MIPS 2021: Proposed Rule Key Takeaways

The Centers for Medicare and Medicaid Services (CMS) has released the Quality Payment Program (QPP) proposed rule for the 2021 performance year. To accommodate for the challenges posed by COVID-19, CMS is not proposing many significant changes to the Merit-based Incentive Payment System (MIPS) for 2021. Here are the highlights of the proposed rule for next year. For information on the current performance year, see our MIPS 2020 page.

MIPS Value Pathways

Introduction of MIPS Value Pathways (MVPs), the new framework originally set to begin implementation in the 2021 performance year, will be postponed. CMS will continue to work on engaging stakeholders and developing the framework’s guiding principles.

APM Performance Pathway

CMS has proposed an APM Performance Pathway (APP), complementary to MVPs. This option would be available to MIPS APM participants only and would be composed of a fixed set of measures for each performance category. The APP performance measures would also satisfy reporting requirements for the Medicare Shared Savings Program quality scoring.

Performance Category Weights

In 2021, the proposed 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.

MIPS Performance Category Weights

Performance Threshold

For the 2021 performance period, CMS proposes to increase the performance threshold (maximum number of points needed to avoid a negative payment adjustment) from 45 to 50 points. There is no change to the exceptional performance threshold (number of points needed for a positive payment adjustment) of 85 points.

MIPS Performance Thresholds

Performance Categories

Quality Category

CMS proposes to use performance period benchmarks, rather than historical, to score quality measures. Previously, the benchmarking baseline period was the 12-month calendar year two years prior to the MIPS performance year. CMS hopes to ensure accurate and reliable data due to possible gaps in baseline data due to COVID-19. Therefore, in 2021, the agency proposes to use benchmarks from the 2021 performance period instead of the 2019 calendar year.

CMS also proposes to end the CMS Web Interface as a quality reporting option for ACOs and registered groups, virtual groups, or other APM Entities beginning with the 2021 performance period.

Improvement Activities Category

Minimal updates would be made to the Improvement Activities inventory. A process would also be established for agency-nominated improvement activities.

In 2021, there are no proposed changes to the requirement that 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.

Cost Category

CMS proposes to update existing measure specifications to include telehealth services that are directly applicable to existing episode-based cost measures and the TPCC measure.

COVID-19 Flexibility Scoring Proposals

For the 2020 performance period only, the maximum number of bonus points available for the complex patient bonus would be 10, to account for the additional complexity of treating patients during the COVID-19 public health emergency.

You can view the full 2021 QPP Proposed Rule fact sheet here.

MIPS and SurveyVitals

SurveyVitals can help you satisfy certain MIPS requirements. Learn more on our MIPS page, sign up for a demo, or chat with us using the blue chat icon below.

August 6th, 2020 Categories: featured, MIPS Information

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COVID-19 and Patient Anxiety: Top 5 Concerns

It’s not uncommon for patients visiting the doctor to experience anxiety related to their symptoms, diagnosis, or treatment. The spread of the novel coronavirus, COVID-19, has introduced a new type of anxiety for many patients: the fear of exposure to the virus. Many Americans are even avoiding medical care due to fear of contracting the virus in a healthcare setting.

Using SurveyVitals’ comment sentiment analysis and keyword search, we reviewed patient comments specific to COVID-19 procedures in office-based practices. We identified the top five patient concerns related to fear of clinical contamination. Taking steps to address these concerns may increase your patients’ comfort level with your care.

Top 5 Patient Concerns

#1: Visitor Screening

Screening patients and visitors prior to entry may look different from one practice to the next. The Centers for Disease Control (CDC) has published recommendations for screening patients for COVID-19 symptoms and risk potential.

This screening at the building entrance gives peace of mind for patients who worry they will come in contact with someone infected with COVID-19. It is important to have a triaging process in place so patients can feel at ease in your facility.

#2: Shared Items

Patients are particularly apprehensive about handling shared items such as pens, clipboards, or tablets. Whenever possible, offer the option for patients to fill out paperwork online prior to their visit.

For patients who do need to fill out forms onsite, disinfect pens and clipboards after each use. Consider having a clearly-labeled ‘clean’ set of pens and clipboards for patients to use.

In the waiting room, remove magazines and toys. If wifi is available, post the login information so patients can use their phones while they wait.

#3: Waiting Room Distancing

Many patients express discomfort with their proximity to other people in the waiting room. The CDC guidelines for clinic COVID-19 preparedness specify that waiting rooms should be set up to allow for six feet of distance between patients. Use signs to designate seating as off-limits, or remove chairs from the waiting room to provide adequate social distancing.

For check-in and check-out, place markers on the floor for patients to stand on to maintain six feet of distance.

If social distancing is not feasible in your waiting room, consider having patients wait in their cars or in a designated outdoor waiting area. If possible, you may also set up partitions inside.

#4: Face Masks

The CDC has published recommendations regarding personal protective equipment (PPE) for clinicians and symptomatic patients. However, required use of masks by all staff (both clinical and office) as well as patients and visitors is important in reducing patient anxiety about COVID-19 exposure.

If masks are required at your facility, make the policy known when scheduling the appointment and again with any reminders sent to the patient.

Sometimes patients can have difficulty with understanding their provider or another staff member due to mask use. Before removing your mask, view this article on communicating effectively while following COVID-19 prevention procedures.

#5: Offering Supplies

It’s crucial to offer hand sanitizer and tissues, and to ensure patients can easily access trash cans and soap at sinks. Patients without access to these supplies are likely to experience anxiety about contamination, especially if they have had to handle shared items such as pens, or if they’ve had to touch door handles or equipment.

SurveyVitals Study of Patient Views on COVID-19

Since March 2020, SurveyVitals has surveyed over 100,000 patients to capture public sentiment regarding COVID-19. View the ongoing study here and sign up for a demo today to learn how you can take part while collecting valuable feedback about the patient experience in your organization.

July 23rd, 2020 Categories: Best Practices, COVID-19, featured, Outpatient Practice

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New Features: Telehealth Survey and Updated Survey Interface

The SurveyVitals solution is continuously evolving to fit our users’ unique needs–healthcare organizations of all sizes and specialties. Improvements and new developments to the online reporting patient experience platform come as a result of direct input and asks from clients.

Our newly released telehealth survey solution makes it easy for practices providing both in-person visits and audio/visual offerings to understand and measure what might feel like a new experience. Additionally, the patient survey interface has been optimized to improve user experience. To learn more about these releases, read below or contact your SurveyVitals account manager.

Interested in learning more about SurveyVitals? Request more information here.

Telehealth Survey

Due to the spread of the novel coronavirus, COVID-19, more healthcare organizations are offering virtual visits than ever before to reduce the risk of exposure to patients and staff. To help our clients adapt, we developed the Telehealth Patient Satisfaction Questionnaire (TPSQ).

The telehealth survey features 12 questions about the patient experience with virtual visits within your healthcare organization. These questions cover scheduling the visit, logging on, provider communication and interactions, and willingness to recommend.

The telehealth survey easily adapts to your workflow. Organizations offering both in-person and telehealth visits can upload a single patient list for both visit types, so no additional work is needed after survey setup is complete.

Updated Survey Interface

Our new digital survey interface was designed to improve the user experience for patients while taking the survey. The update ensures a consistent experience and furthers patient accessibility. Over 90% of SurveyVitals digital surveys are completed on mobile devices.

Telehealth Survey New Interface

If you are interested in enabling the telehealth survey for your organization or have questions about the updated survey interface, reach out to your SurveyVitals Account Manager or contact us using the blue chat icon at the bottom of the screen.

June 16th, 2020 Categories: COVID-19, featured, Outpatient Practice, Patient Experience

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New Feature: SPSQ Low Score Comment Prompts

Low Score Comment Prompts

Better understand patient concerns with our low-score survey logic, now included on our Standard Patient Satisfaction Questionnaire (SPSQ). When patients select a score of a ‘1’ or ‘2’ on the five-point Likert scale for any standard survey question, they will be prompted to leave a comment describing their experience in that area.

The long-term use of this feature on our Anesthesia Patient Satisfaction Questionnaire (APSQ2) has been effective in helping providers to better understand trends and improvement opportunities in specific areas. These prompts encourage patients to include details about a specific part of their experience, providing deeper insights than often gained with generalized comment prompts at the end of a survey. Please note, there will be no change to the existing SPSQ comment questions with the addition of the low score prompts.

To gain even more insight from your patient feedback, use our sentiment analysis tool to review patient low score comments. This will help you to identify the most critical feedback quickly.

Have questions about this new feature or the SPSQ survey? Chat with us using the blue chat icon below, or reach out to your client account manager. Interested in learning more about SurveyVitals? Request a demo of the solution here.

December 16th, 2019 Categories: featured, Outpatient Practice, Patient Experience, Product Features

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10 Million Surveys!

10 million patient experience surveys completed

Together with our clients, we reached 10 million surveys in the SurveyVitals comparative benchmark. Thank you for helping us achieve this incredible milestone!

SurveyVitals 10 million surveys completed

With over 16,000 clinicians across 85 specialties utilizing SurveyVitals at over 3,500 locations, we are excited to watch this benchmark continue to grow. Your partnership and each interaction with your patients strengthens the solution and continues to fuel our mission to improve care and the experiences of patients across the country every day.

Ten million surveys comes on the heels of several new feature releases in 2019. Check them out here:

Report Builder

Upgrades to our custom reporting tool increased its speed and ability to analyze higher volumes of data, and introduced more comparison options, diverse filtering, and deeper comment analysis.

Sentiment Analysis

Using a machine learning algorithm, the new sentiment analysis feature measures the overall tone of text comments to help identify the most positive and negative feedback. The addition of sentiment analysis made it easier and faster for users to gain deeper insights from hundreds and even thousands of comments.

Improvement Center

We launched the Improvement Center in our client portal to aid providers in targeting improvement in the areas where it is needed most. The Improvement Center houses over 120 short videos and articles organized by question group.

Provider Performance by Location

Enhancements to the Location & Provider Details tool optimized how organization and division-level users capture provider performance. The Provider Scorecard breaks down each provider’s performance across multiple locations, making comparison of individual performance at one location versus another fast and easy.

We look forward to continuing to enhance and grow our solution as we work toward the next 10 million surveys!

November 25th, 2019 Categories: featured, Patient Experience

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MIPS 2021: MVPs and QCDR Changes Coming

MIPS Final Rule 2020

Last week, CMS released the final rule for the changes to the Merit-Based Incentive Payment System (MIPS). While there are only minor changes to the program in 2020, bigger changes are expected in 2021. Here are two of the big takeaways from the final rule.

MIPS Value Pathways (MVPs)

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

In the MVP framework, CMS intends to work with stakeholders to create sets of measure options that they say would be more relevant to clinician scope of practice and meaningful to patient care. MIPS-eligible clinicians would no longer choose their measures from a single inventory, but would instead fulfill pre-defined measures and activities connected to a specialty or condition.

At this time, CMS has not determined whether participation in MVPs in 2021 would be optional or mandatory.

Many aspects of the MVP framework are still unclear, and we will be following and providing updates as they are released by CMS. Subscribe to our MIPS newsletter to keep up to date on the MVP discussion.

Qualified Clinical Data Registries (QCDR)

In the current QPP landscape, QCDRs are not required to support multiple MIPS performance categories. However, beginning in performance year 2021, QCDRs will be required to submit data for the Quality, Improvement Activities, and Promoting Interoperability categories for the entire performance year and applicable submission period.

CMS is looking to achieve alignment of similar measures across QCDRs, with an emphasis on outcome measures. Starting in 2021, this would require full measure development and testing at the clinician level prior to the time of self-nomination. Additionally, CMS would implement a set of formalized guidelines for QCDR measure rejections.

You can read more about these proposed changes in the Quality Payment Program final rule.

November 6th, 2019 Categories: featured, MIPS Information

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Provider Spotlight: Tina Eide, MD, Matrix Anesthesia

Provider Spotlight: Tina Eide

Tina Eide, a board certified anesthesiologist from Matrix Anesthesia, was one of the winners of our recent Patient Experience Week giveaway. We asked Tina about the best practices she follows to provide exceptional patient care, and we’re excited to share her responses.

Tina studied medicine at the University of Washington and trained at Virginia Mason Medical Center. Her primary areas of work interest include regional anesthesia, neuroanesthesia, lifestyle/behavior, and anti-aging medicine.

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

Tina Eide: [The] Overtake Hospital pre-operative setting includes private rooms for each patient, so interviews can be conducted with a closed door, and a quiet environment. This is instrumental in developing patient trust, explaining anesthetic choices, and creating a safe space for patients to voice anxieties or fears. Also, the pre-op nurses are excellent and gather information ahead of the anesthesiologist meeting the patient, so we don’t have to be entirely reiterative.

I always try to ask several specific questions about a patient. By knowing a few personal details, I can often begin talking about a familiar topic that helps put the patient at ease. I’ve even gotten three patients to sing for me recently!

Finally, I always offer my first name after I’ve introduced myself as Doctor Eide. I give my patient the choice of which to call me, and most prefer calling me Dr. Tina or just Tina. I am able to communicate through this that I am a professional but I am also a human.

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

Tina Eide: When I first began, I was hesitant to explain all the risks that are inherent to anesthesia with patients. I felt this information might burden them or raise their anxiety prior to surgery. As I grew as a doctor and learned from my patients, I realized that patients are entitled to know the specifics of the care they will receive while under anesthesia. Some patients will decline a total explanation, and this is just fine. Other patients want to know each event that will occur and the possible up and downsides.

I learned that if I was upfront and explicit about the risk discussion, patients were extremely appreciative and their trust in me grew as well.

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

Tina Eide: I look for the specific comments that patients make about their experiences. Often we only hear general feedback like “great job” but when people relay a certain moment that touched them, or a particular action I did that helped them feel at ease, I am able to repeat that going forward.

I also accept any critical feedback with an open mind and heart. As a doctor, I hold myself to an exceptionally high standard to ‘do no harm’ which can sometimes translate in my mind as ‘make no mistakes.’ Clearly, as a human being, I have to accept that I will make a mistake now and again. If I can hear the critical feedback well enough to learn from it, however, I see it as a growth opportunity rather than something negative.

September 16th, 2019 Categories: Anesthesia, Best Practices, Client Spotlight, featured, Patient Experience

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Feature Highlight: Challenge Mode

Feature Highlight: Challenge Mode

Have you set up a challenge yet? Using Challenge Mode, you can create a competition between your providers to encourage improvement. Once the competition is live, you can monitor the results in real-time from your dashboard.

During Challenge Mode setup, choose questions or question areas you want to focus on. At the end of the challenge, the clinician with the highest scores in these categories is deemed the winner.

Challenge Mode Leaderboard

Note that you must be an administrative user with ‘Organization’ permissions to launch a challenge. From the ‘Challenge’ tab in your portal, you can view current challenges, leaderboards, and historical data.

Why create a challenge?

Challenges can create a bit of friendly competition among clinicians. Target questions or question areas where you would like to see improvement in patient experience scores. This can be a fun way to start some friendly competition and encourage provider engagement. Offer prizes or other incentives to encourage providers to achieve the highest possible scores.

Setting up a challenge

Ready to get started? Here’s how to set up a challenge:

Navigate to the Challenge page within your portal.

Challenge Mode

On the Challenge page, click “+Create” and follow the prompts as they appear in the pop-up menu.

Challenge Mode

Participants will receive an email notifying them of the challenge. Once enough surveys have been collected, results will automatically update in the leaderboard. Clinicians can check the rankings from their portal login.

More resources

For more information about Challenge Mode, check out the resources in the Help section, or contact your dedicated support team members.

September 9th, 2019 Categories: featured, Patient Experience, Product Features

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Surveys You Might Not Know SurveyVitals Offers

4 survey types you may not know SurveyVitals offers

SurveyVitals’ digital patient experience surveys help you gain a deeper understanding of your performance with immediate patient feedback. Did you know our solution includes many more surveys at no additional cost to help drive improvement from every angle of your practice?

1. Point of Care

Our Point of Care tool allows you to address patient concerns on the spot before the leave your facility. The survey is sent to patients on their own devices while they’re still onsite, giving you the opportunity to resolve concerns in real-time.

2. Outcomes Surveys
Global Surgical Outcomes Survey (GSOS)

The GSOS survey is sent to surgical patients post-visit to collect feedback about the recovery experience. GSOS works in sync with the Perioperative Surgical Home (PSH) model and ERAS guidelines to identify gaps in care and spot opportunities to improve outcomes.

Emergency Medicine Outcomes Survey (EMOS)

The EMOS survey is sent to patients following an Emergency Department visit. It collects patient feedback related to understanding the recovery plan and accessibility to follow-up care.

3. 360° Surveys

As a part of our 360° solution, we offer a variety of internal and stakeholder surveys to help you better understand the perceptions of employees, peers, surgeons, physicians, and third party groups who work with your organization.

Employee Satisfaction

The Employee Satisfaction survey collects feedback to help increase teamwork, reduce turnover, and keep your teams motivated. The survey assesses individual employee perceptions about the organization, professional interactions, performance, job duties, and more.

Peer-to-Peer

The Peer-to-Peer survey aims to increase accountability and awareness of workplace conflict. Employees rate their peers in a number of areas including attitude, communication, competency, responsibility, teamwork, and timeliness.

Physician Satisfaction

Intended to prevent physician burnout, the Physician Satisfaction survey gathers insights from physicians about their quality of life in the workplace. Drive positive change with candid feedback from your physicians in a number of areas.

Referring Physician

Maximize your referral opportunities with the Referring Physician survey. Receive feedback from referring physicians on reports, recommendations, and interpretations they receive.

Anesthesiologist Surgeon Satisfaction

The Anesthesiologist Surgeon Satisfaction Questionnaire gathers important input from surgeons who work alongside anesthesia providers. This survey gives anesthesia providers valuable insights to strengthen relationships and increase safety and efficiency.

Third Party Group Evaluation

Enhance your third party relationships with feedback from your hospital and facility partners about your care, safety, responsiveness, clinical competency, cost efficiency, support, and more.

4. CAHPS

SurveyVitals is certified by CMS to administer nine different CAHPS surveys. The transition to value-based care has made CAHPS surveys mandatory for many facilities. The CAHPS surveys we offer are:

Note: There may be an additional cost to administer CAHPS surveys.

Questions?

Have questions about the SurveyVitals solution or any of the surveys we offer? Reach out to us today at support@surveyvitals.com or contact us using the blue chat icon below.

August 28th, 2019 Categories: Anesthesia, CAHPS Surveys, Emergency Medicine, featured, Outpatient Practice, Patient Experience

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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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