In November, the Centers for Medicare & Medicaid services released the Final Rule for the second year of the Quality Payment Program (QPP). The purpose of the Quality Payment Program is to incentivize, and improve, quality of care by setting into place payment adjustments based on the data reported to CMS. In an effort to reduce the burden of reporting, the Quality Payment Program is a combination of the current Meaningful Use, Physician Quality Reporting Program (PQRS), and Value-Based Payment Modifier (VBPM) programs.1 The requirements are weighted by four categories, Quality, Resource Use, Clinical Practice Improvement Activities, and Advancing Care Information. Based on the composite score of these four areas, clinicians will receive positive or negative adjustments on reimbursement rates.2
How do you know if you are on track to receive a positive adjustment? Here are a few tips and sources to get you started:
With the ever changing requirements organizations face in providing Behavioral Healthcare services, it is important that the focus remain on the patient, and not on the paperwork and reporting. However, this can be challenging. The foundation for keeping this focus begins with a solid understanding of the requirements you and your organization face. Once the foundation has been established and the requirements are recognized, choose to implement the measures, which can have the most impact on improving patient care and outcomes.
VP, Implementation Services – Business Analyst
Katie Morrow is a Licensed Bachelor’s Social Worker with seven years’ experience in the clinical field. In her clinical experience she was a Case Manager for adults with mental illness and developmental disabilities. After receiving a Masters Degree in Public Administration, she transitioned to also doing quality improvement tasks as a Performance Improvement Clinician, which included coordination of The Joint Commission and State audit reviews, data analysis of the electronic health record data, and staff training for her agency on the use of Streamline products. She began working directly for Streamline in August of 2011. With Streamline, Katie has been the project manager on several implementations as well as providing training and support to Streamline’s customers.