Dr. Birnholz:
New rules issued by the Centers for Medicare and Medicaid Services are providing physicians with a smoother transition to the Quality Payment Program, or QPP. One critical part of this support involves technical assistance programs, which provide information and resources to physicians during and after this transition.
This is Inside Medicare’s New Payment System on ReachMD, and I’m Dr. Matt Birnholz. Joining me today to talk about these technical assistance programs are Dr. Edward Sobel and Temaka Williams. Dr. Sobel is Medical Director at Quality Insights, while Miss Williams is a Health Information Technology Advisor at Telligen.
Welcome to you both.
Dr. Sobel:
Thank you, and great to be here.
Ms. Williams:
Thanks for having me.
Dr. Birnholz:
So, Dr. Sobel, let me start with you. Can you give us some background as to what these technical assistance programs are and for whom they serve?
Dr. Sobel:
The technical assistance programs are to help physicians transition from the Medicare fee-for-service to a quality program. This will involve major changes to how physicians are practicing, and CMS wanted to help physicians make that transition. That’s what this program is all about.
Dr. Birnholz:
What about the QPP-SURS program, in particular? What is that?
Dr. Sobel:
The program is particularly focused on small practices. Physicians that, for instance, belong as part of a hospital system often have a lot of resources, assistance from within their community. The QPP-SURS particularly focuses on small practices, urban practices, practices out in rural areas, that don’t have the resources to make this transition.
Dr. Birnholz:
I see, so the point of this program is to help rural physicians and their practices qualify overall for QPP; is that right?
Dr. Sobel:
Correct, and also small practices where there may be 1 or 2 or even half a dozen physicians and they just don’t have the resources within their practice to make this transition, don’t have any experience or the help to make this transition across, and so this program is designed to help them.
Dr. Birnholz:
Excellent. Miss Williams, let me turn to you. Can you walk us through some of the eligibility criteria for physicians and small practices who are looking to participate in this program? And, of course, how they sign up is a big question that comes up.
Ms. Williams:
Sure, gladly. So, I’m going to speak to the eligibility requirements for the 2017 program year and the 2018 program year because they are slightly a little different. So, you’re included in the Quality Payment Program in 2017 if you are in an advanced APM or if you bill Medicare for more than $30,000 in Part B-allowed charges a year and provide care for more than 100 Medicare patients a year. So, the requirements for 2018 are very similar in that you are included in the program if you are in an advanced APM, and the only main difference to note is that you’re going to be required to bill more than $90,000 in Part B charges and to see or provide care for more than 200 Medicare patients a year. There are actually no signup requirements for the actual program. If you meet those requirements, then you are possibly eligible to participate in the program if you are a physician, physician assistant, nurse practitioner, clinical nurse specialist or certified registered nurse anesthetist.
Dr. Birnholz:
Great. So, Miss Williams, coming back to the technical assistance programs and their place in all of this, what benefits do they offer for physicians?
Ms. Williams:
The technical assistance that we offer is free to clinicians and practices, and honestly, that’s a price that you probably can’t beat. And also, besides technical assistance, the QIN-QIOs in your state have a multitude of initiatives that meet specific requirements of the Quality Payment Program, such as things like improvement activities and you earning percentage points towards your overall MIPS score. So, most of the feedback that I receive from providers is that it’s always reassuring to have someone you can direct your questions to and who can offer you that on-demand kind of education that is often times needed, and we’re definitely there to offer support to clinicians, and we share in their goals of being successful in the reporting program.
Dr. Birnholz:
And, Dr. Sobel, do you receive similar feedback from stakeholders about technical assistance programs?
Dr. Sobel:
Yes, we do. The physicians are appreciative. They often don’t understand the transition that’s going on and what they need to do, and having someone in the office who’s capable of explaining to them how they are going to make this transition and what resources they need to bring, physicians are really appreciative of that.
Dr. Birnholz:
Well, for those who are just joining us, this is Inside Medicare’s New Payment System on ReachMD, and I’m Dr. Matt Birnholz. I’m speaking with Dr. Edward Sobel and Temaka Williams about technical assistance programs available to physicians for helping navigate the Quality Payment Program.
So, turning to my guests’ respective workplaces, I’d like to get a better sense for what Telligen and Quality Insights bring to the table for technical assistance.
Dr. Sobel, let me start with you at Quality Insights. What’s happening there, and what do they bring to the technical assistance program?
Dr. Sobel:
Well, we bring to the program years of experience in helping physicians improve the care that they deliver. We have been at this for years for CMS, but more particularly to this program, our staff, our advisors who go out have been trained in this program. They understand what the practice needs to do. They have a format that’s followed. We have expertise from specialty groups and other resources that really would not be directly available to physicians except for through this program, and it really provides a complete package to help the practice move towards the new Medicare payment programs.
Dr. Birnholz:
Great. And, Miss Williams, what about Telligen?
Ms. Williams:
The services we offer take shape on various levels. They could be group webinars, in-person presentations, telephone support to virtual support or in-person assistance. For example, there’s a practice in the Chicagoland area that I will visit this afternoon, and we’re going to review their MIPS dashboard and their quality measures, and I’ll help them compare their data with the CMS benchmarks in the program, and so from that they can get a better idea of the 6 quality measures each of their physicians will want to report during the attestation period, and that can better help them maximize their score. And then, in addition to that, I can also be available to offer support during the attestation, either virtually or in person. And I have other practices where their needs are a little different. They may reach out to me via e-mail about policy questions or clarifying some requirements for one of our 4 QPP performance categories, so it’s really customized, and it depends on the needs of the practices. So that’s kind of how we gauge technical assistance to providers.
Dr. Birnholz:
And that assistance based on the particular needs, the nuanced needs for each practice and provider, helps lead to the next question for me, which is trying to walk through a typical encounter of what technical assistance looks like. And, Miss Williams, you gave us a good idea of how one of these encounters in the Chicagoland area has looked like, and I want to turn to Dr. Sobel then to also provide some thoughts from his vantage point. Do these encounters occur online, over the phone, Pony Express, all of the above? It sounds like there’s a real variety of ways in which technical assistance can come out to play and help out clinicians who are in need. Can you talk about that?
Dr. Sobel:
The answer to the question is actually all of those. We have a variety of ways. We initially meet with the practice. We’ll sit down with the physicians and the staff and begin to work on a plan going forward. Further contact may come through the webinar that was mentioned, or it may come through documents, reviewing resources, seeing what the practice is capable of doing. Very often the practice may have resources that they are unaware of. I think particularly of one practice, their EHR—they were unaware that they actually had the ability to get reports out of their EHR, so they basically were using it as an electronic method of recording visits, but all of that information, all of those data points, they did not know that they could retrieve all that and use that to improve the quality of the care that they delivered to their patients, and we can come in and show practices how to do that. So, that would be something similar that we would be doing.
Dr. Birnholz:
Now, Dr. Sobel, both you and Miss Williams alluded to virtual assistance, which makes intuitive sense in this day and age for a technical assistance program, but I’d like to center for a moment on virtual groups, in particular, and how they tie into this discussion. So, do TA programs help clinicians form these virtual groups?
Dr. Sobel:
Yes, we can do that with them. This can be valuable for small practices, 1- or 2-clinician practices who would like to pool their resources, who may have a common bond together in practice in a community, but they are really individual practices, and so, it’s possible to form a virtual group and gain numbers and share resources, so that’s available to practices.
Dr. Birnholz:
And, Miss Williams, anything to add to that?
Ms. Williams:
Yes, I think in addition to some of the technical assistance we offer is we can help practices determine if they are eligible to join or form a virtual group before they start allocating time and resources into that area. So, if they reach out to their technical assistance area, we can actually look that up and let them know about the requirements as well.
Dr. Birnholz:
Lastly—and I’ll pose this question to both of you as an actionable takeaway for our audience—where should we call or look up resources to get hands-on support? Miss Williams, let me start with you.
Ms. Williams:
There is a link to the resource library documents outlined on qpp.cms.gov, which is a very good website to go to for assistance and resources. If you go to that website, there’s also a document that will list out all of the TA that’s available in your service areas. If you are in the Telligen service areas, you can reach Telligen via the website at telligenqinqio.com or telligenqpp.com. You can also go to our Twitter page. Our Twitter handle is @telligenqin.
Dr. Birnholz:
Excellent. Dr. Sobel, how about resources from your end?
Dr. Sobel:
In the Mid-Atlantic region, Quality Insights is reachable at qualityinsights—one word—.org.
Dr. Birnholz:
Well, with that, I want to thank my guests, Dr. Edward Sobel and Temaka Williams. We’ve been talking about technical assistance programs for QPP, and to my distinguished technical assistance programs masters, my thanks to you both.
Ms. Williams:
Thank you.
Dr. Sobel:
Glad to be here and to be able to help the clinicians across the country in exploring this new idea.
Dr. Birnholz:
To access this interview and other related content with the AMA, visit ReachMD.com or download the ReachMD app. I’m Dr. Matt Birnholz, as always, inviting you To Be Part of the Knowledge.
