The annual MIPS/MSSP chart abstraction of 2019 data is underway. Healthcare Solutions Network (HSN), a collaborative venture between St. Elizabeth Healthcare and TriHealth, received the 2019 quality sample for the Center for Medicare and Medicaid Services (CMS) Medicare Shared Savings Program (MSSP), on January 7. St. Elizabeth participates via the St. Elizabeth Provider Network (SEPN), and TriHealth through TriHealth Physician Hospital Organization (TIPHO).
In our sample, 2,580 HSN patients have been identified, for a total of 5,584 chart reviews (SEPN 45%/ TPHO 50%/ Shared 5%) of up to 6,160 quality measure reviews. SEPN/HSN contracted again this year with Primaris to review the EPIC charts for the 2018 data abstraction. The remaining 8% of patients who do not have EPIC charts must be reviewed personally by HSN/ SEPN clinical staff. As the Manager of Quality for SEPN and acting Quality Officer for HSN, Shelley Simpson will review the assigned SEPN and Shared independent provider charts.
Shelley has reached out to the practices without EPIC with a list of the patients whose charts need to be available for abstraction, and is in the process of scheduling times to come to the practice and review those charts on site. The CMS submission window closes on March 27, but the internal close date is March 13 to allow for data cleanup prior to the CMS submission. During these 10 weeks, approximately 6160 charts will be reviewed. Last year 94% of this number were abstracted directly from EPIC, this year 92% are EPIC reviews and 8% are reviews for non-EPIC users. Last year’s chart abstraction of 2018 data resulted in a positive payment adjustment of 1.68% for the HSN physician providers (payable during 2020). This abstraction process will determine the 2021 payment adjustment for SEPN/HSN members and determine if the ACO and its providers will receive shared savings from CMS.
A report on our quality performance from these samples will be available later in the year.
We appreciate your participation in SEPN. Success of the MSSP program and data abstraction is not possible without you and your cooperation with the process. Thank you, in advance, for your assistance. If you have any questions, please feel free to contact Shelley at 859-301-7335 or shelley.simpson@stelizabeth.com.