PY2016 Keys to Successful Reporting_Part2.pdf

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Keys to Successful Reporting – Part II Sandra Adams, RN (CMS) Sue Hanlon (CSRA) Sarah Grallert, MPH (RTI) December 6, 2016 12:30pm – 2pm ET

Transcript of PY2016 Keys to Successful Reporting_Part2.pdf

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Keys to Successful Reporting – Part II

Sandra Adams, RN (CMS)Sue Hanlon (CSRA)Sarah Grallert, MPH (RTI)

December 6, 201612:30pm – 2pm ET

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Accessing Slides

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• Today’s presentation is available on the Shared Savings Program ACO Portal, Pioneer and Next Generation ACO Connect Sites.– Shared Savings Program ACOs: Please login to the ACO Portal

(https://portal.cms.gov) and click on today’s event.• ACO contacts maintained in the Health Plan Management System

(HPMS) have access to the SSP Portal and receive the ACO Spotlight newsletter.– If you do not have access to the Portal, please work with your ACO to

obtain the quality webinar slides and the ACO Spotlight newsletter for quality updates and webinar announcements.

• If you need more help to access these slides, please call the ACO Information Center: 1-888-734-6433 (select Option 2) or TTY/TDD 1-888-734-6563. They are available now to assist you. – You may email the ACO Information Center at [email protected]. – Hours are Monday through Friday, 8:30 a.m. – 7:30 p.m. ET.

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Purpose

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Provide an overview of the GPRO Web Interface reporting and resources This presentation is intended for ACOs

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Agenda

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1. Accessing the GPRO Web Interface2. XML for the GPRO Web Interface3. GPRO Web Interface Reports4. GPRO Web Interface Data Submission5. GPRO Web Interface Quality Reporting Q&A Document6. Reminders and Resources7. Q&A

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USING THE 2016 GPRO WEB INTERFACE

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GPRO Web Interface in QualityNet Secure Portal (QSP)

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• The GPRO Web Interface and all Physician Quality Reporting System (PQRS) secure applications are now in QualityNet Secure Portal (QSP)– Has a different look and feel– Enterprise Identity Management (EIDM) requirements remain the same

• Detailed instructions are in PQRS Portal User Guide – listed under User Guides on the PQRS Portal Page

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Accessing the GPRO Web Interface in QSP

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• You must navigate a series of QSP pages:– Starting from PQRS Portal Page, select Sign In button– Terms and Conditions page– Sign In page where you enter User ID (at least 6 characters)– Sign In page where you enter password and security code – QualityNet Secure Portal Landing page– PQRS Landing Page

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PQRS Home Page

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Terms and Conditions

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QSP Sign In Page

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QSP Two Factor Sign In

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QSP Landing Page

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PQRS Landing Page in QSP

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Other Changes Due to QSP

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• Changing Your Organization• User Accessibility

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Changing Your Organization

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User Accessibility

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• User Accessibility is no longer in GPRO Web Interface• Now available in QSP, under User Accessibility

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XML FOR THE GPRO WEB INTERFACE

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Overview of GPRO Web Interface XML

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• GPRO Web Interface XML documentation• Exporting XML files from GPRO Web Interface• Using Excel to view and modify XML files• Uploading XML files to the GPRO Web Interface• XML Element Overview

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XML Documentation

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• The 2016 GPRO Web Interface XML Specification link is available on the GPRO Web Interface page on the CMS Website: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/GPRO_Web_Interface.html

• The XML Specifications link will also be available:– In the GPRO Web Interface Online Help– In the GPRO Web Interface on the Upload Data and Export Data screens

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XML Documentation (cont.)

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• A PDF version of the online XML Specification can be downloaded from the Introduction page of the XML Specifications

• Note that download links for XSD and sample files are not available in the PDF version

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XML Schema Definition (XSD)

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• The XSD files can be downloaded from the XML Specification• Click the XSD Schema Definitions (XSD) link in Contents, then click the link to

download the XSD files using the instructions on the same page

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Exporting XML Files

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• The Export Data screen enables you to export XML files containing the data for your TIN– When the XML file is generated, it will contain the current data stored in the

database– The Export Data Set pull-down menu enables you to select which XML file to

generate: Patients, Patient Medications, Patient Ranking, Providers, or Clinics• After you generate an XML file, the file will be available for download from

the Export Data Results table.– The files in the table contain the data as of the time the file was generated– If data has been updated since the report was generated, you should generate

a new file

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Screenshot of the Export Data Screen

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Using Excel

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• Excel can assist with the following:– Creating an Excel Workbook for Patients XML and Patient Medications XML– Importing the XML File– Exporting the Modified Data

• For detailed instruction on how to use Excel, please refer to the following sections of the GPRO Web Interface XML Specification:

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Upload Data

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• The Upload Data screen enables you to upload XML files to update the quality measure data for patients in the TIN

• The screen provides a status indicating whether or not the upload was successful– If the XML file includes format or data errors, you can view the errors by

clicking on the Status hyperlink• You may upload both Patients and Patient Medication data sets

– The Patient Medication data set should only include the measure data for CARE-3 visit dates

– All other measure data should be uploaded in the Patients data set

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Screenshot of Upload Data Screen

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Select an Upload Data Set, select a Source File using the Windows File Selector, then click Upload

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XML Elements

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• Only include XML elements for disease modules, patient care, and preventive care measures that the patient is ranked in

• Any value uploaded in the XML file will overwrite existing values in the GPRO Web Interface database, but– A value in the GPRO Web Interface will not be replaced by a null or blank value in

the XML• If an XML element is included in the file but is an empty tag, the tag will not be

processed• If no data value is included, the tags are not required

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XML Elements (cont.)

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• If an optional XML element is included in the file, the elements must be listed in the specified order. Including XML elements out of order will prevent the file from being processed

• Appendix A – XML Elements for Patients XML File, and Appendix B – XML Elements for Patient Medications XML File in the GPRO Web Interface XML Specification lists all possible XML elements, in the required order, along with the allowable values for each element, for the 2 XML files

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XML Elements (cont.)

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• The XML Declaration must meet the following three requirements or the file will be rejected:– The XML Declaration must be on the first line– The XML Declaration may not contain any other XML elements– For the Patients XML, the XML Declaration must be an exact match for the valid

value specified in Appendix A – XML Elements for Patients XML File of the GPRO Web Interface XML Specification

OR– For the Patient Medications XML, the XML Declaration must be an exact match for

the valid value specified in Appendix B – XML Elements for Patient Medications XML File of the GPRO Web Interface XML Specification

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XML Elements (cont.)

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• All data for the patients in the group must follow the identification number and must be included between the opening <web-interface> element and the closing </web-interface> element

• The <group-tin> indicates the start of patient data and represents the Primary TIN for ACOs or TIN for PQRS group practices– The TIN in the file must match the TIN associated with the EIDM account of the

submitter

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XML Elements (cont’d)

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• The opening <patient> element and the closing </patient> element are used for each patient in the file. All data for each patient must be between an opening <patient> and closing </patient> element, but the <patient> elements may be repeated as often as necessary for additional patients

• The Medicare ID is the unique identifier for the patient and is a required data element. It may only be used once per patient in a Patients XML file

• The patient’s First Name, Last Name, Gender, and Date of Birth cannot be updated using XML uploads. These values may only be modified directly in the GPRO Web Interface

• The patient’s Rank cannot be updated using XML nor through the GPRO Web Interface

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GPRO WEB INTERFACE REPORTS

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GPRO Web Interface Reports

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• Within the GPRO Web Interface, there is a Reports menu item on Global Navigation Bar

• Many reports can be filtered, viewed online, and be printed • Many reports allow selection of a new report or selection of previously

generated reports– As reports are generated, please note the date they are generated for version

control

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GPRO Web Interface Reports

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• Totals Report – contains completeness information by measure– Summary section contains completeness info– Detail is a drill-down to patient specifics for selected completeness category (e.g.,

Incomplete)• Measure Rates Report – performance and completeness information for each

measure– For each measure in the report, lists the calculated value of critical components of

the performance equation– Report provides a drill-down to the patient data for the selected component

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GPRO Web Interface Reports

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• Patient Summary Report – the data currently in the database listed for the patient(s) selected– Organized similarly to the Patient Status Dashboard within the GPRO Web Interface– Includes the patient status in ranked modules

• Check Entries Report – the existing errors in the data uploaded or entered – Contains all patient data validation errors, warnings, and informational messages

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GPRO Web Interface Reports

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• Pre-filled Elements Report – a display of the original data value and the current data value for the pre-filled elements. – Pre-filled elements exist for CARE-3 and PREV-7 measures– The Pre-filled data value is pre-filled from Claims data

• Comments Report – provides the user comments for all the patients in selected measure modules

• Activity Log – comprehensive audit trail of all user activities performed for the organization during the submission period

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GPRO WEB INTERFACE DATA SUBMISSION

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Data Submission to CMS

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• The patient data you enter and save on the Patient List page or upload on the Upload Data page is saved to the database, but not sent to CMS until you click Submit Data to CMS:

–Note: Data saved but not submitted will not be counted • The Submit screen is the final step and notifies CMS that data submission for

your PQRS group practice or ACO is complete • Every time you update patient data you must submit again in order to send

CMS your most current data • You must perform your final submission before end of Submission Period –

03/17/2017 at 8PM EST

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GPRO Web Interface Submit Page

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Knowing Your Submission Status

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• The GPRO Web Interface provides you with your submission status in three separate places:

– On the Submit screen – In the Submission Status report– Above the GPRO Web Interface navigation bar

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Submit Status Report

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• The Submit Status Report confirms that your completed submission has been received by CMS

• The message indicating you have met the reporting requirements is specific to PQRS or ACO, but the remainder of the information is the same

• The report displays the date and time the Submit Data to CMS button on the Submit screen was clicked –The comments column indicates if the module meets the minimum requirements

• If the Submit Data to CMS button was not clicked, the report will indicate that the data has not been submitted

• If incomplete data has been submitted, the report displays a message indicating the submitted data does not meet the reporting requirements

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Submit Status Report

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Submission Status Messages

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• The GPRO Web Interface header information contains your data and submission status (new in 2017)– When you have not added or updated data:

– When you have added or updated data but have yet to submit that data:

– When there has already been a data submission and you have subsequently added or updated data without submitting it:

– When you have added or updated data and you have submitted that data to CMS:

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GPRO Web Interface User Guide

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• Detailed information on Reports and using the Submit function are in PQRS GPRO Web Interface User Guide – listed under User Guides on PQRS Portal Page.

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Q&A DOCUMENT

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GPRO Web Interface Quality Reporting Q&A Document

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• Available on GPRO Web Interface web page

• Detailed, searchable, list of Questions and Answers, compiled based on previously asked and also anticipated questions

• Make sure to consult any and all specifications and this Q&A document before submitting a question to the QualityNet Help Desk.

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GPRO Web Interface Quality Reporting Q&A Document

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• Document separated into various topic areas related to GPRO Web Interface quality reporting

• Example: if you click on At-Risk Populations: Mental Health….

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GPRO Web Interface Quality Reporting Q&A Document

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• …You’ll be taken to a section with questions on ACO-40: Depression Remission at Twelve Months

• You can then click the Table of Contents link at the bottom of the page to be taken back to the top of the document.

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GPRO Web Interface Quality Reporting Q&A Document: Examples

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• If you search for “3D mammography”, one of the results is an FAQ regarding the use of 3D Mammography in PREV-5:

• If you search for “order”, one of the results is an FAQ regarding whether it matters what order the data are entered into the Web Interface:

• If you search for “consecutively complete”, one of the results provides an explanation of this term and refers to an Appendix with a number of examples.

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Other Key GPRO Web Interface Resources

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GPRO Web Interface Supporting Documents and Measure Flows available on the GPRO Web Interface web page: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/GPRO_Web_Interface.html. Quick Reference Guides for each GPRO Web Interface measure available

on the SSP Portal, the Pioneer Connect site, and Next Generation ACO Connect site. Recordings of past GPRO Web Interface webinars available on Shared

Savings Program Portal, the Pioneer Connect site, and the Next Generation ACO Connect site.

Webinar Title DateQuality: GPRO Web Interface Measures for the 2016 Reporting Period, Part 1

May 19, 2016

Quality: GPRO Web Interface Measures for the 2016 Reporting Period, Part 2

June 2, 2016

2015 GPRO Reporting: Lessons Learned from the Audit“Audit Lessons Learned” August 15, 2016

EIDM for ACOs November 15, 2016

Keys to Successful Reporting, Part 1 December 1, 2016

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Upcoming Web Interface Webinars

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Webinar Date and Time

GPRO Web Interface Education & Outreach Kick Off December 15, 2016; 12:00-1:00pm ET

2016 Quality Measures Validation Audit Overview January 9, 2017; 2:00-3:00pm ET

Weekly Support Call (Q&A Session) January 19, 2017; 1:00-2:00pm ET

Weekly Support Call (Q&A Session) January 26, 2017; 1:00-2:00pm ET

Weekly Support Call (Q&A Session) February 2, 2017; 1:00-2:00pm ET

Weekly Support Call (Q&A Session) February 9, 2017; 1:00-2:00pm ET

Weekly Support Call (Q&A Session) February 16, 2017; 1:00-2:00pm ET

Weekly Support Call (Q&A Session) February 23, 2017; 1:00-2:00pm ET

Weekly Support Call (Q&A Session) March 2, 2017; 1:00-2:00pm ET

Weekly Support Call (Q&A Session) March 9, 2017; 1:00-2:00pm ET2016 GPRO Quality Reporting Lessons

Learned April 6, 2017; 1:00-2:00pm ET

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Reminders and Tips

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Set up your EIDM accounts as soon as possible Download your patient ranking files as soon as they become

available Take advantage of the GPRO Web Interface training environment Don’t wait until the last day to hit ‘Submit Data to CMS’ Make note of where documentation was found (if not obvious), in

case of selection for a Quality Measures Validation Audit

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Technical Assistance

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For questions related to the GPRO Web Interface, EIDM, quality measures, or PQRS payment adjustment:

Contact the QualityNet Help Desk and identify yourself as a representative from an ACO

E-mail: [email protected]: (866) 288-8912 | TTY: (877) 715-6222 | Fax: (888) 329-7377Monday – Friday 7 a.m. - 7 p.m. CT

Medicare Shared Savings Program E-mail: [email protected]

Pioneer Model: Email: [email protected]

Next Generation Model: Email: [email protected]

VM Help Desk Phone: (888) 734-6433 Option 3 or [email protected]

EHR Incentive Program Information Center Phone: (888) 734-6433 (TTY 888-734-6563)

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Questions?

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