In October 2016, the Department of Health and Human Services (HHS) issued its final rule implementing the Quality Payment Program that is part of MACRA (Medicare Access and CHIP Reauthorization Act) which had bipartisan support and approval of congress. The purpose is to provide new tools and resources to patient and deliver best possible highest value care.
I will highlight some of the common quality metrics that is required to be submitted by wound care and hyperbaric physician in upcoming issues of Oxygen Observer – Newsletter.
HgbA1c for Diabetics
Quality metric Report Definition: Percentage of patients 18-77 years of age with diabetes who had hemoglobin A1c > 9 % during the measurement period.
Why is this important?
Diabetes 2030 article illustrates that diabetes presents a major health crisis in terms of prevalence, morbidity and costs. Insights from the updated projections show that crisis will worsen significantly over the next 15 years. There are several reasons cited including 1. An aging population that is overall living longer. 2. The significant decline in the incidence of deaths caused by diabetes which implies that more diabetic patients with significant chronic co morbidities. 3. The increasing population of African American and Hispanic Americans who are at higher risk of diabetes. 4. Dramatic increase in type 2 diabetes in children and adolescents. 5. Increasing obesity may lead to increasing diabetes.
Physicians should understand importance of identifying adults with prediabetes. Physicians should focus on education and awareness as one in 4 Americans do not know that they have prediabetes and it can lead to life threatening complications. There is also huge gap between a recommended guideline and current practice. (I.e. 2014 study by li et al found that only 6.8% of privately insured, newly diagnosed adults participated in Diabetes Self – Management Education and Training within the first year after diagnosis, even though it was free and strongly recommended). The cost of diabetes will increase by 53%( $408 billion to $622 billion) by 2030. Aggressive efforts at local, state and federal level in prevention will be needed to significantly reduce the diabetes epidemic by 2030.
Diabetes epidemic can be prevented by “ Population wide” approach that addresses health promotion, obesity prevention, and creates a physical, cultural, and psychological environment that supports healthy living naturally.
What should you do?
MIPS require reporting up to 6 quality measures, including an outcome measure, for a minimum of 90 days. Groups using the web interface: Report 15 quality measures for a full year. To submit data as a group through the CMS Web Interface. You must register your group between April 1, 2017 and June 30, 2017.
- “Diabetes 2030: Insights from Yesterday, Today and Future Trends” By Rowley MD et al, Population Health Management, Volume 20, Number 1, 2017.