Helping to build the patient-focused, data-driven organization
Starting June 27, the FPSC will be updating the “Midlevel Provider” provider description to “Advanced Practice Provider.” Any provider from your organization with the current designation of Midlevel Provider will be automatically updated to the Advanced Practice Provider designation in the online reports. For questions, please contact Jennifer Jenkins or Will Dardani
The International Classification of Diseases, Tenth Revision (ICD-10) code set will be adopted on October 1, 2015. In preparation for this transition, the FPSC team has updated the same tables and fields currently used by organizations in their billing data feeds to accommodate either ICD-9 or ICD-10 codes.
During testing, the FPSC found that there were a small number of codes “overlap” codes (i.e. used in ICD-9 and ICD-10 with possible different diagnosis assignments) that relate to obscure cases such as “fall from a railway train” or “lifestyle issues.” Our system will be checking the service date and for any codes where there is duplication between ICD-9 and ICD-10, and if the service was performed before October 1, 2015 it will be assigned the description for the ICD-9 code. If the service was performed on or after October 1, 2015, it will be assigned the description for the ICD-10 code.
A reminder that faculty practices that plan to report Medicare quality data as a group NEED to register by June 30. Groups could face up to a 6% Medicare penalty in 2017 (through the PQRS and Value Modifier programs) if they do not report PQRS data in 2015.
Please note, after June 30, provider can do individual PQRS reporting, but not group reporting. Also, groups that are part of an MSSP or Pioneer ACO do not need to register. Instructions for registering to participate in the 2015 PQRS GPRO are provided in the 2015 PQRS Registration Guide available on the CMS website.
FPSC Annual Conference 2015
+ INFLUENCE: REVOLUTIONIZING PERFORMANCE
Don't miss this one-of-a-kind event on June 18-19 at the Hyatt Regency Chicago, designed exclusively for multispecialty faculty physician practices and their hospital partners.
As the health care revolution gains momentum, academic medical centers and faculty physician organizations are under increasing pressure to optimize clinical and operational performance across the continuum of care. The theme of + INFLUENCE was selected for the 2015 FPSC Annual Conference to reflect the power of using positive persuasion to promote engagement, alignment, and sustained peak organizational and personal performance. This year’s Annual Conference features an exciting agenda packed with three fantastic keynotes, focus track sessions on practice, revenue cycle, and quality and efficiency management, as well as ample professional and pre-conference social networking activities.
The 2014 FPSC Work and Total Relative Value Unit (RVU) benchmarks were released this March. All member reports have been refreshed with the 2014 benchmarks. All clinical benchmarks were updated including New Patient Visits; the Revenue benchmarks listed were updated earlier in the year.
Please note - the 2014 benchmark values will carry forward for comparison to your 2015 data until the next set of benchmarks are released in late 2015/early 2016.
The FPSC would like to highlight several enhancements to the benchmarks and online tools with the release of the 2014 FPSC benchmarks:
Fifty-three organizations participated in the CFTE collection process for the 2014 RVU benchmarks.
The minimum provider threshold necessary for a Ambulatory Gynecology benchmark was not met this year and was dropped from the list of specialties with benchmarks.
Eleven new specialties were added this year. The specialties include: Gynecology; Nephrology without Dialysis; Orthopedic Surgery: Shoulder / Elbow; Pediatrics: Cardiology Interventional; Pediatrics: Cardiology-Invasive; Pediatrics: Dermatology; Pediatrics: Rehabilitation; Physical Therapy; Podiatry; Surgery: Breast; and Surgery: Oral are specialties that have been added this year. All specialties now have benchmarks available in the FPSC reporting tool.
The FPSC team thanks you for your participation in the 2014 RVU benchmark development process. For questions related to the benchmarks, please contact Dave Troland (312-775-4357). If you need to update or remap your provider FPSC specialty categories, please contact Will Dardani (312-775-4510).
FPSC Resources on 2015 Physician Fee Schedule
UHC and AAMC staff recently hosted several web conferences to help faculty practice organizations understand the implications of the 2015 Medicare Physician Fee Schedule final rule and to better prepare organizations as Medicare starts implementing the pay-for-performance programs. PDF versions of the presentations and recordings of the web conferences are available below. For questions related to the physician payment provisions, please contact Dave Troland or Will Dardani. For questions about quality related provisions, please contact Shaifali Ray.
Webinar 1: CY 2015 Medicare Physician Fee Schedule - Understanding the Final Quality and Value Modifier Provisions
UHC and AAMC are partnering with five academic medical centers across the country on an initiative to improve health care coordination between primary care physicians and specialty physicians. The $7 million project is being funded by the Center for Medicare and Medicaid Innovation (CMMI) to evaluate the impact of implementation of a consultation and referral platform that is integrated into the electronic health record. To learn more, please visit the UHC, AAMC, or CMS websites.
The New Quality & Efficiency Module
42 groups have already signed up for the new module, is your group one of them?
The UHC-AAMC Faculty Practice Solutions Center is pleased to offer a new module to help inform and support member initiatives to improve the cost, efficiency and quality of patient care.
Features of the New FPSC Quality & Efficiency Module:
Reports & Comparative Data
Improvement Toolkits & Networking Opportunities
Robust comparative data on specific CMS quality, cost and outcome measures by GPRO reporting type
Automatic enrollment in focused learning collaboratives that provide guidelines ad toolkits to help improve performance
Comparison of quality tiering scores by GPRO reporting type
Member case studies on successful practices
Additional dynamic, detailed reports with comparative data to further help members assess performance
Expanded networking opportunities including Webinars and symposiums
Staff who can help interpret your QRUR report and provide ad hoc custom analyses
Staff who can serve as liaisons to help facilitate questions and share feedback directly from CMS on your behalf
Please note, the only additional data needed to participate in this module can be pulled directly from your 2012 CMS Quality and Resource Use Report.
To learn more about the Quality & Efficiency Module please contact Shaifali Ray (312-775-4305).
UHC Bundles of Care Tool
The UHC Bundles of Care (BOC) tool links patient-level data from the UHC Clinical Data Base (CDB) and the Faculty Practice Solutions Center (FPSC) to allow monitoring of patient outcomes and utilization patterns beyond the inpatient setting. Each report offers over 100 bundle-specific metrics to assist with better understanding of variation, readmissions, complications, resource utilization, and length of stay. Designed for high-level, executive viewing, the dynamic dashboard puts all of these metrics in easy-to-understand graphs and charts.
BOC is provided free of charge to organizations that subscribe to both the UHC CDB and the FPSC. For additional background and to view sample reports, click here. For more information, contact Bob Browne.