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2022 | HFSA

CMS Field Testing New Episode-Based Cost Measures January 10-February 25

Practice News Advocacy

The Centers for Medicare & Medicaid Services (CMS) and its contractor, Acumen, LLC, will conduct field testing from January 10 to February 25, 2022, for 5 new episode-based cost measures. The measures will undergo field testing before consideration of their potential use in the cost performance category of the Merit-based Incentive Payment System (MIPS). These measures, which were developed with input from various specialty societies, including HFSA, include a Heart Failure cost measure that may be of significant interest to HFSA members. 
 
Field testing is an opportunity for clinicians and other stakeholders to learn about episode-based cost measures and to provide feedback via an online survey on the draft measures. Conducting field testing helps Acumen to assess each measures’ importance, scientific acceptability, and clinical validity. Feedback shared on these draft specifications will be used to consider potential measure refinements following field testing.
 
Clinicians and clinician groups attributed at least 20 episodes for the Heart Failure measure will receive a Field Test Report with information about their cost performance.
This information will be for field testing purposes only.
 
The measurement period for these Field Test Reports is January 1 to December 31, 2019. The draft measure specifications for each measure will be available on the MACRA Feedback Page once field testing begins. Details about how to access the Field Test Reports are provided below. 

How to Provide Feeback 

All stakeholders—regardless of whether you receive a report—are invited to provide feedback. You can provide feedback on the draft measure specifications through this online survey once the field testing period begins. A document containing specific questions about the measures for stakeholders to reference while reviewing the materials will be available on the MACRA Feedback Page

  • The survey will open on January 10 and close at 11:59pm ET on February 25.
  • All survey questions will be optional. Participation is voluntary, and all feedback may be submitted anonymously. 
  • You may attach a comment letter (as a PDF or Word document) in addition to or as an alternative to responding to the survey questions.  
  • The link to the survey, which does not require a login, will be included in the Field Test Reports and across other supplemental documentation so that you will be able to navigate easily to it from the documents you review.

Stakeholder feedback on cost measures is vital in the measure development process and will inform the final specifications of the 5 episode-based cost measures currently under development. We hope you will consider sharing your input.   

Field Testing Materials

Field testing materials will be available on the MACRA Feedback Page at the start of field testing, including: 

  • Specifications for the measures undergoing field testing 
    • Draft Measure Methodology for each measure
    • Draft Measure Code Lists with codes and logic for each measure
  • Informational field testing documents 
    • Frequently Asked Questions (FAQ) document
    • Measure Development Process document 
    • Measure Testing Form for each measure and National Summary Data Report, which provide analytic results about the measures
    • Mock Field Test Reports
    • Questions for Field Testing Measure Specifications document which contains a list of the survey questions for stakeholders to reference while reviewing materials
  • Documents about accessing the Field Test Reports  
    • Quality Payment Program Access User Guide with guidance on how to create an account
    • Field Test Report User Access Guide with information on how to access the report on the Quality Payment Program website

Cost Measures Field Testing Webinars

CMS and Acumen will post a recorded field testing webinar to provide information on the cost measures undergoing field testing. The webinar will be available to stakeholders on the QPP Webinar Library once field testing begins.
 
Accessing the Field Test Reports

You or your group’s authorized representative can access the Measure Field Test Report(s) at https://qpp.cms.gov/login using a Quality Payment Program website account. If you do not have an account, you will need to register for a HCQIS Access Roles and Profile (HARP) account in order to sign in. [1] Once you have access, you can connect with your organization by navigating to the “Manage Access” tab of the Quality Payment Program website. If you’re part of a clinician group, you’ll select the “practice” organization type, and if you’re an individual clinician, you’ll select the “individual clinician” organization type.
 
The Quality Payment Program Access User Guide provides more information on how to sign up for a Quality Payment Program account and how to connect with the appropriate organization. [2]
 
Note: Field Test Reports are separate from the Quality Payment Program Performance Feedback Reports, though both reports are made available through this website.
 
Groups are identified by their Medicare billing TIN. A group consists of two or more eligible clinicians, as identified by their NPIs that bill under the same TIN. A group will receive a Field Test Report if the TIN is attributed the minimum number of cases for a measure among all NPIs billing under the TIN. For a QPP account, a group can have either of the following roles:

  • Security Official
  • Staff User

Users who have a Security Official role will be able to see all TIN- NPI reports within their TIN, as well as the TIN’s overall report, so it’s a role that is more appropriate for someone who is in an administrative position at the TIN. Each organization must have a Security Official role before any other group members can request a Staff User role. The group-level users (i.e., Security Official and Staff Users) have access to the group practice’s reports and the individual-level reports for the solo practitioners within the group practice.
 
An individual eligible clinician (or a solo practitioner) is identified by a single NPI that bills under the TIN. They’ll receive a Field Test Report if the NPI is attributed the minimum number of cases for a measure. Clinicians looking to view only their TIN-NPI report should connect to the individual clinician organization type, regardless of whether they’re a part of a group practice or they practice on their own. The Field Test Report Access User Guide available on the MACRA Feedback Page at the start of field testing provides more information on accessing a Field Test Report.

Project Background

To learn more about the episode-based cost measure development process, please refer to the Measure Development Process document available on the MACRA Feedback Page at the start of field testing.
 
The Heart Failure measure represents Wave 4 of CMS/Acumen’s episode-based cost measure development. This process began in December 2020 and is scheduled to conclude in May 2022. The workgroups providing input on the five Wave 4 measures undergoing field testing in 2022 represent a total of 86 members affiliated with 66 professional societies, including HFSA. Summaries from workgroup meetings held to-date can be found on the MACRA Feedback Page.

Questions? 

If you have questions regarding anything in this article, contact Rachel Groman, MPH, Vice President, Clinical Affairs and Quality Improvement, Hart Health Strategies, Inc. at rgroman@hhs.com.


 

 [1] CMS, “QPP Account,” Quality Payment Program, https://qpp.cms.gov/login?page=register  
 [2]  CMS, “Quality Payment Program Access User Guide,” Quality Payment Program, https://qpp-cm-prod-content.s3.amazonaws.com/uploads/335/QPP%20Access%20User%20Guide.zip