Hospital Outpatient Quality Reporting Program
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1 CY 2018 OPPS/ASC Final Rule: Hospital Outpatient Quality Reporting (OQR) Program Questions & Answers Moderator: Pam Harris, BSN, RN Project Coordinator, Education and Speaker: Anita Bhatia, PhD, MPH, Program Lead Hospital OQR Program, Centers for Medicare & Medicaid Services (CMS) December 4, a.m. ET Do we stop collecting these measures beginning with January 1, 2018 discharges? Data for OP-1, -4, -20, and -21 will be collected in quarter 1 of 2018, as that quarter is part of the CY 2019 Payment Determination. You will no longer collect data on these measures after March 31, Do you know if The Joint Commission (TJC) is also ending OP-21, the pain management measure? We cannot speak for TJC. You may contact them directly at their website at Is it known if there will be changes to the CPT codes to be used for OP-26 for the CY 2017 encounter period? Yes; updates to the codes will be posted on the QualityNet site on or before January 1, If you are signed up for ListServes, you will receive notification of when they have been posted to the site. Is OP-31 still going to be voluntary for the CY 2020 program? Yes; OP-31 is still a voluntary measure. There were no finalized changes to this measure. Is the CY 2020 Payment Determination based on CY 2018 encounters? Will the retired measures be retired as of 12/31/2017 encounters? Page 1 of 7
2 For clarification, data for OP-1, -4, -20, and -21 will be collected in Q1 of 2018 (encounter dates of January 1 through March 31), as that quarter is part of the CY 2019 Payment Determination. You will no longer collect data on these measures after that Q1 submission. For the web-based measures OP-25 and OP-26, you will report your 2017 data. However, you will no longer collect data beginning January 1, 2018 on these two webbased measures. It was stated earlier in the presentation that removal dates were CY 2018 Payment Year. There were no measures removed for the CY 2018 Payment Determination. Correct; there were no measures removed for CY The measures are removed for the CY 2020 Payment Determination but affect 2018 data. For example, OP-1, -4, -20, and -21 will be collected in Q1 of 2018, as that quarter is part of the CY 2019 Payment Determination. Please clarify the dates that we can stop collecting chart-abstracted measures. You will collect and report data for the clinical measures through the first quarter of 2018, which are encounter dates January 1 through March 31, This is due to Q being part of the CY 2019 payment determination. Please clarify the encounter dates being collected in quarter one 2018 for OP-1, -4, -20, and -21. The Q encounter period is January 1 through March 31, So for OP-25 and OP-26, does that mean the CY 2017 data will not be reported, as the data reporting opportunity occurs starting with January 1, 2018, or will the CY 2017 data be reported? For the web-based measures OP-25 and OP-26, you will report your 2017 data. This data submission should be entered on or before the May 15, 2018 submission deadline. However, you will no longer collect or report data beginning January 1, 2018 on these two web-based measures. Sorry if this is obvious, but if something states removed beginning with the CY 2020 Payment Determination, does that mean it is no longer collected for performance CY 2018? Page 2 of 7
3 To clarify, the chart-abstracted measures are finalized for removal for the CY 2020 payment determination and subsequent years. As such, OP-1, -4, -20, and -21 data should be collected through Q for encounter dates of January 1 through March 31, Data will no longer need to be collected for these measures after that Q1 submission. Will we still submit our January December 2017 data for OP-25 and -26 after January 2018? Yes; for the web-based measures submitted to QualityNet, OP-25 and OP- 26 data for encounters occurring in 2017 should be submitted to QualityNet in 2018 by the submission deadline of May 15, Data will no longer need to be collected for these measures after that time. When will the new rules for NOP start (for example, the new facilities after October 2017)? There were no finalized changes for the NOP submission deadlines in this rule-making cycle. Please clarify what Payment Year of 2020 means and if abstraction stops January 1, The chart-abstracted measures are finalized for removal for the CY 2020 Payment Determination and subsequent years. As such, OP-1, -4, -20, and -21 data should be collected through Q for encounter dates of January 1 through March 31, Data will no longer need to be collected for these measures after that Q1 submission. Please verify the calendar years for the 2020 payment year determination. The clinical data submission for the CY 2020 Payment Determination includes Q2 2018, Q3 2018, Q4 2018, and Q Regarding OP-26, do we submit volume data for the calendar year 2017 in the spring of 2018 or not? Yes. For the web-based measures submitted to QualityNet, OP-25 and OP- 26 data for encounters occurring in 2017 should be submitted to QualityNet in 2018 by the submission deadline of May 15, Data will no longer need to be collected for these measures after that time. Does the removal of these measures start on January 1, 2018 discharges? Page 3 of 7
4 For clinical data and population and sampling: OP-1, -4, -20, and -21 data should be collected through Q for encounter dates of January 1 through March 31, Data will no longer need to be collected for these measures after that Q1 submission. For the web-based measures submitted to QualityNet: OP-25 and OP-26 data for encounters occurring in 2017 should be submitted to QualityNet in 2018 by the submission deadline of May 15, Data will no longer need to be collected for these measures after that time. Should hospitals continue to abstract these measures for 3rd and 4th quarter 2017 data submission? For the removed measures: OP-1, -4, -20, and -21 data should be collected through Q for encounter dates of January 1 through March 31, Data will no longer need to be collected for these measures after that Q1 submission. So this CY 2020 payment determination starts April of 2018? The clinical data submission for the CY 2020 Payment Determination includes Q2 2018, Q3 2018, Q4 2018, and Q Do you have a calendar or timeline that can serve as a reference for collection timeframes? The CY 2020 Payment Determination information is currently being updated. You can find information on CY 2018 and CY 2019 which is now posted on qualityreportingcenter.com at The OP-21, OP-26, etc. are removed for the CY 2020 payment determination. Does this mean that we do not abstract or report in CY 2018? For clinical data and population and sampling: OP-1, -4, -20, and -21 data should be collected through Q for encounter dates of January 1 through March 31, Data will no longer need to be collected for these measures after that Q1 submission. For the web-based measures submitted to QualityNet: OP-25 and OP-26 data for encounters occurring in 2017 should be submitted to QualityNet in 2018 by the submission deadline of May 15, Data will no longer need to be collected for these measures after that time. Page 4 of 7
5 What is the difference between OP-18a and the reporting section of OP- 18? The data for OP-18b is publicly reported. What is the last quarter of data collection for those measures being discontinued with the CY 2020 Payment Determination? For clinical data and population and sampling: OP-1, -4, -20, and -21 data should be collected through Q for encounter dates of January 1 through March 31, Data will no longer need to be collected for these measures after that Q1 submission. When is the OP-18c collection date? Data will not be reported until, at the earliest, July When you say, "Finalized removal beginning with the CY 2020 Payment Determination," can you verify that this means the last quarter that needs to be reported for the chart-abstracted measures will be Q1 2018? Once Q has been sent, we no longer need to submit these measures, correct? Yes, you are correct. The chart-abstracted measures are finalized for removal for the CY 2020 Payment Determination and subsequent years. As such, OP-1, -4, -20, and -21 data should be collected through Q for encounter dates of January 1 through March 31, Data will no longer need to be collected for these measures after Q1. Will the proposals for removal also affect ecqms? The Hospital OQR Program does not have ecqms currently. For specific questions regarding these measures, please call the ecqm helpdesk at Will the QualityNet warehouse accept these measures until January 1, 2018 encounters? The system will update according to the submission requirements. Do any of these rules now affect Critical Access Hospitals (CAHs)? For the Hospital OQR Program, data submission by CAHs is voluntary. Page 5 of 7
6 Does the removal of OP-20 remove the Hospital Outpatient (HOP) Emergency Department (ED) throughput measure? No. You will continue to collect and report the other throughput measures for this program. Does the removal of OP-1 and OP-4 negate the collection of all the HOP AMI and Chest Pain measures? No, you will continue to collect and report for OP-2, OP-3, and OP-5, as they still remain part of the program requirements. For those organizations that have already implemented OAS CAHPS voluntarily, will the data be publicly reported? If a facility voluntarily submits any data, the data are subject to public reporting. For more information about the OAS CAHPS measures, contact oascahps@rti.org. Has the Fiscal Year terminology changed to CY Payment Determination? I am familiar with seeing the word "Fiscal Year" and not "CY Payment Determination." No; there has been no change. This program uses the terminology of Calendar Year not Fiscal Year. Does the CY 2020 payment determination start with 2018 data collection? The clinical data submission for the CY 2020 Payment Determination includes Q2 2018, Q3 2018, Q4 2018, and Q I just want to verify that the CY 2020 Payment Determination means Fiscal Year 2020 and Calendar Year 2018 to begin removal of a measure. For chart-abstracted measures, that is accurate. The first quarter of 2018 is part of the CY 2019 Payment Determination. The CY 2020 Payment Determination begins with Q The clinical data submission for the CY 2020 Payment Determination includes Q2 2018, Q3 2018, Q42018, and Q What are the discharge dates for the CY 2020 payment determination, please? Page 6 of 7
7 The CY 2020 Payment Determination begins with Q The clinical data submission for the CY 2020 Payment Determination includes Q2 2018, Q3 2018, Q42018, and Q For OP-18c, is there a minimum requirement for the number of cases and public reporting on this measure? For OP-18c, footnote 1 will be applied for a hospital with fewer than 11 cases. Just to confirm, the collection for all six removed measures ends with discharges beginning January 1, 2018 and forward (this constitutes the beginning of CY 2020 payment determination)? No. For clinical data and population and sampling: OP-1, -4, -20, and -21 data should be collected through Q for encounter dates of January 1 through March 31, Data will no longer need to be collected for these measures after that Q1 submission. Is outpatient population and sampling still voluntary? Yes. Can you repeat the starting quarter for OP-18c? The data will be shared in 2019, but when are these discharge dates from? The data will be reported in July 2019, at the earliest, using patient encounters during the third quarter of Page 7 of 7
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