Providersl  EvaluaEonboxcheckedl  DocumentLibrary(3documents/element)l  SupportTextNotesl  Print/save

l FinalDueDate:September30,2017

MustPassElements&CriEcalFactorsl  6MustPassElements(50%+topassatall)

l  1APaEentCenteredAppointmentAccessl  2DThePracEceTeaml  3DUseDataforPopulaEonManagementl  4BCarePlanningandSelf-CareSupportl  5BReferralTrackingandFollow-Upl  6DImplementConEnuousQualityImprovement

l  CriEcalFactors(9)l  Impactscoringl  1A1,4A6,5A12,5B8youhavetopasstogetanypointsforthatelement

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HITPrevalidaEonPrograml  Areyourvendorsprevalidated-approvedfor2014auto-credit,givingyoupoints(credit)?

l  Processtogetapprovalanduse

l  YourpracEcehastousethefuncEonalityanddoit!l  E.g.,CampaignsforpopulaEonhealth3D

l  UsethePrevalidaEontabunderOrganizaEonalBackground

DocumentaEon–YourEvidencel  Withinlast12months

l  Reportsl  Timeframel  Rundatel  Numerator/denominator(%or#)l  DefiniEonofthemeasure

l  Screenshots

l  Examples

l  PII(nopersonalpaEentinformaEon)

Documents–YourEvidencel  Policies,Procedures,Workflows(descripEonsofwhatyoudo,howyoudoit,whendone,bywhom…)

l  DateofimplementaEonl  Aminimumof90daysbeforeyousubmitl  9.30.17submit(alldatedprior6.30.17)

l  FullyoperaEonalattheclinic

l  3documentsperelement(notfactor!)

Reviewer–anothersetofeyesl  ExternaltoyourpracEce

l  Reviewdocumentsforaccuracyl  Alldocumentsthatarerequiredl  CheckthattheMPEareallmetat50%+l  ReviewISS

l  RevieweratyourpracEce

l  NCQAReviewer–literall  MayaskforclarificaEon

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NCQAToolsl  RecordReviewWorkbook(RRWB)

l  4A6universe,followinstrucEonsfor30paEentselecEonl  Audit30paEentrecordsforfactorsin3C,4B,4Cl  Screenshotsofeachfactor

l  QualityMeasurementImprovementWorksheet(QMI)l  1A6:showimprovement,PDSA,no-showscommonl  6D&6E;basedon:

l  36Ameasures–showimprovementonatleast2l  16Bmeasurel  16Cmeasurel  AvulnerablepopulaEonmeasure

Renewalvs.Conversion

l  2011to2014orrenewing2014

l  11ElementsrequireDocumenta?onforStreamlinedRenewal:1A,2D,3C,3D,4A,4B*,4C,5B,6B,6D,6E

l  15ElementsrequireABesta?onforStreamlinedRenewal

l  StreamlinedRenewalRecogni?onisfor3years.Whenthe3yearrecogniEonexpiresapracEceiseligibletosubmitforrecogniEonunderNCQA'snewsustainingmodel.

l  Conversion:PCMH2011pracEcesthathaveachievedLevel3canusetheconversionprocesspriortoyourexpiraEondateandnolaterthan9/30/2017.

OtherRemindersl  Threedocuments/element

l  Outstandingissuesform(OIF)status–NCQAgoesbacktopracEceformoreinfo

l  IfrenewaloldP/PincludedifchangeP/Pfornewsubmission

l  Audits:anyfactorsthatwerescoredasyesintheindividualpracEcesitesurveytoolissubjecttobeingreviewedinrealEme.Anyelementandfactoryouaoestedtowillbesubjecttobeingauditedaswell.

l  LostID&password:providethefullpracEcesite,5digitlicensenumber(ifyouhaveit),mailingaddress,previouscontactname,andnewcontactemailaddress.

l  Updateyourprovidersintheproviderdirectory.

l  PaEents–dotheyknowaboutPCMH,doyouinvolvethem?Includethem!

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TipstobeSuccessfull  Don’twaitunElthelastday

l  6weeksleq

l  Tellyourstory

l  Labelwell,beclear

l  Givethemwhattheyaskfor(moreisokay,butnotneeded)

l  Detailsareimportant

l  Let’stakealookattheISS!

MoreNCQAResourcesNCQAPCMH2014FAQhop://www.ncqa.org/Portals/0/Programs/RecogniEon/PCSP/PCMH_2014_Standards_FAQ.pdf

NCQAPCMH2014trainingslideshops://www.ncqa.org/Portals/0/Programs/RecogniEon/RPtraining/PCMH%202014%20Intro.%20Training%20Slides%20Part%201%20-%20Standards%201-3%20-%2011.26.pdf

hops://www.ncqa.org/Portals/0/Programs/RecogniEon/RPtraining/PCMH%202014%20Intro.%20Training%20Slides%20Part%202%20-%20Standards%204-6%20-%2011.26.pdf

2017PCMHStandards&Processl  40corecriteria&60elecEve

l  All40coremustbemetl  25of60elecEvemustbemet

l  Concepts=Elementsl  Mustmeetcriteriainallsixconceptareas

l  2017DisEncEonModulesl  PracEceopportuniEestoshowexcellence

l  PaEenceexperiencereporEngl  BehavioralhealthintegraEonl  ElectronicMeasureReporEng

l  Q-PASS

2017PCMHeCQMsl  Beginning with PCMH 2017 program, option to submit electronic clinical

quality measures (eCQMs) to NCQA in support of their recognition process. l  Submit via E.H.R., HIE, QCDRs & data analytics companies (defined by CMS

for ambulatory quality reporting) l  Measure categories:

l  Acute l  Behavioral Health/Chronic Care l  Chronic Disease Care l  Overuse l  Immunization l  Preventative Care l  Admin QMS

l  http://www.ncqa.org/portals/0/Programs/Recognition/PCMH/Quality_Measures_Crosswalk.pdf

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hop://www.ncqa.org/Portals/0/Programs/RecogniEon/PCMH/PCMH%202014-PCMH%202017%20Crosswalk%206.19.17_Final_web.pdf?ver=2017-06-23-142418-887 PracEcalApproachesforYourPCMHJourney

l  Beginwithanassessment

l  IdenEfypracEcechampions

l  Picklow-hangingfruit

l  AligntransformaEonwithpayment

l  MaketheEmeandhonorit

l  Workoncrosscuvngelements

l  Startwithareasthatareeasytoenhance

l  Incorporatestafftraining

YourPCMHAcEonPlanandQuesEons

l Willyousubmitby9.30.17?

l WhatareyouwanEngmoreinformaEonabout?

l Whatareyournextsteps?

l Wheredoyouwanttostart?

l Doyouneedsupport,areviewer?

Let’sConnect!DawnGentsch,MPH,MCHES,PCMHCCE

KPCAPCMHConsultant

PCMHConsultant&PracEceFacilitator

515.360.1731|ddgentsch@msn.com