1. Hess, Cathy Thomas BSN, RN, CWCN

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This column is a continued series related to the Strategic Objectives for the Quality Payment Program (QPP). Part 2 of this series appeared in the March issue of Advances in Skin & Wound Care. In this column, we will review Objectives 4 through 6. The following objectives are direct excerpts from the Centers for Medicare & Medicaid Services' (CMS) Strategic Objectives for the Quality Payment Program.1


Objective 4: Promote program understanding and maximize participation through customized communication, education, outreach, and support that meet the needs of the diversity of physician practices and patients, especially the unique needs of small practices. The CMS is committed to reaching its various user segments, including clinicians, the technology community, private payers, and beneficiaries to raise awareness that Medicare is evolving quickly to pay for a better, smarter, healthier system. In addition to raising awareness that change is occurring, we will work to engage in a learning process with clinicians, the technology industry, private payers, and beneficiaries where these groups may voice opinions and suggestions to help collaboratively drive the goals of the QPP. We will also work to set expectations that this will be an iterative process, and while change will not happen overnight, we are committed to continuing our work to improve how Medicare pays for quality and value, instead of the quantity of services. The CMS will continue to reach out to the clinician community and others to partner in the development of ongoing education, support, and technical assistance materials and activities to help clinicians understand program requirements and how to use available tools to enhance their practices, improve quality, reduce cost, and progress to participation in Advanced Alternative Payment Models if that is the best choice for their practice.


Objective 5: Improve data and information sharing to provide accurate, timely, and actionable feedback to clinicians and other stakeholders. Clinicians increasingly depend on multiple sources of information to determine how they operate their practice, manage their patient populations, and engage individual patients, families, and caregivers. The CMS has administrative and clinical data that are highly valued by the clinician and wider stakeholder community. The information is valuable only if it is accessible, accurate, timely, and inclusive of the elements that matter the most to clinicians. Much of the data in the immediate future will also be in the form of electronic health information that informs care and brings the most recent scientific evidence to the point of care in an effort to bolster clinical decision making. Vendors and physicians will be important partners in ensuring that such information is available in actionable formats and in a timely manner.


Objective 6: Ensure operational excellence in program implementation and ongoing development. The CMS strives to design and implement the QPP in such a manner that it exceeds the expectations of all stakeholders. This objective will be accomplished through excellence in project management, focusing on customer needs, promoting problem solving, teamwork, and leadership that results in ongoing improvement. We will use an agile management approach that offers flexibility as the team minimizes focus on "set" requirements and plans and instead uses iterative approaches with an emphasis on people, their discipline, competencies, and abilities to work together to get the job done rather than on sticking to unchanging plans. We will integrate this approach with our Lean Management Operating System, which complements the principles of agile development and seeks the elimination of waste and empowerment of employees to raise concerns early and provides a structure to address identified concerns. Such changes will help us deliver the highest-value product to our most important customers: our beneficiaries.


Although it is important to understand the underpinning of the QPP program, it is equally important to understand the Merit-based Incentive Program System (MIPS) timeline to avoid the payment adjustment for 2019.


* Performance year 2017: Performance period opens January 1, 2017, and closes December 31, 2017. Clinicians care for patients and record data during the year.


* Data submission March 31, 2018: Deadline for submission of data is on March 31, 2018. Clinicians are encouraged to submit data early.


* Feedback: The CMS provides performance feedback after the data are submitted. Clinicians will receive feedback before the start of the payment year.


* Payment adjustment: The MIPS payment adjustments are prospectively applied to each claim beginning January 1, 2019.



Focus on a documentation strategy and plan. There is no time like the present!




1. Centers for Medicare & Medicaid Services. Strategic Objectives for the Quality Payment Program. Last accessed February 17, 2017. [Context Link]