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A professional practice transformation consultant, David H. Smith has 20 years of experience with health information technology (HIT). Trained in practice coaching for Primary Care Medical Home implementation by the National Committee for Quality Assurance and TransforMED (part of the American Academy of Family Physicians), he has participated in national TransforMED practice transformation efforts and the national Beacon Community effort to transform use of HIT to improve quality of care. He is trained in project management and has expert knowledge of HIT and electronic health record certification standards.

Quality Improvement Fundamentals and MIPS

Stethoscope and money

Connecting basic quality improvement (QI) work to new government programs can be a bit of work. A case in point is the Merit-based Incentive Payment System (MIPS), one of two payment tracks for Medicare Part B clinicians under the Quality Payment Program.

If your practice takes part in an Advanced Alternative Payment Model (AAPM), you don’t necessarily need to participate in MIPS unless your AAPM requires it. Most AAPMs do require participation in the same requirements of the MIPS program. So, in most cases you’ll need to participate in MIPS (or prescribed components of it for your AAPM) in 2018 to avoid a negative payment adjustment. And starting in 2020, the cost of care you provide will affect the way you get paid for Medicare services, based on your MIPS performance in 2018.

The four variables of MIPS―Costs, Quality Reporting, Advancing Care Information and Improvement Activities―will all count toward a performance score that can swing your payment as much as 5 percent downward or upward, depending on your performance. Costs will account for only 10 percent of your overall performance score in 2018 (for 2020 implementation), but will increase to 30 percent of your score in 2019 (for 2021 implementation), as it affects your payment fee schedule from Medicare.

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Focus on the fundamentals

Kids playing basketball

Round the back, under the legs, and...It's a miss!

Don't you love March Madness? Go Cougars, Ducks, Beavers, Lobos, Bruins, Trojans, Rebels and Utes (if your team is missing, please add them somewhere in between the Cougars and the Utes).

I love to play and watch basketball. From ages 13-15, I would get up at 6 a.m. nearly every day to practice the fundamentals of shooting foul shots and layups at the hoop outside my home. With the ultimate goals of scoring and winning the game, the fundamentals are the best way to ensure that the ball will go in the hoop.

I love quality improvement too. You set your aim and goal; create your plan; use outcome, process and balance measures to guide the effort; put it in practice; and study the outcomes. When it works, you save people from mistakes, help them realize how to manage their care better and catch people before they fall through the cracks.

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