After an extensive outreach with clinicians, patients, and other stakeholders, CMS tweaked their original strategic objectives to drive progress and improvements.
These minor enhancements to the strategic objectives will help guide their final policies and future rule-making in order to design, implement, and advance a Quality Payment Program that aims to improve health outcomes, promote efficiency, minimize participation burden, and provide fairness and transparency in operations. Let’s review the strategic objectives.
Conquer the 7 Strategic Objectives of the Quality Payment Program
Tackle the key pointers of the 7 QPP objectives:
Objective 1 — Improve beneficiary outcomes and engage patients through patient-centered Advanced APMs and Merit-Based Incentive Payment Systems (MIPS) policies
It is essential for physicians and other healthcare clinicians to create meaningful partnerships with patients, families, caregivers, and communities to bring their preferences into the care discussion. The QPP provides new opportunities to improve care delivery by supporting and rewarding clinicians as they find new ways to engage patients and families and improve care coordination and population management.
Better care coordination can means giving patients more quality time with their doctors, expanding the ways patients are able to communicate with their team of clinicians, and involving patients and families more in care decisions. These activities can ultimately lead to the delivery of higher-value care. The CMS Person and Family Engagement (PFE) Strategy, or Strategic Plan, and the CMS Equity Plan serve as valuable resources for informed and coordinated care for patients, families, and communities. You can learn more about these plans on the CMS site at www.cms.gov.
Objective 2 — Enhance clinician experience through flexible and transparent program design and interactions with easy-to-use program tools.
Clinician experience is defined as the end-to-end experience when clinicians interact with CMS in the Quality Payment Program components, including their people, resources, and systems. A true enhancement to the experience will start with supporting clinicians through accurate, timely data; a modernized payment system; and tools that work and add value to their practice. By developing a program that is flexible instead of one-size-fits-all, CMS is trying to meet clinicians where they are, so that they can make the choice about how to participate in a way that is best for them, their practice, and their patients. CMS goals include reducing burden, ensuring flexible program design, and improving how they measure cost and quality performance to support clinicians in doing what they do best — making their patients healthy.
For the Quality Payment Program, Advanced Alternative Payment Models (Advanced APMs) focus on reducing overall healthcare costs and improving the quality of care. APMs are highly diverse in their target participants, subject matter, and approaches.
Key: Some APMs measure total cost of care for entire patient populations, while other APMs may focus on particular episodes of care, diseases, or practitioner types.
The theme that ties all Advanced APMs together is that they are designed to improve quality and control healthcare costs. The incentives under the Quality Payment Program available to clinicians for sufficient participation in Advanced APMs meeting certain criteria are central to increasing the proportion of Medicare payments through APMs.
Takeaway: By setting ambitious, but achievable goals for the adoption of APMs, it is expected that healthcare clinicians and professionals will move with greater certainty toward these models.
CMS is committed to reaching multiple user segments, including clinicians, the technology community, private payers, and beneficiaries to raise awareness that Medicare is evolving quickly to pay for a better, smarter, healthier system and is encouraging these groups to voice opinions and suggestions to help collaboratively drive the goals of the Quality Payment Program.
CMS will also work to set expectations that this will be an iterative process and, while change will not happen overnight, they are committed to continuing the work to improve how Medicare pays for quality and value, instead of the quantity of services.
Bottom Line: CMS will continue to reach out to the clinician community and others to partner in the development of ongoing education, support, and technical assistance materials and activities to help clinicians understand program requirements, how to use available tools to enhance their practices, improve quality, reduce cost, and progress to participation in Advanced APMs if that is the best choice for their practice.
Clinicians increasingly depend upon multiple sources of information to determine how they operate their practice, manage their patient populations, and engage individual patients, families, and caregivers. CMS has administrative and clinical data that is highly valued by the clinician and wider stakeholder community. The information is only valuable if it is accessible, accurate, timely, and inclusive of the elements that matter the most to clinicians.
Takeaway: Much of the data in the immediate future will be interfaced with electronic health records to bring the most recent scientific evidence to the point of care to bolster clinical decision-making. Vendors and physicians will be important partners in ensuring that the information is available in correct formats and is timely.
Through the Quality Payment Program, CMS continues to lay the groundwork for building a healthcare system that leverages health information technology to support clinicians and patients and foster collaboration across care settings. Their goal is to promote technology that supports patient engagement and allows clinicians to focus on providing high-quality healthcare for their patients.
Don’t miss: CMS plans to continually assess whether certified EHR technology (CEHRT) is used meaningfully through MIPS and will continue to look for ways that CEHRT can support the exchange of patient information, engagement of patients in their own care, and quality goals of the practice.
Takeaway: CMS encourages the use of the 2015 edition of CEHRT but have included flexibilities to allow the use of the 2014 edition of CEHRT to meet MIPS requirements.
CMS strives to design and implement the QPP to exceed everyone’s expectations through five standards:
CMS will use an agile project management approach that offers flexibility as the team minimizes focus on “set” requirements and plans and instead uses iterative approaches or the breaking down of processes into smaller portions with an emphasis on people, their disciplines, core competencies, and abilities to work together to get the job done.
Read more about agile project management principles here: https://blog. hubspot.com/agency/basic-principles-agile-project-management.
CMS will integrate the agile approach with their Lean Management Operating System (LMOS), which complements the principles of agile development and seeks the elimination of waste and the empowerment of employees to raise concerns early and provides a structure to address identified concerns, which will help CMS to deliver the highest-value product to their most important customers: beneficiaries.
Read more about Lean Operating Systems here: https://www.plantservices. com/articles/2013/02-implementing-lean-operating-systems/.
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