Q&A with Megan Fisher: Quality Payment Program

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Megan Fisher, CMS

Megan Fisher, RN, MSN, MBA is a nurse consultant at the Centers for Medicare & Medicaid Services (CMS). Her primary responsibilities include serving as the subject matter expert for Quality Reporting for the CMS Quality Improvement Organization (QIO) Program’s Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs). Fisher also works with the Quality Payment Program Engagement team to provide a technical assistance perspective when needed. Prior to joining CMS in 2014, Fisher worked in the Clinical Documentation Excellence (CDE) Program at Johns Hopkins Hospital in Baltimore, Maryland. She started as a Clinical Documentation Specialist and transitioned into the Manager of the Johns Hopkins Hospital (Main Campus) and Johns Hopkins Bayview location for the last year and a half. Before working in CDE, she was a post-partum nurse for almost five years at Mercy Medical Center in Baltimore. She earned a bachelor’s and master’s degree in nursing from the University of Maryland at Baltimore, and a master of business administration degree in business administration and management from the University of Baltimore.

Q. Can you give us a brief update on CMS’ Quality Payment Program?

In June, we released the Proposed Rule for Year 2 (2018) of the Quality Payment Program, which included a 60-day comment period that recently closed. The feedback we received on the 2017 Proposed Rule was invaluable, so we looked forward to hearing from clinicians, partners, stakeholders and others on our proposals for Year 2, and also on the ways that we can continue to ease burdens.

We are, however, still in the midst of the first year—also known as the “transition” year—of the Quality Payment Program. As we move closer to the end of the transition year on December 31, 2017, it is very important to remind clinicians who are included in the program that it is not too late to participate and avoid a negative payment adjustment. In fact, clinicians have the flexibility to decide how and when they will participate. Clinicians who are included in the Merit-based Incentive Payment System (MIPS) track of the program still have the opportunity to submit 90-days (or a partial year) of 2017 data, or submit a minimum amount of data making 2017 a “test” year. However, please be mindful that October 2, 2017 is the start of the last 90-day reporting period in 2017.

There is plenty of support available to help clinicians get started in the Quality Payment Program at absolutely no cost to them. I encourage those interested in learning about the program to visit qpp.cms.gov for excellent educational resources. We also have free on-the-ground support available immediately through our Technical Assistance initiative to clinicians who are included in the program. Clinicians can find the contact information for their local Technical Assistance organization at qpp.cms.gov

Q. What has the general feedback been thus far from clinicians who are participating in the program?

We have received a variety of feedback from clinicians at all levels of participation. We are receiving participation and eligibility questions from those who are new to participating, and more in-depth questions from larger practices and/or those clinicians who have previously participated in quality reporting, such as scoring methodologies and measure specifications.

Q. How are the QIO Program’s Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) helping clinicians succeed in the Quality Payment Program?

The QIN-QIOs are employing a number of different approaches to help clinicians prepare for and participate in the Quality Payment Program. The QIN-QIOs are providing broad outreach and education to generate an awareness and understanding of the program. They have developed unique websites, portals, help centers and resources to support their educational effort. They are partnering with state and local medical societies and associations, as well as local organizations to help outreach and engage clinicians. They are successfully reaching out— the majority within a few hours—to those clinicians who have been referred to their organization by the Quality Payment Program Service Center. Lastly, the QIN-QIOs are working very closely with the other organizations supporting the Technical Assistance initiative to connect clinicians to the resources and support that is best for their practice.

Q. What types of resources are available for clinicians who want to learn more?

We have a variety of helpful resources available on qpp.cms.gov as well as links to accredited Quality Payment Program courses that are available on the Medicare Learning Network (MLN).

Some recent resources on the qpp.cms.gov resource page include A Quick Start Guide to MIPS; a Technical Assistance Resource Guide; Advancing Care Information Measure Specifications; and An Introduction to Group Participation in MIPS in 2017.

Four new, online and self-paced courses on the Quality Payment Program are now available through the MLN Learning Management System. Participants can choose from four courses:

These courses are designed as an evolving curriculum on the Quality Payment Program, where participants will gain knowledge and insight on the program while earning valuable continuing education credit. Clinicians can check back with us regularly for updates on new courses. First-time participants will need to register for the MLN Learning Management System. Once registered, you will be able to access additional courses without having to register. For information on how to log in or find training, you can visit our MLN Learning Management System FAQ sheet.

Q.  Anything else you would like QIO News readers to know?

Feedback is very important in helping us continually improve the Quality Payment Program. Help us identify the aspects of the program that are working, as well as areas that we can improve. The Quality Payment Program is a big change, so we will continue to go slow and use the feedback we receive to help reduce burden and make it easier for clinicians to participate and put their patients first.