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preparing for apm participation

Results Relating to Aims

  • Understand the requirements and options for participating in MIPS (guide here) and various APMs (guide here)

  • Gaining the support of internal staff is critical to APM success (one-pager here) and it is imperative to go into external negotiations prepared (one-pager here)

Results Related to Aims

Results Relating to Aims

Quality and Resource Use Reports (QRUR)

Patient and Family-centered Care Design

Patient and Family Engagement

Team Based Relationships

Population Management

Practice as a Community Partner

Coordinated Care Delivery

Organized, Evidence-Based Care

Enhanced Access

Continuous, Data-Driven Quality Improvement

Engaged and Committed Leadership

Quality Improvement Strategy

Transparent Measurement and Monitoring

Optimal Use of HIT

Sustainable Business Solutions

Strategic Use of Practice Revenue

Workforce Vitality and Joy in Work

Capability to Analyze and Document Value

  • Healthcare Finance 101 – Massachusetts General’s presentation on key financial concepts relevant to healthcare providers

Operational Efficiency

  • JIT in Healthcare: An Integrated Approach – An International Journal of Advances in Management and Economics research article on how to utilize JIT strategies can be applied to lower costs and increase quality in service industries

Recommended CLinical Resources

Cardiovascular Treatment & Management Protocol

Pulmonary Clinical Protocol

Gastrointestinal / Cancer Screening

The Wellness Network - Heartcare Channel Resources

Educational Awareness Resources

Quality Payment Program Toolkit

Merit-Based Incentive Payment System (MIPS)

2017 Quality Performance Category

NCQA Patient-Centered Medical Home Recognition Program

Behavioral Health and Substance abuse Disorders

QualityImpact recommends following the CDC's Recommendations for Determining when to initiate or continue opioids for chronic pain. Below is a summary and suggested resources to support your implementation. View CDC guidelines here.

Determining when to Initiate or Continue Opioids

1. Non-opioid pharmacologic or non-pharmacologic therapy

Encourage communication within practice about opioid prevention and management, however communication approach is left up to practice

2. Establish and measure goals for pain and function

Recommend using PEG pain screening tool

3. Discussing benefits and risks & Patient contracts

Recommend using Patient-Provider Controlled Substance Education Agreement

Opioid Selection, Dosage, Duration, Follow-up and Discontinuation

4. Use Immediate-release opioids when starting therapy for chonic pain instead of (ER/LA)

5. Start low (less than 50MME/day) and go slow (avoid increasing to greater than 90MME/day)

Follow state guidelines

6. Acute pain, prescribe no more than needed and do not prescibe ER/LA opioids for acute pain

Follow state guidelines, with special consideration for using them for shortest duration since there is clear evidence that prescription duration has direct impact on long term outcomes (i.e. abuse)

7. Follow-up and re-evaluate risk of harm; reduce dose or taper and discontinue if needed

Utilize the PEG tool to evaluate benefit, harms at every visit

Assessing Risk and Addressing Harms of Opioid Use

8. Evaluate risk factors for opioid-related harms

Provide naloxone as co-prescription with every opioid and use Opioid Risk Tool (ORT) prior to starting patients on any chronic opioid treatment

9. Check PDMP for high dosages and prescriptions from other providers

Follow state PDMP requirements

10. Use urine drug testing to identify prescribed substances and undisclosed use

Recommends use of UDS, included in patient education agreement and define frequency by clinic - for more information on urine drug screening, see what our advisers recommend here.

11. Avoid concurrent benzodiazepine and opioid prescribing

Limit co-prescribing unless provider deems it appropriate and documents the medical reason(s)

12. Arrange treatment for opioid use disorder if needed

Offer MAT in conjunction with CBT and other behavioral therapies in PCP setting, or arrange for evidence-based treatment in the community

Getting started guides

QualityImpact has compiled best practices and recommendations in a succinct manner for a range of topics.

Patient Management

1. Annual Wellness Visit

2. Access to Care

3. Care Management

4. Team-based Care

Practice Operations

1. Advanced Payer Contracting

2. Business Acumen

3. Data-driven Population Management

4. Risk Stratification