This seems like a lot of work. What will NNE-PTN provide for my practice?
Benefits of being part of the NNE-PTN include:
- Increased staff and patient satisfaction.
- Improved health outcomes for patients.
- Reduction of unnecessary hospitalizations through enhanced care coordination.
- Continuing improvement to sustain efficient care delivery and generate lower health care costs.
- Assessment of practice status, readiness for change, and customized plan and technical assistance.
- PTN Learning Collaborative (with Continuing Medical Education (CME) and Part IV Maintenance of Certification (MOC) credit).
- Direct, practice-based QI support from Practice Coach.
- No-cost assistance from PQRS Solutions for reporting PQRS to CMS.
- Get assistance with leveraging existing Medicare payment opportunities – e.g. Annual Wellness Exam, Transitional Care Codes, Chronic Care Management (CCM) codes.
- Access team-building resources – e.g. TeamSTEPPS for ambulatory practices.
- Opportunities to network with and learn from the best practices with primary care, specialty, and behavioral health peers.
Our clinicians are not affected by the new MACRA legislation until Year 3 and beyond. Why should we join now?
Initially, the MACRA legislation includes certain types of professionals as eligible for receiving incentives or penalties for participating in MIPS (this includes MDDO, DDS, DDM, DPM, OD, DC, PA, NP, CNS, CRNA’s). In subsequent years, additional groups of clinicians will be included in the MIPS’ risk and benefit payment adjustments. As your practice works with NNE-PTN, now, you will be ready to receive the enhanced payment adjustments due to the two-year look back period between the reporting year and the performance year. (eg 2019 uses 2017 performance data).
How much does participation in NNE-PTN cost?
This is at no cost to you. These resources have been made available through the “Transforming Clinician Practice Initiative” recently launched by the Centers for Medicare and Medicaid Services. Together, the states of Maine, Vermont, and New Hampshire have been funded to create the Northern New England Practice Transformation Network. This is a federally funded program that allows our experienced and trusted quality improvement organizations to provide practice improvement and learning resources at no cost.
What do I need to be eligible?
We accept any practices that have clinicians that bill to Medicare and do not participate in four Medicare ACOs (Medicare Advanced Primary Care Practice Demonstration = MAPCP, Medicare Shared Savings ACO = MSSP, Medicare Pioneer ACO, and Next Gen ACO).
What is expected of me?
We will work with practices and provide QI assistance to move through these five transformative steps:
- Participate in a baseline practice assessment with PTN staff Set aims
- Use data to drive care
- Achieve progress on aims
- Benchmark status
- Thrive as a business through pay-for-value approaches
Practices agree to participate in a baseline practice assessment with PTN staff and then work with PTN staff to develop practice goals and strategies, based on assessment findings. Practices will participate in a PTN Learning Collaborative, including regional learning events, webinars, and online educational tools. Practices will need to submit data through PQRS on a quarterly basis. We are working to develop measures that will overlap with many of the ones that practices typically need to submit to PQRS.
I’ve been contacted by a SAN. What’s the difference between a SAN and a PTN?
A PTN is a Practice Transformation Network, which includes trusted partners with QI expertise, best practices, coaching, and assistance for clinical and operational practice transformations. A Support and Alignment Network (SAN) is a group of professional associations and others that align their memberships, communication, channels, CME credits, MOC, and other work to support PTNs and clinical practices. They also offer many free resources.
Where can I find enrollment information?
We are excited that we have met our initial goal of helping 1665 clinicians in Maine, New Hampshire, and Vermont. This means that we are currently at our capacity. However, it is possible that as practices graduate from our program we will be able to support practice transformation with other groups. Please visit our waitlist at https://www.surveymonkey.com/r/NNE-PTN so that we are aware of your interest.
I am waitlisted. What do I do now?
As of January 2017, we expect that some practices will graduate from our program, and we anticipate being able to enroll additional practices in the NNE-PTN at that time. If you have visited the waitlist and left your information, we will know that you are interested and will contact you at that time to discuss possible next steps.
How can I include new clinicians in our practice’s work with NNE-PTN?
If you have had clinicians either join or leave your practice, please notify NNE-PTN. We need updated records to share with CMS as part of our funding opportunity. Please contact us with this information and a member of the NNE-PTN team will connect with you about these changes.
Why do we have to do an assessment?
This program is focused towards providing support for practices so that they can succeed in value-based payment models. In order to prepare for these changes, we want to be sure that our practices are progressing in their individual goals. In order to see this growth, we complete assessments throughout your practice’s work with NNE-PTN so that we can identify areas of success and develop areas that need improvement.
Why do we need patient demographics?
Part of CMS’ goal with PTNs is for better health outcomes for participants in Medicare, Medicaid and CHIP (https://innovation.cms.gov/files/slides/tcpi-sanbidders.pdf, slide 8). Part of our work is focused on improving the health outcomes of individuals in small, rural, medically underserved communities. . In order to ensure that we are reaching these populations, we collect patient demographics to understand our practices and our practices’ patients better. By providing patient demographics, you are supporting our work within the PTN which demonstrates that we are working with clinicians in communities in need of additional capacity to support the needs of their communities. We understand that patient demographics can be difficult to collect, so please keep informed about the specific needs of your practice so that we can work with you to gather the information needed by CMS.
Who should be present in an assessment? How long does it take?
The assessment process has been refined over time, and currently, we request that there is a person present that can speak to the medical side of the practice (i.e., “Lead Clinician”) and someone that can discuss the administrative side of the practice (i.e., “Lead Administrator”). The assessment typically takes a half hour to complete, and this conversation is supported by an NNE-PTN Practice Facilitator. A member of the NNE-PTN will contact you to arrange these assessments, and we appreciate your flexibility in coordinating these assessments in a timely manner.
How often do we need to do assessments?
We want to measure your practice’s development over time. Therefore, we complete assessments at the beginning of your work with NNE-PTN (ideally within a month of enrollment) and every six months after enrollment. We request updated patient demographics yearly (at the 12-month, 24-month, 36-month, and if appropriate 48-month follow-up assessments).
How often do we need to share PQRS data or other reports with you?
We are currently developing a system through which practices can share selected process and outcome measures on a quarterly basis (Requirement 10 of the “Northern New England Practice Transformation Network Commitment”); because this is still being developed, there are no reports that practices need to independently submit. We do request that if you have access to your practice’s Quality Resource Use Reports (QRURs) that you please share your data with NNE-PTN so that we can better understand your practice’s current performance and your practice’s access to process and outcome measures. We also ask that primary care practices permit NNE-PTN staff to access available Medicare claims data. We strongly urge practices to register with Mingle Analytics as soon as possible; this will ensure that your practice has ample time to prepare for 2016 (2016 data gets submitted in 2017) PQRS submission at no cost to your practice while enabling NNE-PTN to learn more about your practice from this PQRS data.
PQRS submissions will not occur until March 2017. Why am I worrying about it now?
We request that practices begin the registration process with Mingle Analytics as soon as possible. We understand that PQRS submissions can be very burdensome on practices and can be costly. By starting your practice’s work with Mingle Analytics now, you are giving your practice more time to collect the necessary information and to answer any questions that arise during this process, making your chances of a successful submission much greater.
Who is our executive sponsor?
As you complete the registration, it will ask for your Executive Sponsor. Please do the following:
- List “Northern New England Practice Transformation Network” or “NNE-PTN.”
- Use the email email@example.com as the contact email for the executive sponsor.
We want Mingle to be able to identify that you are a practice affiliated with efforts. This is also done when you use the PQRS Coupon Code, which your Practice Facilitator or another member of the NNE-PTN gave you during your NNE-PTN enrollment process.
What will Mingle Analytics provide my practice?
As soon as you complete the registration process (and use the NNE-PTN PQRS coupon code that that this service is free to your practice), Mingle Analytics will assign a Project Manager to your specific practice. This person will be your guide as you work to enter your practice’s information. This Project Manager will help you determine which way you should submit your data which will be most beneficial for your practice’s needs and will be able to answer any questions you have as you complete the submission process.
We use another vendor. Why should we use Mingle Analytics?
We are offering PQRS submission services at no cost to your practice if you submit through Mingle Analytics. This also enables us to have access to your PQRS reports through Mingle so that you do not have to develop a separate sharing process with a different vendor. We want to make sharing measures data less burdensome for you and your practice, and we believe that by offering use of Mingle Analytics to your practice for PQRS submissions, we provide you a service while collecting the information we need to share with CMS to demonstrate our practices’ growth.
This FAQ list is updated monthly as we work with NNE-PTN members. If you do not see an answer to an important question you have about PTN processes or practices, email: firstname.lastname@example.org.
Or please reach one of your regional Practice Facilitators, listed on our staff pages: