Looking for a few good family doctors to help improve a quality measure

Tags: Medicare quality measure, Mathematica Policy Research

By Jonathan Nelson

Want some extra cash and a chance to help refine and validate a Medicare quality measure? Check out this email we recently received from Shari Glickman, a program analyst with Mathematica Policy Research, Inc.


Hello. I am writing in hopes you will share this email with the practices in your state membership.

The Centers for Medicare & Medicaid Services is currently seeking primary care practices to help test a potential change to an electronic clinical quality measure related to clinician referrals. The measure is entitled “Closing the Referral Loop: Receipt of Specialist Report” (CMS50v5). The benefit to practices testing this measure is they will directly contribute to the refinement and validation of an eCQM that CMS uses in its quality reporting programs. In addition, honoraria will range from $2,000-$4,000, depending on practices’ level of testing participation.

Interested practices should be reporting this eCQM under the Merit-Based Incentive Payment System or another CMS quality improvement initiative. Data elements should be documented in structured fields of the electronic health record or electronic medical record, and practices should be able to extract patient-level information about data elements. Under the current measure specification, the denominator includes the first referral for each patient who was referred to other clinicians during the measurement period. Under the proposed revisions to the measure, the denominator includes all referrals during the measurement period.

The testing activities will involve practice staff—both clinicians and, if applicable, practice managers—speaking with a project team from Mathematica Policy Research, a CMS contractor, about the practices’ workflows and the data elements they capture in their EHRs. Practices will be asked to submit an extract of de-identified patient-level data from the EHR, including all of the data elements required to calculate the current and proposed revised versions of the measure. Additionally, practices will be asked to work with the Mathematica project team who will abstract data from a sample of charts to verify the accuracy of the data elements. The de-identified patient-level data will be shared with Mathematica for analysis. Practices will receive feedback from Mathematica about their data, including rates of referrals and the proportion of referrals with follow-up information returned to the referring provider by the specialist. None of the testing activities will involve an audit of the practices’ performance scores reported to CMS quality reporting programs.

For more information or if you are interested in assisting with this activity, please contact Shari Glickman at SGlickman@mathematica-mpr.com and Omoniyi Adekanmbi at OAdekanmbi@mathematica-mpr.com

Shari Glickman, MSSW, PMP
Principal Program Analyst | Mathematica Policy Research, Inc.
P.O. Box 2393 | Princeton, NJ 08540-2393
Office:  609-675-2383 | Mobile: 301-351-5530

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