NCMS Morning Rounds 11-8-19

Happy Friday! Enjoy your end-of-week

NCMS Morning Rounds.

Nov. 8, 2019

NC ACO Council Focuses on Person-centered, Provider-engaged Care

The NC ACO Council, which brings together North Carolina accountable care organizations (ACO) twice a year to share best practices and opportunities for improving outcomes in accountable care, held its 4th quarter meeting yesterday at the NC Healthcare Association in Cary.

About 40 representatives from a variety of ACOs from throughout the state heard three presentations around the theme ‘Focusing Forward: Person-centered, Provider-engaged.’

Selam Wubu, MPH, director of the American College of Physicians’ (ACP) Center for Quality, spoke to the group on ACP Advance, a physician coaching resource offered to physicians to help them be successful in quality improvement activities. Wubu spoke about the barriers to success, which include time and access to actionable data. She said physicians aren’t looking for another ‘toolkit,’ to help them — “Toolkit automatically results in an eyeroll,” she said.

Instead, ACP Advance provides specially trained physician coaches who provide peer to peer contact, usually virtually, offering a jargon-free curriculum over a 12-month period. The ACP can provide a curated assortment of resources depending on the specific needs of the practice and access to a virtual community that facilitates sharing of best practices.

Anyone, not just ACP members have access to this coaching. Learn more.

Jami Berger, BSN, RN, MBA, the executive director of the Arizona Care Network (ACN), shared information about the innovative ACN Care.Wallet. This blockchain technology offers physicians timely, transparent and meaningful information about quality measures on their cell-phone as well as how much they are earning through the savings they generate. She termed it “innovation that treats what ails providers most.”

In the coming weeks ACN plans to roll out a patient version that offers patients a ‘care wallet’ that includes their ID card, easy access to appointments and referrals and, if they receive transportation to appointments as part of their benefits, a quick way to request a ride through Uber or Lyft.

Rebecca Onie, JD, and Rocco Perla, EdD, co-founders of The Health Initiative USA  spoke about Quality Measures and Financial Incentives for Addressing Social Determinants of Health. In addition to sharing the results of focus groups they held in North Carolina that showed that both average citizens of all political persuasions and physicians tend to agree on what drives health.  Often — around 70 percent of the time — is not what happens in the medical clinic but factors like food insecurity, housing and transportation deficits among other non-clinical issues.

Perla recounted a conversation he had with the architect of ‘Triple Aim,’ who told him that originally there was just one aim — health — but because the focus was on the health system, care and quality were included and thus it became the Triple Aim.

Onie and Perla encouraged the NC ACO Council members to ask the questions around how to truly pursue ‘health’ for their patients — how best to measure the outcomes and financial impact of addressing the social determinants of health within the existing framework. Several Council members commented on the challenges they face in doing this and others offered examples of how they address these needs, including screening for hunger, domestic violence and other issues that effect health outside of the clinic and connecting the patient to community resources, something the state is pursuing through its NCCares360 initiative.

Each quarter the NCMS convenes either the NC ACO Council or the NC Population Health Collaborative to bring together a community of stakeholders in the move to value to discuss and share the challenges and opportunities they face. Watch your NCMS Morning Rounds for information about the next meeting, which will be the NC Population Health Collaborative on Thursday, March 12, 2020.

AMA’s Health Workforce Mapper Offers Valuable Information

The AMA’s Health Workforce Mapper (HWA) gives physicians, physician assistants and other members of the health care team information—using reliable AMA, Centers for Medicare and Medicaid Services (CMS) and Center for Disease Control and Prevention (CDC) data sources—to identify health professional shortage areas, hospital locations, as well as other related workforce trends. The tool can help new physicians close the gap in patient access to care by giving residents and medical students access to important information that allows them to see, from state-to-state, where there are shortages in certain medical specialties.

This interactive tool graphically illustrates the geographic locations of the health care work force in each state – including all physician specialties and subspecialties included in the AMA Masterfile. Recently, addiction medicine was added as a new physician specialty.

The “Population Health Explorer” feature of the mapper offers data on a variety of population health factors, including health care access and quality, health behaviors such as smoking and alcohol use, demographics, and social environment factors. With this new feature, you can not only see where the physicians of the country practice, but overlay where the patients are, and what factors influence their health and access to care.

The HWM was developed in collaboration with the American Academy of Family Physicians Robert Graham Center and HealthLandscape, and funded through the Scope of Practice Partnership.

Access this free, interactive tool.

Practices Affected by Hurricane Dorian Get MIPS ‘Break’

In response to the Federal Emergency Management Agency (FEMA) designation of Hurricane Dorian as a national disaster, the Centers for Medicare and Medicaid Services (CMS) has determined that the automatic extreme and uncontrollable circumstances policy will apply to Merit-based Incentive Payment System (MIPS) eligible clinicians in FEMA-identified North Carolina and South Carolina areas.

MIPS eligible clinicians in these areas will be automatically identified and receive a neutral payment adjustment for the 2021 MIPS payment year. During the data submission period for the 2019 performance period (January 2, 2020 to March 31, 2020), all four performance categories for these clinicians will be weighted at zero percent, resulting in a score equal to the performance threshold.

However, if MIPS eligible clinicians in these areas choose to submit data on two or more performance categories, they will be scored on those categories and receive a 2021 MIPS payment adjustment based on their 2019 MIPS final score.

The automatic extreme and uncontrollable circumstances policy will not apply to MIPS eligible clinicians in MIPS Alternative Payment Models (APMs) who are subject to the APM scoring standard for the 2019 performance period, or to those participating in MIPS as groups or virtual groups.

For More Information please reference the Extreme and Uncontrollable Circumstances Overview section on the MIPS > About Exception Applications page. You can also contact the Quality Payment Program Service Center at (866) 288-8292/TTY (877) 715-6222, Monday through Friday, 8 a.m. to 8 p.m. or by email at To receive assistance more quickly, consider calling during non-peak hours—before 10 a.m. and after 2 p.m.

In the News

Why Legal Questions Surround the Use of Voice Technology in Care Delivery, HealthData Management, 10-16-19

Learning Opportunity

The 2019 PCPI Conference: The Quality Landscape: Charting the Course for Success, will be held Nov. 10-12, in Chicago. The conference will focus on population and patient-centered care and utilizing data for maximum impact. It will feature a range of talks, discussions and networking opportunities on furthering the reaches of quality with experts and thought leaders in measurement, registries and quality improvement. Learn more and register.


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