Home Forums Discussions Meaningful Use Core 10: CQM question

Core 10
Objective: Report ambulatory clinical quality measures to CMS.
Measure: Successfully report to CMS ambulatory clinical quality measures selected by CMS in the manner specified by CMS.

Those who have already successfully attested may be able to easily answer this...
What is the process to "successfully report to CMS"? Has this yet been defined? Is it similar to submitting to the vaccine registry? Or, is this still just measuring our ability TO BE ABLE TO REPORT (or generate the data report... similar to the CQM Required/Alternates) at this time... in which case the MU Wizard certainly does it by default, and we just answer "yes" to the attestation.

Thanks

Core 10 is easy--when you attest just put "yes". The process of attesting clinical quality measures is considered fulfilling this core measure. That's why in the AC Wizard under Core 10 it says: "HOW TO DO THIS IN AC: See each individual Clinical Quality Measure (CQM) for How To instructions." I know, it's dumb, but at least it's easy. :-)

yes in fact it was this easy.
I read and re-read this attestation question several times.
But you are correct, just click yes.

So are you actually sending data in on these, or just clicking that you are checking the data?

Core 10 is redundant. You do not enter data for this item; by saying "yes" you are indicating that you WILL be entering data for the CQM's later in your attestation.

The redundancy does make it confusing.

JBS is 100% correct. it is redundant. Just click yes.
Then later in the attestation you input the data for the CQM and alternate CQM's.
This is what you attesting to, that you are going to give this data.
You input said data directly on the website during the attestation. It's very straightforward.

Sorry, not really following.

I am a registry person. Meaning, I have been getting my PQRI money by submitting 30 patients for the past few years through a data base...costs a few $, but always worked...as opposed to my first year with the system...

So, do I need to pick patients and submit G codes through my billing? Please clarify how the submission of data works....how many patients? is it recorded somewhere etc....

Neil, two points you raise:
1) PQRI participation. I do the similar thing you are doing. I submit through the American Osteopathic Association's portal all the data I've collected and get the incentive payment. Here's the GREAT news, you can participate in MU AND PQRI concurrently and get incentive payments for both programs.

2)Regarding the MU Core 10:CQM attestation issue. This question is simply asking if you are going to participate in sharing data collected by your EMR for CQM and alternate CQM. The answer is YES. If you say no, you cannot pass the attestation. So you click YES. Later on, a few webpages later during attestation, the screens pop up asking for your data generated by AC. You simply input the numerators and denominators generated by AC. It is this later step to which Core 10 is asking. It is saying: are you going to give us these numbers? Then several questions later in the attestation, you are going to say: here are the numbers that you asked for.

To clarify, there is no requirement to submit G-codes for this.

Just to make sure I'm understanding your question, are you asking how to attest to MU?
CLICK HERE TO REGISTER FOR MU INCENTIVE
CLICK HERE TO ATTEST

I understand that Core 10 is just a 'yes' about the CQM to follow. However, I am still a little unclear about how these will work. I know they are tracked in different ways, some use a CPT code, some are tracked through the HM indicators. That is probably the biggest problems with remembering them - remembering to track them in different ways (i.e. remembering to use the code for obesity counseling and the ICD-9 for overweight on a patient whose BMI happens to be elevated). This is not very intuitive, and I think will have to be improved if we are going to reach a specified percentage on these.

Here is my question: do they just want us to report these CQM numbers? Right now they have no pass/fail standard? I have one where it looked at the quality indicator and the numerator is only about 3% of the denom but it still says pass. This is not that I haven't been doing foot checks or A1c, it just hasn't been tracked with the way they want it entered.

you are correct in your assumption Boondoc. For the CQM's and alternate CQM's presently in Stage 1 MU there is no minimum passing percentage. you could be at 0.0001% for a certain measure and you'll still pass.

They simply want the numerator and denominators, that's it. Very simple.

What is not simple is remembering how AC records them. I made a cheat sheet and taped it to the physical desktop near each computer keyboard in the exam rooms, only for my alternate CQM's and menu items. This helps me remember which ones we are tracking and how to records the data. Since I've been practicing recording the data for these specific measures for several months, it's easy to recall which ones needs CPT codes entered and which needs ICD9 codes entered and which needs the HM checked.

I guess I'll try not to worry about the percentages, but I hate them to think my controlled A1c patients are only 9%. This number may not be accurate just because of the tracking problem. In the future, when we are paid by our tracking, AC better make it simpler!

I agree and hope so too. In fairness to AC, they worked hard to get a MU interface put together and approved by CMS at the end of 2010 and in a timely manner so we could take advantage of MU in 2011. I am $18,000 grateful for it! Is it imperfect? yes. Can it be improved? I sure hope so.

However, I truly wish however AC would sideline the push to get PM functionality in favor of making an easier and more reliable MU interface. This will be critical to attest in Stages 2 and 3. Maybe someday if we put this in the wish list...

In the short term however, as long as I attest successfully in 2011 (stage 1) and 2012 (stage 1), I'll get 18K and 12K (30K total). If due to the MU interface challenges I don't successfully at stages 2 & 3, I will only miss out on 8K, 4K, and 2K (14K total) of incentives but no penalties. Starting in 2015 I will only get penalized between 2-5% of my Medicare allowable charges which for our average annual Medicare reimbursement of approx $125,000, this equals between $2,500-5,000 in penalties per year.

So either way they slice it, I come out ahead for several years despite the somewhat sloppy nature of the MU interface. Again thanks to AC this is a minimum 30K that I would not have had.

Also without AC, I would be spending thousands of more dollars per year in paper costs, staffing to handle all the paper flow and medical records, not to mention the countless hours of my time spent inefficiently handling paper messages. AC really gave my life back to me. Thanks AC!

I too am grateful for their efforts. It is nice that you have been successful and are willing to help the rest of us Adam!

In reading about your post and visualizing doing all this with paper, I think the key for AC might to be to visualize how you would make a flow sheet for the CQM with paper - for instance check boxes for DM, HTN, and smoking on one sheet. Then with the patient, there it is all together on one simple page. Prensently there are several routes required to access the various CQM items. Not only do you have to remember to do them each visit, but remember how to get to it in a way that causes the program to remember your actions. The program should do everything it can automatically, for instance excluded child HTN from the data, and the have an efficient system to remind the physician what needs to be checked off at the end of the visit. I would have the physician first pick the parameters they are going to measure, the 3 required and 3 alternate, and then the program would have a box pop up to check items off like smoking cessation counseling and DM foot exam. You could turn this feature off so it does not annoy non-participators, but as it is - the default is to do nothing unless you remember.

dude you are a genius. I hope AC programmers are taking notes on your idea!

Boondoc,
I think AC did a pretty good job of setting up V6 to facilitate meeting the requirements for the core and menu items. The CQM's could use some work, perhaps along the lines that you suggest. Keep in mind that for now, CMS only asks that you report the numbers, not that you reach some threshold. They are satisfied that you can show the ability to report the data, so don't sweat this (at least for 2012 and 2013).

Adam and others: Did you pick 3 of the alternate CQMs and shoot for them with the visits, or just wait until attestation time and run a search? It looks like more than 3 are satisfied on my chart right now without shooting for it.

Boondoc, I picked alternate CQM's for which AC already had data recorded. So I literally picked a few, ran a report on AC to see if any data was already collected, and if I had data for it already I kept that one selected. If another alternate CQM had no data, I abandoned it and selected a different one.

My advice, pick the low hanging fruit. Go for the Alternate CQMs that you already have data on.

However in relation to your other post, when stages 2 and 3 MU come into play we WILL have to meet certain minimum goals. Your points about the ease with which AC identifies our data will become much more relevant.