Provider Spotlight: Clint Allred, CRNA, Anesthesia Associates of Boise

Provider Spotlight: Clint Allred

Clint Allred, a full-time CRNA for Anesthesia Associates of Boise, was the grand prize winner of our recent Patient Experience Week giveaway. He is performing in the top 25% of anesthesia providers nationally. We asked Clint about his best practices for providing exceptional patient care, and we’re excited to share his responses.

Clint completed his nursing education at Weber State University in 2006, and then attended the University of Tennessee for CRNA training. He has been practicing in Boise since 2011.

What best practices do you and the staff you work with follow that you attribute to your positive scores?

Clint Allred: There is a huge push in our profession to unite with our surgeon colleagues and work toward “enhanced recovery after surgery ” protocols. We have known that there are a lot of different ways to manage the anesthetic of a patient, and each patient requires a different anesthetic. The downside to this is the fact that everyone does something different so the continuity of care is sometimes lacking.

To correct this discrepancy, we created a quality committee within our group. This committee was tasked with reviewing literature along with some of the bigger medical institutes, and then sitting down with anesthesia providers from within our group and developing some protocols for the surgeries that we provide routinely. This initiative at least put all of us on the same page to start with. These protocols deal not only with the patient during surgery, but also some interventions before surgery to improve their outcomes. Since installing these protocols, it has been incredible to see the patient, surgeon, and nurse satisfaction elevate. Every anesthetic still needs to be tailored just right, but this has really helped us be proactive in our decision prep.

What is one example of how you improved your relationship with your patients and/or the care you provide?

Clint Allred: It has amazed me how a little bit of effort goes a long way in ensuring comfort for our patients. It can be something as simple as a warm blanket in the cold metal OR, or talking with the patient on their level trying to take time to explain things.

One thing that we have instituted is in our pediatric population. The inhalational anesthetics that we use have a pungent smell. Kids really hate inhaling that odorous gas. So, we bought a bunch of Lip Smacker chapsticks and then bring the mask to the kids and let them pick out a flavor. They paint the inside of the mask with the flavor they selected and it negates that bad smell when the mask is on their face. Little things like these efforts don’t really take a cumbersome amount of time or energy. They just require a little effort and can really improve the relationship with patients.

What is one thing you avoid doing in order to provide a better experience for your patients?

Clint Allred: The biggest thing I have had to make a conscious effort to try and avoid is just going through the motions with my patients preoperatively. I have always taken pride in the quality of anesthesia care that I provide, but I realized when my son had surgery, that I really needed to change my approach to patients before they even have anesthesia. The day of surgery for patients is an overwhelming experience. Even before you get to the surgery and recovery phase, so much is thrown at them. I found that because administering anesthesia is a routine part of my life, I was just doing the bare minimum to educate and put my patients at ease. We would then whisk them away and go provide anesthesia. My experience taught me that taking an extra five minutes to sit down and talk with the patients about what they were going to experience, both for them and their family members, went a long way to easing their anxiety.

How do you best use your SurveyVitals data for your own personal improvement?

Clint Allred: SurveyVitals definitely serves as a reminder to keep those goals and changes, instituted in my own personal practice, in the forefront of my mind daily. Obviously, I won’t make everyone happy all the time. I used to just shrug my shoulders and act like it didn’t matter. However, what I did find is that when I changed my attitudes and practice – all of a sudden the SurveyVitals data meant something to me. It is a way to drive and improve my practice. I still won’t make every patient happy all the time, but I can take pride in my work and raise the bar for my patients.

August 6th, 2019 Categories: Anesthesia, Best Practices, Client Spotlight, featured, Patient Experience

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CMS Proposes New Measure Specialty Sets, MIPS Value Pathways

What are MIPS value pathways


The final rule for MIPS 2020 outlines the changes to the MIPS program coming in 2021. Read more here.

This week, CMS released the proposed rule for Year 4 of the Quality Payment Program (QPP). Many of the Year 3 requirements will be maintained going into the 2020 performance year; we highlighted the proposed changes in our blog post here. However, there are bigger proposed changes in store for Year 5 of the QPP starting in 2021.

In the latest release, CMS expressed an intention to move toward what they say would be a more streamlined MIPS program. To fulfill upon this vision, the agency is aiming to reduce reported complexities with data submission and confusion surrounding measure selection with a new framework they are calling MIPS Value Pathways (MVPs).

Check out key takeaways below from the proposed rule on MVPs and what CMS has put forth as a very loose framework for the future of the program.

CMS is soliciting public comment on the proposed rule until September 27, 2019 at 5 PM EST.

MIPS Value Pathways defined

The MVP framework would create sets of measure options that CMS says would be more relevant to clinician scope of practice and meaningful to patient care by connecting MIPS measures across the four performance categories specific to specialty or condition. It would also incorporate a set of administrative claims-based quality measures that focus on population health and provide data and feedback to clinicians. CMS says it intends to use the current MIPS specialty measure sets as a base framework for developing these new MVPs. The agency also indicated they will seek to enhance information provided to patients, with possible exploration of new forms of public reporting.

How does the MVP framework change MIPS?

If implemented, all MIPS-eligible clinicians would no longer choose their measures from a single inventory, but would instead fulfill measures and activities connected to a specialty or condition as a part of an MVP. This means the MIPS program would no longer require the same number of measures or activities for all clinicians.

CMS anticipates that an MVP would use a single benchmark for each measure, and all clinicians and groups in the MVP would be compared against the same standard. It is proposed that scoring policies would be evaluated to ensure scoring across MVPs is equitable, so that clinicians reporting a specific MVP are not unfairly advantaged. The agency says this would eliminate the need for special scoring policies and bonuses to incent selection of high priority or outcome measures, as clinicians would be required to report all measures in the MVP.

Additionally, MVPs will focus on bundling quality measures with existing, related cost measures and improvement activities as CMS sees feasible.

How will MIPS data collection be impacted by MVPs?

It is unclear at this time exactly how clinicians and groups will be expected to report data to satisfy measures under the new MVP framework. CMS says that the current MIPS performance measure collection types will continue to be used to the “extent possible,” creating some uneasiness for clinicians and industry leaders who have invested time and resources in their current reporting mechanisms. CMS is soliciting feedback around data submission mechanisms, particularly QCDRs and their role in the program. The agency maintains that a driving force behind the proposed changes is that the flexibility of the program in years 1-3 resulted in multiple benchmarks for each measure and specialty, hindering the ability of CMS to make meaningful comparisons.

Agency emphasizes patient experience and patient reported outcomes

The proposed rule also emphasized an increased focus on patient reported measures, including patient experience, satisfaction and outcomes in their performance measurement. The agency anticipates the MVP framework will provide more meaningful information to patients, which will enable them to make decisions about their care and achieve better outcomes.

CMS Example of Possible MIPS Value Pathway
MVP Example Quality Measures Cost Measures Improvement Activities Promoting Ineroperability
Preventive Health
  • Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention (Quality ID: 226)
  • Osteoarthritis: Function and Pain Assessment (Quality ID: 109) Adult Immunization Status, proposed (Quality ID: TBD)
  • Controlling High Blood Pressure (Quality ID: 236)
  • PLUS: population health administrative claims quality measures (e.g., allcause hospital readmission)
  • Total Per Capita Cost (TPCC_1)
  • Medicare Spending Per Beneficiary (MSPB_1)
  • Chronic Care and Preventive Care for Empaneled Patients (IA_PM_13)
  • Engage patients and families to guide improvement in the system of care (IA_BE_14)
  • Collection and use of patient experience and satisfaction data on access (IA_EPA_3)
  • All measures in Promoting Interoperability***

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August 1st, 2019 Categories: featured, MIPS Information, Patient Experience

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CMS Releases 2020 MIPS Proposed Rule


CMS has released the final rule for MIPS 2020. Read the key takeaways here.

If you’re participating in MIPS, you’ll need to know about the changes to the program in 2020. This week, CMS released the Quality Payment Program proposed rule for the next performance year. While their goal is to maintain many of the requirements from the 2019 performance year, there are some updates to the MIPS track. Here are the highlights of the proposed changes.

Quality and Cost performance category weights

In 2020, the Quality performance category weight will be reduced from 45 percent to 40 percent. The Cost category weight will increase from 15 percent to 20 percent.

Payment adjustment

The maximum negative payment adjustment will increase from -7% to -9% in 2020. Positive payment adjustments (not including exceptional performance) will increase from 7% to up to 9%.

Performance threshold

The performance threshold–the minimum number of points to avoid a negative payment adjustment–will increase from 30 points in 2019 to 45 points in 2020. The exceptional performance threshold, which determines additional positive payment adjustments, will increase to 80 points in 2020.

A full breakdown of proposed MIPS changes can be found in the table below. CMS is accepting feedback on the proposed rule at regulations.gov through September 27, 2019 with the file code CMS-1715-P.

CMS has also proposed larger changes to the program starting in 2021. Click here to read our summary of their new proposed framework.

For more information on the current MIPS performance year and how SurveyVitals can help you fulfill your requirements, visit our MIPS page or chat with us using the blue chat icon below.

Policy Area Current Year 3 (Final Rule CY 2019) Year 4 (Proposed Rule CY 2020)
Performance Category Weights
  • Quality: 45%
  • Cost: 15%
  • Promoting Interoperability: 25%
  • Improvement Activities: 15%
  • Quality: 40%
  • Cost: 20%
  • Promoting Interoperability: 25%
  • Improvement Activities: 15%
Quality Performance Category Data Completeness Requirements
  • Medicare Part B Claims measures: 60% of Medicare Part B patients for the performance period
  • QCDR measures, MIPS CQMs, and eCQMs: 60% of clinician’s or group’s patients across all payers for the performance period
Call for Measures
CMS seeks measures that are:
  • Applicable
  • Feasible
  • Reliable
  • Valid at the individual clinician level
  • Different from existing measures
Measure Removal
  • A quality measure may be considered for removal if the measure is no longer meaningful, such as measures that are topped out
  • A measure would be considered for removal if a measure steward is no longer able to maintain the quality measure
QCDR Measure Requirements
  • QCDR measures must be beyond the measure concept phase of development
  • CMS will show a preference for QCDR measures that are outcome-based rather than clinical process measures
  • Measures should address significant variation in performance
  • QCDR measures are approved for use in MIPS for a single performance period
Measure Removal
There is no formal policy for measure removal, as QCDR measures must be submitted for CMS approval on an annual basis as part of the self-nomination process.
Data Completeness Requirements
  • Medicare Part B claims measures: 70% sample of Medicare Part B patients for the performance period
  • QCDR measures, MIPS CQMs, and eCQMs: 70% sample of clinician’s or group’s patients across all payers for the performance period
  • Note: If quality data is submitted selectively such that the data are unrepresentative of a MIPS eligible clinician or group’s performance, any such adat would not be true, accurate, or complete
Call for Measures
In addition to current requirements:
  • Measures submitted in response to Call for Measures would be required to demonstrate a link to existing and related cost measures and improvement activities as appropriate and feasible
Measure Removal
In addition to current measure removal criteria:
  • MIPS quality measures that do not meet case minimum and reporting volumes required for benchmarking for 2 consecutive years would be removed
  • We may consider a MIPS quality measure for removal if we determine it is not available for MIPS Quality reporting by or on behalf of all MIPS eligible clinicians (including via third party intermediaries)
QCDR Measure Requirements
In instances in which multiple, similar QCDR measures exist that warrant approval, we may provisionally approve the individual QCDR measures for 1 year with the condition that QCDRs address certain areas of duplication with other approved QCDR measures in order to be considered for the program in subsequent years. Duplicative QCDR measures would not be approved if QCDRs do not elect to harmonize identified measures as requested by CMS within the allotted timeframe.

QCDR Measure Rejections
CMS is proposing the following guidelines to help QCDRs understand when a QCDR measure would likely be rejected during the annual self-nomination process:

  • QCDR measures that are duplicative of an existing measure or one that has been removed from MIPS or legacy programs
  • Existing QCDR measures that are “topped out” (though these may be resubmitted in future years)
  • QCDR measures that are process-based (consideration given to the impact on the number of measures available for a specific specialty) or have no actionable quality action
  • Considerations and evaluation of the measure’s performance data, to determine whether performance variance exists
  • QCDR measures that have the potential for unintended consequences
  • QCDR measures that split a single clinical practice/action into several measures or that focus on rare events
  • QCDR measures that are “check-box” with no actionable quality action
  • Existing QCDR measures that have been in MIPS for two years and have failed to reach benchmarking thresholds due to low adoption (unless a plan to improve adoption is submitted and approved)
  • Whether the existing approved QCDR measure is no longer considered robust, in instances where new QCDR measures are considered to have a more vigorous quality action, where CMS preference is to include the new QCDR measure rather than requesting QCDR measure harmonization
  • QCDR measures with clinician attribution issues, where the quality action is not under the direct control of the reporting clinician. (that is, the quality aspect being measured cannot be attributed to the clinician or is not under the direct control of the reporting clinician)
  • QCDR measures that focus on rare events or “never events” in the measurement period
Improvement Activities Performance Category Definition of Rural Area
Rural area means a ZIP code designated as rural, using the most recent Health Resources and Services Administration (HRSA) Area Health Resource File data set available.

Patient-Centered Medical Home Criteria
To be eligible for Patient-Centered Medical Home designation, the practice must meet one of the following criteria:

  • The practice has received accreditation from one of four accreditation organizations that are nationally recognized:
    • The Accreditation Association for Ambulatory Healthcare
    • The National Committee for Quality Assurance (NCQA)
    • The Joint Commission
    • The Utilization Review Accreditation Commission (URAC); OR
  • The practice is participating in a Medicaid Medical Home Model or Medical Home Model; OR
  • The practice is a comparable specialty practice that has received the NCQA Patient Centered Specialty Recognition
Improvement Activities Inventory
  • Added 1 new criterion, “Include a public health emergency as determined by the Secretary”
  • Removed “Activities that may be considered for a Promoting Interoperability bonus”
CMS Study on Factors Associated with Reporting Quality Measures
MIPS eligible clinicians who successfully participate in the study receive full credit in the Improvement Activities performance category.

Removal of Improvement Activities
No formal policy but invited public comments on what criteria should be used to identify improvement activities for removal from the inventory.

Requirement for Improvement Activity Credit for Groups
Group or virtual group can attest to an improvement activity if at least one clinician in the TIN participates.

Definition of Rural Area
Rural area is proposed to mean a ZIP code designated as rural by the Federal Office of Rural Health Policy (FORHP) using the most recent FORHP Eligible ZIP Code file available.

Patient-Centered Medical Home Criteria
To be eligible for Patient-Centered Medical Home designation, the practice would need to meet one of the following criteria:

  • The practice has received accreditation from an accreditation organization that is nationally recognized
  • The practice is participating in a Medicaid Medical Home Model or Medical Home Model
  • The practice is a comparable specialty practice that has received recognition through a specialty recognition program offered through a nationally recognized accreditation organization; OR The practice has received accreditation from other certifying bodies that have certified a large number of medical organizations and meet national guidelines, as determined by the Secretary. The Secretary must determine that these certifying bodies must have 500 or more certified member practices, and require practices to include the following:
    1. Have a personal physician/clinician in a team-based practice
    2. Have a whole-person orientation
    3. Provide coordination or integrated care
    4. Focus on quality and safety
    5. Provide enhanced access
Improvement Activities Inventory
  • Addition of 2 new Improvement Activities
  • Modification of 7 existing Improvement Activities
  • Removal of 15 existing Improvement Activities

Please review Appendix 2 in the CY 2020 NPRM for a comprehensive look at the changes proposed to the inventory.

CMS Study on Factors Associated with Reporting Quality Measures
Study year 2019 (CY 2019) is the last year of the 3-year study, as stated in CY 2019 PFS final rule (83 FR 59776). CMS will not continue the study during the 2020 performance period. Final study results will be shared at a later date.

Removal of Improvement Activities
Establish factors to consider for removal of improvement activities from the Inventory. An activity would be considered for removal if:

  • It is duplicative of another activity
  • An alternative activity exists with stronger relationship to quality care or improvements in clinical practice
  • The activity does not align with current clinical guidelines or practice
  • The activity does not align with at least one meaningful measures area
  • The activity does not align with Quality, Cost, or Promoting Interoperability performance categories
  • There have been no attestations of the activity for 3 consecutive years
  • The activity is obsolete
Requirement for Improvement Activity Credit for Groups
  • Group or virtual group would be able to attest to an improvement activity when at least 50% of MIPS eligible clinicians (in the group or virtual group) participate in or perform the activity
  • At least 50% of a group’s NPIs must perform the same activity for the same continuous 90 days in the performance period
Promoting Interoperability Performance Category – Hospital-Based MIPS Eligible Clinicians in Groups

A group is identified as hospital-based and eligible for reweighting when 100% of the MIPS eligible clinicians in the group meet the definition of a hospital-based MIPS eligible clinician.

A group would be identified as hospital-based and eligible for reweighting if more than 75% of the NPIs in the group meet the definition of a hospital-based individual MIPS eligible clinician.

For non-patient facing groups (more than 75% of the MIPS-eligible clinicians in the group are classified as non-patient facing) we would automatically reweight the Promoting Interoperability performance category.

No change to definition of an individual hospital-based MIPS eligible clinician.

Promoting Interoperability Performance Category Objectives and Measures
  • One set of objectives and measures based on the 2015 Edition CEHRT
  • Four objectives: ePrescribing, Health Information Exchange, Provider to Patient Exchange, and Public Health and Clinical Data Exchange
  • Clinicians are required to report certain measures from each of the four objectives, unless an exclusion is claimed
  • PTwo new measures for the e-Prescribing objective: Query of Prescription Drug Monitoring Program (PDMP) and Verify Opioid Treatment Agreement as optional with bonus points available
Objectives and Measures
  • CMS would require a yes/no response for the Query of PDMP measure
  • CMS would redistribute the points for the Support Electronic Referral Loops by Sending Health Information measure to the Provide Patients Access to Their Health Information measure if an exclusion is claimed
Cost Performance Category Measures
  • Total Per Capita Cost (TPCC)
  • Medicare Spending Per Beneficiary (MSPB)
  • 8 episode-based measures
Case Minimums
  • 10 for procedural episodes
  • 20 for acute inpatient medical condition episodes
Measure Attribution
  • All measures are attributed at the TIN/NPI level for both individuals and groups
  • Plurality of primary care services rendered by the clinician to determine attribution for the total per capita cost measure
  • Plurality of Part B services billed during the index admission to determine attribution for the MSPB measure
  • For procedural episodes, we attribute episodes to each MIPS eligible clinician who renders a trigger service (identified by HCPCS/CPT procedure codes)
  • For acute inpatient medical condition episodes, we attribute episodes to each MIPS eligible clinician who bills inpatient evaluation and management (E&M) claim lines during a trigger inpatient hospitalization under a TIN that renders at least 30% of the inpatient E&M claim lines in that hospitalization
Measures
  • TPCC measure (Revised)
  • MSPB-C (MSPB Clinician) measure (Name and specification Revised)
  • 8 existing episode-based measures
  • 10 new episode-based measures
Case Minimums
No changes.

Measure Attribution
  • Measure attribution would be different for individuals and groups and would be defined in the measure specifications
  • TPCC attribution would require E&M services to have an associated primary care service or a follow up E&M service from the same clinician group
  • TPCC attribution would exclude certain clinicians who primarily deliver certain non-primary care services (e.g. general surgery)
  • MSPB clinician attribution changes would have a different methodology for surgical and medical patients
  • No changes proposed for attribution in episode-based measures (existing and new)
Final Score Calculation: Performance Category Reweighting due to Data Integrity Issues
  • No policy to account for data integrity concerns
  • Several scenarios for reweighting have previously been finalized, including extreme and uncontrollable events (all performance categories) and hardship exemptions specific to the Promoting Interoperability performance category
  • We would reweight performance categories in rare events due to compromised data outside the control of the MIPS eligible clinician. MIPS eligible clinicians or third party intermediaries can inform CMS that they believe they are impacted by a relevant event by providing information on the event (CMS may also independently learn of qualifying events)
  • If we determine that reweighting for compromised data is appropriate, we would generally redistribute to the Promoting Interoperability performance category as well as the Quality performance category
  • In rare cases, we would redistribute to the Cost performance category
Performance Threshold / Additional Performance Threshold / Payment Adjustment
  • Performance Threshold is set at 30 points
  • Additional performance threshold set at 75 points for exceptional performance
  • As required by statute, the maximum negative payment adjustment is – 7%
  • Positive payment adjustments can be up to 7% (not including additional positive payment adjustments for exceptional performance) but are multiplied by a scaling factor to achieve budget neutrality, which could result in an adjustment above or below 7%
  • Performance Threshold would be set at 45 points
  • Additional performance threshold would be set at 80 points for exceptional performance
  • As required by statute, the maximum negative payment adjustment is -9%
  • Positive payment adjustments can be up to 9% (not including additional positive adjustments for exceptional performance) but are multiplied by a scaling factor to achieve budget neutrality, which could result in an adjustment above or below 9%
Targeted Review

MIPS eligible clinicians and groups may submit a targeted review request by September 30 following the release of the MIPS payment adjustment factor(s) with performance feedback.

All requests for targeted review would be required to be submitted within 60 days of the release of the MIPS payment adjustment factor(s) with performance feedback.

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July 30th, 2019 Categories: featured, MIPS Information, Patient Experience

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Breakout Provider Performance by Location

Provider Scorecard

SurveyVitals has enhanced the Location & Provider Details reporting feature to optimize how organization and division-level users capture provider performance.

Location & Provider Details allows organization and division-level users to quickly filter, sort, and rank division and provider performance for the whole organization. This time-saving tool eliminates the work of running custom reports and organizing data.

LAPD Sample

Based on client feedback, the Location & Provider Details data models have been updated to provide a more granular look at your organization’s data and individual provider performance across locations.

Provider Performance by Division

Organization-level users will continue to see all providers and their performance across all divisions where they practice. Division-level users will now see only the providers and their performance data for that particular division. At this level of granularity, the data becomes more pertinent by giving division leaders and clinicians a better sense of how providers interact with patients in different locations and settings.

Location codes and provider NPIs have also been added to the Location & Provider Details data. This information may be useful to match up providers and locations appropriately when downloading raw data.

Provider Scorecard

You can compare a provider’s individual performance across locations by viewing the new provider scorecard. Simply click the name of any provider in the report results to view this data.

The scorecard allows you to see how a provider is performing at one location versus another or overall. For example, the scorecard below shows the provider performing in the 100th percentile for some question groups at certain locations, but in the 1st and 3rd percentile for the same question groups at different locations.

Provider Scorecard

Benchmarks

Organization, National, and Specialty benchmarks have been added to provide ease of use for users who want to see a breakdown of their provider or location performance and compare it to the national average and specialty benchmarks. These benchmarks can be added to division-level data as well as the provider scorecards.

Questions?

Want to know more about Location & Provider Details? Contact our support team today or reach out to us. You can also always drop us a message using the blue chat icon below.

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July 25th, 2019 Categories: featured, Patient Experience, Product Features

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Five Features You Might Not Be Using but Should

surveyvitals features

With SurveyVitals’ comprehensive solution, you have access to all of our features without any extra cost. It’s likely you’re using our robust reporting tools, but are you taking full advantage of everything your solution has to offer? Here are five SurveyVitals features you should consider incorporating into your improvement strategy today.

1) Comment Sentiment Analysis

Sentiment analysis was rolled out with SurveyVitals’ recent Report Builder upgrade. Using natural language processing (NLP) and a machine-learning algorithm, sentiment analysis helps you gain a better understanding of your patient comments by providing tonal and sentiment insights.

Sentiment Analysis

Text comments can be sorted by sentiment ranking to help you identify the most critical feedback. Sentiment analysis saves you time and drives a higher awareness of your patient experience. See your comment analysis today by using the ‘Report Builder’ in your portal.

2) Improvement Center

You’ve reviewed your data and you know your improvement priorities, but that’s only the first step. Improvement can be overwhelming. Using input from top performers combined with extensive scientific-based research into the patient experience, we created the Improvement Center. Log in to your portal today to access dozens of articles and videos to gain a better understanding of the behaviors that contribute to higher patient satisfaction. Simply click ‘Improvement Center’ in the left navigation of your portal.

Improvement Center Featured Articles and Videos

3) Challenge Mode

Challenge Mode is an excellent way to boost user engagement and drive improvement. Administrators can issue challenges to providers throughout the organization and focus on specific survey questions or question areas. Then watch as participants work to rise to the top of the leaderboard! Scores are tracked throughout the specified challenge timeframe and providers can see how their scores compare to their peers. Start using Challenge Mode today by clicking ‘Challenge’ in the left navigation on your portal.

Challenge Mode Leaderboard

4) Email Alerts

We know you’re busy, and checking in on the portal can easily get away from you. From instant low-score alerts to bi-weekly kudos emails, our email alerts keep you up to date on your performance. Alerts are designed to provide constant awareness of your strongest areas as well as highlight your improvement opportunities.

Alerts can be enabled by an administrator on the ‘Manage Users’ page.

5) Survey Customization

Did you know you can personalize the survey requests sent to patients for all three modes of contact? Customizing these requests adds a level of familiarity, which may contribute to higher response rates and more accurate feedback.

To customize survey requests, access the options under the ‘Survey Settings’ tab in the left navigation in your portal.

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July 23rd, 2019 Categories: featured, Patient Experience, Product Features

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Understand Patient Needs with Sentiment Analysis

Sentiment Analysis

SurveyVitals has long helped our clients gain a better understanding of patient comments with semantic keyword analysis. With the release of our new Report Builder, we’re taking comment analysis to the next level with sentiment reporting.

A recent review of SurveyVitals data showed that 36% of patients leave at least one comment when responding to our digital surveys. In a March 2019 patient experience study conducted by NEJM Catalyst Insights Council, 97% of clinicians agreed that listening to a patient’s voice helps improve care. Patient comments give context to Likert-scale scores, helping to bring the data to life.

Comments are vital to understanding your patients’ needs, but reading through hundreds–or even thousands–of them can be time-consuming. SurveyVitals is excited to introduce our new sentiment analysis tool to help you gain deeper, faster insights.

How does it work?

Our sentiment analysis uses natural language processing (NLP) and machine learning algorithm to provide tonal or sentiment insights for text comments. The sentiment process, provided by Amazon Web Services, measures how positive, neutral, mixed, or negative a full comment is. Unlike semantic keyword analysis, sentiment measures the overall tone of the comment–for example, it looks for negation keywords such as ‘not’ in conjunction with emotional keywords for a better understanding (e.g., ‘The doctor made me not feel so afraid’).

Sentiment Analysis

Identifying the most critical feedback has never been easier. The ability to sort by positive, negative, mixed, and neutral sentiment scores allows for quick identification of the best and worst comments. Sorting by these scores or searching keywords may also be beneficial in reviewing comments for trends and prevailing concerns.

Sentiment analysis saves you time, drives awareness, and helps you to better understand your data and implement change.

Have questions or feedback about sentiment analysis? Reach out via the blue chat icon below or contact a member of your support team today.

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June 25th, 2019 Categories: featured, Patient Experience, Product Features

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Low Score Alerts Revamped To Include Mean Score

Improved Low Score Alert Emails

Expect alert emails to look a bit different when they hit your inboxes this week! Based on client feedback, we’ve updated alerts emails with a sleek new interface and made it easier for clinicians to view trends in performance.

Previous alert emails included the display of a provider’s percentile rank over time for the corresponding question area(s). When looking at short performance periods, a higher beta sometimes caused variability in rank which made it more difficult to track individual performance. The updated email alerts will now show mean score over time, making it easier for providers to gauge both an increase or decrease in scores over the last 90 days.

Survey Alerts

When email alerts are enabled, providers receive instant email notifications including the question, score, mean versus time, best practices, and links to other improvement resources (example image above).

If you aren’t receiving email alerts, talk to your administrator today about enabling them. Low score alerts help drive improvement by providing continuous, instant awareness of patient concerns. Simply turning on these alerts has been proven to drive improvement with no additional coaching.

Have questions about alerts and notifications, or need help enabling them? Contact us using the blue chat icon below!

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June 20th, 2019 Categories: featured, Patient Experience, Product Features

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Introducing the SurveyVitals Improvement Center!

Introducing SurveyVitals Improvement Center

SurveyVitals is excited to announce the launch of the Improvement Center in our client portal!

Our reporting, alerts, and dashboards have given our clients the real-time data needed to identify trends and work toward improving the patient experience. The Improvement Center takes the solution to the next level with a wealth of educational videos and articles to aid providers in targeting improvement where it is needed most.

To get started using the Improvement Center, login to your portal and click ‘Improvement Center’ in the left navigation. Browse general resources on the Improvement Center homepage, or view resources by survey. Survey-specific content is broken down by question group.

Not sure where to start? Use the Report Builder to analyze your data and comments and identify improvement opportunities. Then utilize the resources in the Improvement Center to gain a better understanding of what may help your patients in those areas.

SurveyVitals created the Improvement Center using input from top performers combined with extensive scientific-based research into the patient experience. Check back often for new content as our improvement resources evolve and grow with your solution.

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May 6th, 2019 Categories: Anesthesia, featured, Outpatient Practice, Patient Experience, Product Features

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MACRA Quality Payment Program: MIPS 2020

The Quality Payment Program (QPP) falls under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). It is a value-based program that determines reimbursement for clinicians treating Medicare patients.

The Centers for Medicare and Medicaid Services (CMS) recently released the final rule outlining the Quality Payment Program (QPP) for 2020. Keep reading to learn how the changes could affect you, and how SurveyVitals can help your organization meet reporting requirements.

Who Participates?

If you bill Medicare Part B more than $90,000 in allowed charges per year and provide over 200 covered professional services under the Physician Fee Schedule for more than 200 unique Medicare patients a year, then you are part of the QPP. If you do not meet all three criteria, you could be exempt from participating in the program in 2019 under the the low-volume threshold exemption. Beginning in 2019, clinicians who meet the low-volume threshold may still opt in to MIPS if they meet at least one criterion.

Eligible clinicians under the program include:
  • Physicians
  • Physician assistants
  • Nurse practitioners
  • Clinical nurse specialists
  • Certified registered nurse anesthetists
  • Physical therapists
  • Occupational therapists
  • Qualified speech-language pathologists
  • Qualified audiologists
  • Clinical psychologists
  • Registered dietitian or nutrition professionals

If you are unsure if you are required to participate in MIPS, CMS has provided a resource to check your status by entering your NPI into an eligibility “calculator.” Additionally, the agency plans to send letters to clinicians notifying them of their eligibility in 2020.

MIPS Eligibility

Two Tracks: Which is right for you?

There are two participation tracks in the Quality Payment Program. Most Medicare Part B clinicians and groups will fall under the Merit Incentive Payment System (MIPS) track, while a smaller percentage will qualify to participate in the Advanced Alternative Payment Models (APM) track if considered an “advanced APM.” It is important to note that those APM models which are not considered “advanced” by CMS will still participate in the MIPS track.

Learn more about APMs here.

The MIPS Track

You will receive a performance-based adjustment to your Medicare fee schedule in 2022 based on your performance in 2020. The amount of the adjustment, either positive, negative, or neutral, is based on an eligible clinician or group’s Composite Performance Score (CPS). The CPS is calculated using data across four categories of measurement:

  1. Quality
  2. Promoting Interoperability
  3. Improvement Activities
  4. Cost

MIPS Category Weights

How do I avoid a negative payment adjustment?

For the 2020 performance year, CMS extended a portion of the “pick your pace” program, allowing clinicians to submit just 90 consecutive days of performance data for the required measures in the Improvement Activities and Promoting Interoperability categories. However, clinicians will need to report data on all required measures in the Quality category for the full performance year (12 months).

CMS will also score and measure the Cost category for the full 12 month period as well. Since CMS gathers the Cost category information through Medicare claims data, no additional submission mechanism is required. If you do not participate in MIPS in 2020 you could be faced with a 9% penalty.

MIPS Performance Periods

Individual vs. Group Reporting

Eligible clinicians have the option to report as an individual, within a group, or within a virtual group.

An individual is a single National Provider Identifier, or NPI, tied to a single Taxpayer Identification Number, or TIN.

A group is a single TIN with two or more eligible clinicians (including at least one MIPS eligible clinician), as identified by their NPIs, who have reassigned their Medicare billing rights to the TIN. Participants are scored as a group and receive one payment adjustment based on aggregate performance.

A virtual group is a combination of two or more TINs assigned to one or more solo practitioners or one or more groups consisting of ten or fewer eligible clinicians that elect to form a virtual group for a performance period for a year. There is currently no limit on the number of TINs that can participate in a virtual group. Virtual Groups bring additional flexibility to the program, allowing clinicians to participate in MIPS with their peers, regardless of their geographical proximity or specialty. Those wishing to participate in a MIPS Virtual Group must make a formal election with CMS by December 31, 2019.

MIPS Individual and Group Reporting

Data for participants can be reported by various submission types by an individual or group as applicable. Alternatively, data may be reported by a Third Party Intermediary that submits data on measures and activities on behalf of a MIPS eligible clinician or group.

Selecting and Reporting Measures

The aim of the MIPS program is to provide clinicians and groups with the flexibility to select measures that best suit their practice. For the Quality category, participants can choose from several types of measures, which vary based on whether they are reporting as individuals or as part of a group. Submission methods are dependent on the types of measures chosen.

MIPS Data Collection

For the Improvement Activities and Promoting Interoperability categories, participants choose their measures from the QPP website. There are three submission methods for these measures.

  1. Direct: Users transmit data through a computer-to-computer interaction such as an API.
  2. Log-in and upload: Users log in with a set of authenticated credentials and upload and submit data in a CMS-specified format.
  3. Log-in and attest: Users log in with a set of authenticated credentials and manually attest that certain measures and activities were performed.

MIPS Requirements

Quality Category

Eligible clinicians are required to report six measures of their choosing for the Quality category. One of those measures must be an outcome measure. If no outcome measure is available, a ‘high priority’ measure must be reported in its place. High priority measures are contained in the following domains: outcome, appropriate use, patient safety, efficiency, patient experience, efficiency, and care coordination.

What are specialty measurement sets?

CMS developed specialty measure sets as a part of the available MIPS measures in the Quality Category. Participating clinicians must choose six measures to report within their specialty set. If there are fewer than six Quality measures to choose from in a specialty set, the clinician or group must complete all available measures contained in the set.

For anesthesia clients

SurveyVitals can help anesthesia clients who utilize a Qualified Clinical Data Registry (QCDR) meet a measure–AQI 48 (anesthesia patient experience)–in the Quality performance category. Learn more here.

Improvement Activities

The IA category requires clinicians to participate in a combination of measures totaling 40 points to fully satisfy reporting requirements. Activities weighted “high” are worth 20 points, while “medium” weighted activities are valued at ten points. Clinicians and groups considered non-patient facing, and practices with 15 or fewer eligible providers and/or clinicians practicing in rural and health professional shortage areas, may face reduced reporting requirements. Learn more about these special exemption statuses here.

MIPS Improvement Activities

In order for a group or virtual group to attest to an improvement activity, at least 50% of the clinicians in the group or virtual group must perform the same activity during any continuous 90-day period in the performance year.

Your SurveyVitals solution can help you satisfy measures in the IA category. Download our “Road-Map to Improvement Activities” or contact us at info@surveyvitals.com to learn more.

Promoting Interoperability

The Promoting Interoperability category places an emphasis on interoperability and patient engagement with certified EHR technology. Eligible clinicians must report on certain measures from four ‘objectives,’ or claims exclusions if applicable. Scoring is performance-based at the individual measure level, for a total of up to 100 points. In 2020, organizations must use the 2015 Edition CEHRT.

Special Status

Clinicians and groups considered non-patient facing, and practices with 15 or fewer eligible providers and/or clinicians practicing in rural and health professional shortage areas, may face reduced reporting requirements. Watch the video below to learn more.

Anesthesia QCDR Reporting

SurveyVitals can help anesthesia clients who utilize a Qualified Clinical Data Registry (QCDR) meet a measure–AQI 48 (anesthesia patient experience)–in the Quality performance category. We currently support NACOR (Anesthesia Quality Institute), Anesthesia Business Group, Anesthesia Quality Registry (ePreop), and MiraMed (Anesthesia Business Consultants). Learn more here.

What are the current MIPS dates and deadlines?

December 31, 2019

Last day to make a virtual group election for the 2020 performance year

January 1, 2020

2020 performance year begins

January 2, 2020

Data submission period for the 2019 performance year begins

March 31, 2020

Data submission for the 2019 performance year closes

October 3, 2020

Last day to begin the continuous 90-day performance period for Improvement Activities

December 31, 2020

2020 performance year ends

How is MIPS different in 2020?

To learn about the changes from year 3 (2019) to year 4 (2020) of the MIPS program, see our article on the 2020 updates.

Does SurveyVitals administer CAHPS for MIPS?

Yes! SurveyVitals is a CMS-approved vendor ready to administer CAHPS for MIPS on behalf of your organization in 2019. The CAHPS for MIPS survey can be used to satisfy one Quality measure or one Improvement Activity.

Contact us at info@surveyvitals.com to learn more about our CAHPS program.

Interested in meeting measures with SurveyVitals?

Want to learn how SurveyVitals can help you prepare for MIPS? Subscribe to our MIPS update list below or email us at support@surveyvitals.com. You can also send us a message using the blue chat icon below to speak to a member of our support team.

*Note: Information and program details are based solely upon SurveyVitals’ experience with MACRA and our interpretation of CMS rule-making and policy statements. The information presented does not reflect the views or policies of CMS or any other governmental agency and is not to be construed as practice management advice.

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March 13th, 2019 Categories: Ambulatory and Outpatient Surgery, Anesthesia, CAHPS Surveys, Emergency Medicine, featured, MIPS Information, Neonatology, Outpatient Practice, Radiology, Urgent Care

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2018 Year in Review

SurveyVitals 2018 Year in Review

SurveyVitals 2018 Year Stats

The patient experience is improving because of your dedication. Here are some remarkable metrics you were a part of in 2018.

Over 2 million surveys were completed last year, providing feedback on more than 31 million questions and bringing in over 2 million comments. Patient comments were overwhelmingly positive–there were 57 positive words for every one negative word!

Patients aged 64-75 years old were the best respondents, with the highest response rates for email, SMS, and overall. The most satisfied patients were males 25-34 years old for APSQ, and females 65-74 years old for SPSQ.

Our clients logged in over 124,000 times last year and received 138,000 low score alerts and 18,000 contact requests. This helped drive improvement in every area of care, but the most improved areas were Privacy Respected for APSQ and Communication for SPSQ.

Thank you for working with SurveyVitals to help your patients and your organization. We look forward to helping you continue to meet your patient experience goals in 2019!

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January 8th, 2019 Categories: Anesthesia, featured, Outpatient Practice, Patient Experience

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