January 22, 2021

Hard to Catch Up: Don’t Forget Quality Improvement and Reporting Requirements throughout COVID-19

With the COVID-19 pandemic in its ninth month in New York City, primary care practices have needed to become masters of everything. They are concurrently responsible for regulatory reporting to Medicare, Medicaid, and health plans, developing COVID-19 testing protocols, planning for potential vaccination distribution, delivering telehealth services, restarting in-person services, and managing new remote workforces. The challenges continue to grow, especially as the city enter a second wave of the pandemic. 

Throughout this time, PCDC staff have been working with practices to maintain their access to incentive payments, including individual health plan pay-for-quality contactsMedicare’s Merit-based Incentive Payment System (MIPS), Patient-Centered Medical Home (PCMH), and Meaningful Use (MU). As many of these requirements are based on in-person activity, providers have had to be creative in how best to meet the competing demands of these programs. 

Isaac Kastenbaum, Vice President of Clinical and Quality Partners at PCDC recently sat down with a subset of the Clinical and Quality Partners’ team to talk about their experience supporting practices through COVID-19 

The team suggested a few key considerations for practices to keep front-and-center during the pandemic: 

  1. Don’t let your Meaningful Use or MIPS reporting be the first thing to go while in crisis mode; these programs require a year’s worth of data to successfully meet the thresholds. The financial impact won’t be immediate, but you’ll want to secure future year’s incentive payments. 
  2. Make sure you keep routine meetings to review essential quality measures. Your agenda should include the core measures for MU and MIPS. Work with your EHR / reporting vendor to ensure these measures are included in a standard dashboard.
  3. If you’re involved in testing or other public health responses, make sure you double-check the denominators for your quality measuresIt’s possible one-time testing patients might be included in your metrics. 
  4. Don’t completely drop patient experience surveys; this can be an early indicator of how things are working when you switch between telehealth and in-person visits.  

Maia Morse, Senior Program Manager, noted, “Practices have been good about maintaining chronic disease management activity because those patients are at higher risk for COVID-19but preventative screenings have gone by the wayside when [practices] don’t know whether they’ll be remote or not next week.” “It can be hard to recover form a year’s worth of missing documentation,” stated Deborah Johnson-Ingram, Senior Directorwhen discussing an independent practice that the team was supporting.  

These are challenging times – recent estimates show ambulatory volume returning to approximately 80%+ of pre-pandemic levels, but practices are still struggling to maintain the necessary revenue to cover their expensesThe pandemic is far from over, but practices are continuously evolving and being creative in their solutions to meet the needs of their patients. We’re observing and learning a lot from each partner – whether FQHC, independent practice, or behavioral health provider – and using those stories to inform our advocacy workOur resiliency work is focused on ensuring local practices can learn from those lessons, too. 

If we can be of assistance to your practice in managing your PCMH, MU, MIPS, or health plan reporting or to think through how best to deliver service during the pandemic, please don’t hesitate to reach out to us.