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8/17/17
1
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|[email protected]