November 2018

New This Month: CMS Releases Year 3 QPP Final Rule

On November 1, CMS released the QPP Final Rule outlining what the changing and expanding MIPS programs will look like in their third year, 2019. As we wind down Year 2 and prepare to report data in January, remember the Telligen team is available to answer questions and offer assistance. Phone: 844-358-4021 or email. 


Year 3 Final Rule Summary:

  • Expanding eligible clinicians, including: physical therapists, occupational therapists, speech-language pathologists, audiologists, clinical psychologists, registered dietitians or nutrition professional
  • Adding a third element – number of covered professional services to the low-volume threshold determination 
  • Providing an opt-in policy for ECs that meets or exceeds one or two elements of the low-volume threshold – the ability to participate in MIPS
  • Applying facility-based scoring for eligible facility-based clinicians
  • New performance thresholds: 30 points to avoid a negative payment adjustment and 75 points to receive an exceptional performer bonus
  • Allowing small practices to submit data for covered professional services through the Medicare Part B claims submission type for the Quality Performance category
  • Increasing the small practice bonus to six points and moving the bonus to the Quality category score
  • Quality is weighted at 45 percent. There are eight new quality measures to choose from. Only six are required to be reported
  • Cost will be weighted at 15 percent
  • Improvement activities will remain 15 percent of the total score, and will include six additional activities:
    • Double activity points for small/rural/non-patient facing clinicians
  • Promoting Interoperability category weight will remain at 25 percent, performance and bonus measures have been eliminated
  • You are required to use 2015 CHERT in 2019
  • Security risk analysis will be required but not scored
  • Five mandatory performance measures and two bonus measures
  • Changes are being made to support greater EHR Interoperability and patient access while aligning with the new Promoting Interoperability requirements for hospitals

More Information: 


Upcoming Webinars: Mark Your Calendar

Medicare Learning Network Webinar: 

  • CMS Physician Fee Schedule Final Rule Call November 19 from 1 to 2:30 p.m. CT The final rule is expected to increase the amount of time clinicians spend with patients by reducing Medicare paperwork. CMS experts will answer questions and address: 1) streamlining evaluation and management and reducing burden; 2) advancing virtual care; and 3) improving the QPP by reducing burden and offering flexibility

CMS encourages review of the following materials prior to the call:

CMS LAN Webinar

Telligen QPP Resource Center Webinar 


Update: Year 1 (2017) QPP Performance Data

On November 8, CMS released additional 2017 QPP performance data. 
Following the release of preliminary data earlier this year, CMS is releasing additional data elements showing significant success and participation in both the MIPS and Advanced APM tracks.

CMS is committed to sharing performance data as it becomes available. They’re listening and looking for ways to improve the program to drive value, reduce burden, promote meaningful participation by clinicians and improve outcomes for beneficiaries. For a complete breakdown of the 2017 performance data, please see CMS’ blog post and 2017 QPP performance year data infographic.


New Resources: Tools, Training and More

Security Risk Assessment Tool: Version 3.0 The Office of the National Coordinator developed an updated version of the Security Risk Assessment Tool. This new version is user-friendly and applies to the risks of the confidentiality, integrity and availability of health information. Visit Healthit.gov to download the new tool and the SRA Tool User Guide.

QPP CMEs The Medicare Learning Network offers multiple QPP online learning classes with the opportunity to earn CME credit. Log in or set up a new account here. Browse the catalog, or search Quality Payment Program to find courses to fit your needs.

Diabetes Toolkit To promote better outcomes for patients with diabetes, the CDC now offers a diabetes toolkit for pharmacy, podiatry, optometry and dentistry practices. The toolkit covers how clinicians can work with each other and members of the care team, including: primary clinicians, physician assistants, nurse educators and community health workers.


New: Meet Your QPP Resource Team

Meet Telligen’s Dr. Karen Korth

Dr. Karen Korth is the Director of Quality Performance for Best Practices Academy.

Karen’s work with Telligen includes behavioral health and chiropractic clinicians. At BPA, she focuses on guiding practices through patient- centered recognition programs.

Karen is a nationally certified mental health counselor, a NCQA PCMH Certified Content Expert and currently taking courses on Agile methodology.

As a self-proclaimed life-long learner, she’s passionate about helping practices become learning organizations. After conducting doctoral research in change management, Karen has spent 20 years helping organizations facilitate change. She’s a believer in challenging the status quo and helping individuals and organizations actualize their potential.

Karen, and her partner, Greg, live in a cabin on the Lewis and Clark Lake. They enjoy gardening, grilling and walking among the majestic eagles near the Gavin’s Point dam. Their combined family includes eight children and five energy-filled grandsons. 


Reminders: 2018 Claims Submissions & Opioid Series

2018 Claims Submissions CMS has updated the QPP website to enable ECs who select Quality data via claims to access Year 2 (2018) preliminary feedback on an ongoing basis. The feedback will be updated on a monthly basis.

Opioid Safety Project Telligen QIN-QIO and the American Medical Association will take a deeper dive into safely managing patients with opioids in a webinar series held the 2nd Wednesday of each month.

  • December 12: Patient and Family Perspectives
    • Presenter: Jennifer Westlund, American Academy of Pain Medicine       
    • Time: Noon to 1 p.m. CT                                                               
    • Registration Link: goo.gl/SzqZ6t

All opioid-related webinars will be recorded and posted on the Telligen QIN-QIO website. For more information, contact Sandy Swallow at sandy.swallow@area-d.hcqis.org or 515-223-2105.


QPP Resources: Now Available on CMS.gov

On October 30, the QPP resource library moved back to QPP.CMS.gov. Resources will remain on CMS.gov until November 30. Update your bookmarks and search new materials. 


This material was prepared by Telligen QPP-SURS Resource Center, theQuality Payment Program for Iowa, Nebraska, North Dakota and South Dakota,under contract with the Centers for Medicare & Medicaid Services (CMS), anagency of the U.S. Department of Health and Human Services. The contentspresented do not necessarily reflect CMS policy. HHSM-500-2017-00012C.

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