As the demand for information about health care performance has risen, MNCM’s measurement activities have also grown. And in the years to come, the pressure for improved value from our care systems – and the need to measure and report results – will only increase. Unfortunately, this has the potential to place a greater burden on providers. MNCM is taking several steps to ensure our measurement activities have the greatest impact for the least burden. Among other things, we are working to align the use of reported and submitted measure results across payers and to reduce the redundancy of reporting.
The 2013 Federal Budget Reconciliation Act allows Medicare to recognize providers who participate in clinical data registries that are able to generate quality measures for Medicare. This change has opened the door for providers to meet the requirements of federal programs by participating in reporting processes such as MNCM’s. In February 2013, the Centers for Medicare and Medicaid Services (CMS) issued a Request for Information to solicit responses from the public about how clinical registries could be used for the Physician Quality Reporting System (PQRS) and Meaningful Use (the Electronic Health Record Incentive Program). These registries could include those operated by specialty boards or societies, regional health improvement collaboratives (or RHICs) such as MNCM, or other non-federal reporting programs.
The concept of “deeming”
CMS could recognize providers who submit data to MNCM as meeting CMS data reporting requirements and qualify for any applicable financial incentives. In its simplest form, CMS could “deem” MNCM as a qualified clinical data registry. Through MNCM, Minnesota has a large set of high-impact measures that are focused on specific improvement efforts in the community. These measures are not, however, always aligned with those required in federal health care programs. And this problem is compounded because the measures also vary across different Medicare programs. These differences in the details increases data burden for providers. Using MNCM measures in federal programs would reduce the duplicative efforts created by Medicare quality reporting programs.
Providers reporting to MNCM would then benefit from a streamlined and more efficient process in which a single data submission meets the requirements of multiple parties. With deeming, a provider submission to MNCM could also fulfill the requirements of the Minnesota Department of Health’s Statewide Reporting Mandate (SQRMS), Minnesota health plan contracts, and the requirements of CMS for PQRS, Meaningful Use or other programs.
CMS and Medicare enrollees would also benefit by using MNCM data for Medicare programs. MNCM can verify the validity and reliability of the healthcare quality data collected, support higher rates of provider participation, focus on measures that will drive the most benefit for patients and the community, and the test new measures that will increase value or have greater impact.
How to move deeming forward
MNCM is recommending that CMS move forward with allowing data registries for Medicare programs. We recommend CMS allow our measure set to be used across all programs and also encourage us to develop new higher impact measures will meet the future needs for value-based purchasing and quality improvement. CMS would need to establish standards that MNCM and other data registries would need to meet in order to ensure the data we submit will continue to help patients and providers improve the value of care. CMS could also expand the incentives for eligible professionals of all specialties (primary care and sub-specialists) to report quality data. In addition, CMS could also benefit the community by encouraging the use of this reported data in local quality improvement initiatives.
Allowing clinical data registries to participate in Medicare is a great opportunity for Medicare to gain higher value measures while reducing the burden on providers. We hope you will support this important discussion with CMS and we look forward to keeping updated as the work progresses.
View this article and others in The Measurement Minute — September 2013 newsletter.