Questions to Ask GPRO Reporting Partners

l i g h t p o e t | Shutterstock

Accountable Care Organizations (ACOs) know that when the calendar turns to January, it is time to prepare for quality measure reporting in the new year. For those still transitioning to the shared savings program, the Group Practice Reporting Option (GPRO) is a Centers for Medicare & Medicaid Services (CMS) reporting process to measure quality scores for the previous performance year to obtain eligibility for shared savings and other incentives. But for the performance year (PY) 2019, the process goes by a new name for reporting: the CMS Web Interface.

The PY 2019 quality data submission period for ACOs started on January 2, 2020, and closes on March 31, 2020. Groups submit quality data using the CMS Web Interface. For ACOs participating in the Merit-based Incentive Payment System (MIPS), CMS also uses this data to assess quality performance.

CMS has sent a Web Interface Beneficiary Sample Excel file to each ACO that can be accessed from their Managed File Transfer (MFT) mailbox. The file enables ACOs to download their beneficiary samples and submit Web Interface data.

Two significant changes this year are the requirements of using the CMS Web Interface when requesting to exclude a patient from reporting, and the use of the Interface for the final submission of data at the end of March. The ten measures for the PY 2019 are as follows:

The CMS Web Interface Measures for PY 2019
MH-1 Depression Remission at Twelve Months*
CARE-2 Falls: Screening for Future Fall Risk*
DM-2 Diabetes: Hemoglobin A1c (HbA1c) Poor* Control (>9%)
HTN-2 Controlling High Blood Pressure
PREV-5 Breast Cancer Screening*
PREV-6 Colorectal Cancer Screening
PREV-7 Preventive Care and Screening: Influenza Immunization
PREV-10 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention*
PREV-12 Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan*
PREV-13 Statin Therapy for the Prevention and Treatment of Cardiovascular Disease*
The asterisk (*) means that measures have updated their specifications in the 2019 performance year.

The above information is taken from the 2019 Merit-based Incentive Payment System (MIPS): CMS Web Interface Fact Sheet.

The ACO Web Interface (Formerly GPRO) Reporting Partner Checklist:

The following functionality checklist is to aid ACOs as they begin to report on their selected patients. When selecting a software partner to support reporting efforts, their offering should include:

  • The ability to integrate with electronic health record(s) (EHR) to auto-populate the reporting registry with clinical data
  • A dashboard where users can load ranking files and generate files to upload to the CMS interface
  • A file validation feature to qualify incoming data
  • The ability to create a Web Interface-compliant XML file
  • A measures progress dashboard that tracks all measures and provides a summary and patient ranking view
  • A web-based reporting dashboard that is accessible by all administrators and clinic staff with role-based security
  • The ability to measure progress by practice, provider, specialty, and patients
  • Filtering by measure category to find reporting gaps
  • A dynamic header to provide a summary view of progress
  • The ability to show reportable patients by measure ranking, showing the:
    • Total ranked
    • Consecutive target
    • Total skipped
    • Total complete
    • Consecutively complete
    • Total incomplete
    • Remaining to target
  • The ability to add comments or notes to provide evidence of documentation or chart location by patients
  • The capability to measure status pop-ups
  • Account managers to help throughout the data collection and reporting process

Already Leveraging the Lightbeam GPRO Module?

For users of our platform, we have an array of resources to prepare for Web Interface submission with Version 3.2. To begin, clients who have purchased the Lightbeam GPRO module can download the User Guide for a step by step visual on how to navigate each function and requirement within the platform. On November 22, 2019, I hosted a training for clients covering the various enhancements the module has for this reporting year. The training can be found on the Lightbeam eLearning Portal.

For all readers, CMS has a resource library for the Quality Payment Program, including user guides, final rules, summaries, and fact sheets. The library can be found here: https://qpp.cms.gov/about/resource-library.

Read more from Caleb Cook, Lightbeam’s Education & Training Specialist.

Leave a Reply

Your email address will not be published. Required fields are marked *