42
2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

ACO GPRO 2017 Ready to Report Basics - · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

  • Upload
    vudung

  • View
    244

  • Download
    6

Embed Size (px)

Citation preview

Page 1: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

2017 GPRO ACO Random Sample Reporting

January 22, 2018 to March 16, 2018

ACO GPRO 2017 Ready to Report Basics

Page 2: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

ACO GPRO 2017 Ready to Report Basics

• Accountable Care Organization (ACO) and Quality Reporting?

• What is the time period to report GPRO?

• What are the GPRO quality measures in an ACO?

• How do I report the GPRO quality measures?

• Which patients am I responsible to report quality measures? Verify your login credentials and access today.

• Reminder of reporting timeline.

• How do I use the Health Endeavors GPRO 2017 Tool?

• What is my score (not ACO score?)

• How do I mass import EHR data into the tool?

January 4, 2018 pg 2

Page 3: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 3

Accountable Care Organization (ACO) and Quality Reporting?

The Shared Savings Program ACOs are groups of doctors and other health care providers who voluntarily work together with Medicare to give high quality service to Medicare Fee-for-Service beneficiaries. An ACO is not a Medicare Advantage plan or an HMO. An ACO’s MIPS is reported under the ACO GPRO WI Portal. Your ACO has contracted with Health Endeavors to collect quality data and

send to Medicare.

ACO

ACO Participant Medical Practice

ACO Participant Hospital

Page 4: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 4

What is the time period to report GPRO?

Description Time Period

Patient ranking files are scheduled to be available for download from

Medicare GPRO WI. January 8, 2018

Patient list populated in Health Endeavors GPRO 2017 interface. January 10, 2018

GPRO 2017 Medicare reporting period January 22 – March 16, 2018

Last date to safely manually key GPRO 2017 data March 9, 2018

Page 5: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 5

GPRO Quality Measures?

Care Coordination/Pati

ent Safety

Clinical Care for At-Risk Population

Preventive Health

Page 6: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

15 GPRO Quality Measures

1. ACO-12 (CARE-1) Medication Reconciliation Post – Discharge

2. ACO-13 (CARE-2) Falls: Screening for Future Fall Risk

3. ACO-27 (DM-2) Diabetes: Hemoglobin A1c Poor Control

4. ACO-41 (DM-7) Diabetes: Eye Exam

5. ACO-28 (HTN-2) Controlling High Blood Pressure

6. ACO-30 (IVD-2) Ischemic Vascular Disease: Use of Aspirin of Another Antithrombotic

7. ACO-40 (MH – 1) Depression Remission at 12 Months

8. ACO-20 (PREV-5) Breast Cancer Screening

9. ACO-19 (PREV-6) Colorectal Cancer Screening

6 January 4, 2018

Page 7: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

15 GPRO Quality Measures

10.ACO-14 (PREV-7) Preventive Care and Screening; Influenza Immunization

11.ACO-15 (PREV-8) Pneumonia Vaccination Status for Older Adults

12.ACO-16 (PREV-9) Preventative Care and Screening: Body Mass Index Screening and Follow-up.

13.ACO-17 (PREV-10) Preventative Care and Screening: Tobacco Use: Screening and Cessation Intervention

14.ACO-18 (PREV-12) Preventative Care and Screening: Screening for Depression and Follow-up Plan

15.ACO- 42 (PREV-13) Statin Therapy for the Prevention and Treatment of Cardiovascular Disease.

7 January 4, 2018

Page 8: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 8

How do I report GPRO Quality Measures?

Page 9: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

Access GPRO 2017 – Health Endeavors

9 January 4, 2018

Page 10: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 10

Which patients am I responsible to report?

What is difference between GPRO 2017 and QM 2017?

Page 11: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 11

Description Time Period

GPRO Reporting Readiness Webinar conducted by Health

Endeavors on Thursday, January 4, 2018.

January 4, 2018

Patient ranking files are scheduled to be available for download

from Medicare GPRO WI.

January 8, 2018

Patient list populated in Health Endeavors GPRO 2017 interface. January 10, 2018

A training version of the Medicare GPRO WI is scheduled to be

open for the 2017 reporting period.

January 9-21, 2018

Health Endeavors GPRO 2017 tool opens for Excel data

collection. Health Endeavors uploads the excel to Medicare GPRO

WI on weekday daily basis commencing January 22, 2018

January 22, 2018

Health Endeavors to stop taking 2017 HER Imports (automation

and Submit a Request files)

February 20, 2018

Reminder - Reporting Timeline?

Description Time Period

GPRO Reporting Readiness Webinar conducted by Health Endeavors

on Thursday, January 4, 2018. January 4, 2018

Patient ranking files are scheduled to be available for download from

Medicare GPRO WI. January 8, 2018

Patient list populated in Health Endeavors GPRO 2017 interface. January 10, 2018

A training version of the Medicare GPRO WI is scheduled to be open

for the 2017 reporting period. January 9-21, 2018

The Medicare GPRO WI opens for quality reporting (Data entry and

submission) on Monday, January 22, 2018 January 22, 2018

Page 12: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 12

Description Time Period

Health Endeavors GPRO 2017 tool opens for Excel data collection.

Health Endeavors uploads the Excel to Medicare GPRO WI on

weekday daily basis commencing January 22, 2018

January 22, 2018

Health Endeavors to stop taking 2017 EHR Imports (automation and

Submit a Request files)

February 20, 2018

Health Endeavors GPRO Options Imports, Single and Spec File Mass

Imports

Last Date to submit March 9,

2018

Health Endeavors Manual Key Last Date to submit March 9,

2018

The Medicare GPRO WI closes on Friday, March 16, 2018 at 8PM ET

(7 PM CT, 6PM, and 5PM PT)

March 16, 2018

Reminder - Reporting Timeline?

Page 13: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

Tips & Pitfalls

• Have a Plan of Action for excessive measure Skips; e.g. not able to confirm diabetes.

• Do not get stuck on 1 record. In the first 10 days complete as many records as possible.

• You can always return to a record.

• Do not spend a lot of time on requested dates in the questions if not legible as CMS allows us to default to December 31, 2017 if date is illegible.

• Do not overwrite data unless you are certain of the data is correct and more recent than the data entered.

• Be done in 6 weeks (NOT 8 weeks)

13 January 4, 2018

Page 14: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

Access GPRO 2017 – Health Endeavors

14 January 4, 2018

How do I use the Health Endeavors GPRO 2017 Tool?

Page 15: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 15

Page 16: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

Ranks

• Random Sample Rank File received in January 8, 2018

• Patients Ranked 1 to 616 in each Module

– May have less than 616 if not enough patients to fill the module

• ACO Required to complete 1 to 248 consecutively

• 249 to 616 the oversample [Patient or Module Skips]

16 January 4, 2018

Page 17: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

17 January 4, 2018

Page 18: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

Mandatory Patient Defaults & Data Imports

“N/A” if outside age range, gender

Carryover prior year responses; e.g. Pneumonia

Deceased and Hospice mark patient as N/A

EHR and Claims data has been imported – See label.

1/4/2018 18

Page 19: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 19

Page 20: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 20

Sort Ranks for a Measure Lowest to Highest

Example: Hypertension

Page 21: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 21

Click on Grid

Page 22: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 22

Page 23: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 23

Data

Source

Page 24: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 24

Claims

Data

Expansion

Page 25: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 25

Page 26: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 26

Rank Filter

Page 27: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

27 January 4, 2018

Page 28: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

28 January 4, 2018

Page 29: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 29

Page 30: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 30

Page 31: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 31

Page 32: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 32

Page 33: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 33

Page 34: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 34

What is my practice or NPI GPRO Score?

Page 35: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 35

GPRO Optimal Gaps Analysis Report

Page 36: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 36

How do I mass import EHR data into the tool?

Setup a 1-1 meeting with Health Endeavors to be trained on the process.

GPRO Options Import and

Spec File Mass Import

Page 37: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

Description Time Period

GPRO Reporting Readiness Webinar conducted by Health Endeavors on

Thursday, January 4, 2018.

January 4, 2018 Suggest all quality staff attend and

those conducting manual key

functions.

Patient ranking files are scheduled to be available for download from

Medicare GPRO WI.

January 8, 2018 Health Endeavors will download all

files IF we have access to your MFT,

otherwise you must download and

provide in Submit a Request

Patient list populated in Health Endeavors GPRO 2017 interface. January 10, 2018 Manual key and clinical data uploads

accepted to Health Endeavors

repository.

A training version of the Medicare GPRO WI is scheduled to be open for

the 2017 reporting period.

January 9-21, 2018 DO NOT key directly in Medicare

GPRO WI or you may NOT get

credit for excel upload.

The Medicare GPRO WI opens for quality reporting (Data entry and

submission) on Monday, January 22, 2018

January 22, 2018 DO NOT key directly in Medicare

GPRO WI or you may NOT get

credit for excel upload.

Health Endeavors commences uploads of the Excel to Medicare GPRO

WI on weekday daily basis commencing January 22, 2018 IF we have

EIDM access to your account.

January 22, 2018 Manual key and clinical data uploads

accepted to Health Endeavors

repository.

Health Endeavors to stop taking 2017 EHR Imports (automation and Submit a Request files) February 20, 2018

Health Endeavors GPRO Options Imports, Single and Spec File Mass Imports Last Date to submit March 9, 2018

Health Endeavors Manual Key Highly Suggest – be finished

March 9, 2018 and have final

submit to Medicare

The Medicare GPRO WI closes on Friday, March 16, 2018 at 8PM ET (7

PM CT, 6PM, and 5PM PT)

March 16, 2018

GPRO 2017

Page 38: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

Decisions and Information

Topic Response

Confirm QM Import Chart data priorities and preferences

QM Import Chart configuration ensures the data that is utilized to

answer a patient's measure is prioritized correctly.

January 15, 2018 – Deadline Date

Enable Save for GPRO 2017

Confirm date for enabling the "Save" button on your GPRO 2017

tab. Save enabling allows you to import and update measure

responses in GPRO 2017. Portal is currently in preview only mode.

Enter requested date

Enable Save for QM 2018 (Complete QM 2018 Import Chart) Enter requested date (any date after January 12, 2018)

HASSIGN 2018 file will be used for patient population

Unlock TIN and NPI assignment for GPRO 2017

The assignment in GPRO 2017 will be locked so no changes may be

made to patient assignment in GPRO 2017 portal. Please let us

know if you want to unlock it and be able to update the TIN and NPI

assignment in GPRO 2017 portal.

Enter Response

Page 39: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

Decisions and Information

Topic Response

How many patients you want to submit to CMS for GPRO

2017?

• All patients sampled for GRPO 2017 (full sample).

• Only the minimum of 248 patients, plus additional patients

needed to replace the skips to complete the module (minimum

required).

• Specific rankings for each measure. Identify the last patient in

each measure you would like to submit up to (custom sample

size).

By default Health Endeavors submits the minimum that is required.

Enter Response

When do you want to finalize your submission to CMS and

disable "Save" in GPRO 2017?

After this date Health Endeavors stops submitting your data to CMS

and GPRO 2017 interface in Health Endeavors will be locked down

to avoid any future modifications after the final submission.

Enter requested date

Page 40: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

January 4, 2018 pg 40

Resource page - webinars

Page 41: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

Submit a Request or 1-888-862-0366

41 January 4, 2018

Page 42: ACO GPRO 2017 Ready to Report Basics -  · PDF file2017 GPRO ACO Random Sample Reporting January 22, 2018 to March 16, 2018 ACO GPRO 2017 Ready to Report Basics

42 January 4, 2018