Payment Reform & More
CliniSyncPLUS Consulting
No matter what Promoting Interoperability, Quality measures or reporting program you need support for, we’re able to help you maximize your incentive payments, avoid penalties, and ensure that you comply with program requirements. Let us conduct a “mock audit” for you.
Promoting Interoperability & MIPS Information
Get the most-up-to-date information Promoting Interoperability requirements and changes in regulations. Use the experience of our experts to help you navigate through the maze of Promoting Interoperability & MIPS!
Quality Reporting
Learn about resources available to ensure quality reporting requirements are missed! We will help answer your questions and steer you in the right direction
Value-Based Programs
Our CliniSyncPLUS team will provide guidance on how Health Information Technology can benefit you and your patients and how you can streamline work to meet payer and other reporting requirements.
Payment Reform Initiatives
Learn how CliniSync can assist with Health Plan Services, Accountable Care Organizations, Patient-Centered Medical Homes and state initiatives to promote payment reform.
E-Prescribing of Controlled Substances
Our CliniSyncPLUS team is working across the state to ensure that the medical community knows how to e-prescribe controlled substances to pharmacies.
Frustrated by the complexity of Payment Reform? Get relief from your CliniSyncPLUS advisors.
Through the Office of the National Coordinator of HIT’s Regional Extension Center program, we assisted more than 6,000 primary care physicians and 100 hospitals to ensure they received federal incentive funds while maximizing their incentive payments. Our experience as the largest Regional Extension Center in the nation allows us to use our expertise to provide specialized assistance to both hospitals and practices. Although a grant provided funding for implementation of that work, it has ended. We now function as an independent nonprofit and are offering our services under the name of CliniSyncPLUS at a very reasonable cost.
Services
We Provide:
- Education on and assistance with meeting the requirements of Ohio CPC, CPC+, Primary Cares First and other value-based reporting programs.
- Understanding and preparing for the proposed MIPS Value Pathways program.
- Resources to help you understand and stay abreast of changes in the Promoting Interoperability, MIPS and Quality reporting programs.
- Guidance on using your feedback reports and reporting programs to maximize reimbursements.
- Assistance with the attestation process for Promoting Interoperability and MIPS.
- Customized education for practices and hospital personnel on Payment Reform requirements, strategies, and timelines.This education can occur virtual or onsite.
- Promoting Interoperability and MIPS “mock audits” and with preparation of responses to a CMS or Medicaid audits.
For more information on the CliniSyncPLUS program, contact Scott Mash (smash@ohiponline.org) or Cathy Costello (ccostello@ohiponline.org).
Promoting Interoperability Information
Work with us to see what the latest changes in CMS regulations require for Promoting Interoperability (PI) reporting. Specifically, we can assist you in:
- Determining what PI measures are required to be reported and what measures can be excluded.
- Understanding the differences in the hospital and MIPS programs as related to Promoting Interoperability.
- Understanding what is required to successfully respond to a Promoting Interoperability or MIPS audit.
- Analyzing which type of public health reporting or clinical data reporting will meet the regulatory requirements.
- Assessing which quality measures should be reporting for Promoting Interoperability or MIPS.
Downloadable Documents
- 2015 MU Measures (316.00 KB)
- 2015-2017 MU Final Rule Presentation (3027.00 KB)
Audits for Promoting Interoperability or MIPS
- Conduct mock audits for the Medicare or Medicaid Promoting Interoperability programs.
- Assess security review requirements to meet Office of Inspector General audits, Office of Civil Rights audits or Promoting Interoperability/MIPS audits.
Quality Reporting
Quality reporting and its technicalities can be overwhelming, even for sophisticated practices. Understanding the quality reporting programs can be daunting.
Let Our Clinisyncplus Team Help You Analyze:
- Whether group, individual, eCQM or registry reporting is most suited to your practice and the various specialties reporting in your tax-id.
- The selection of quality measures to report which will achieve the most benefit for the practice.
- How quality reporting affects your practice or hospital’s reimbursement.
- Understanding the CMS feedback reports from the prior year’s quality submission.
Value-Based Program Support
The CPC+, Ohio CPC, Primary Cares First and other programs are a national advanced primary care medical home models that seek to strengthen primary care through regional multi-payer payment reform and care delivery transformation.
The CliniSync Health Information Exchange is your supplemental IT source to help you meet your requirements!
- Our CliniSyncPLUS team can provide education on these program requirements, assist with the registration process and assist with reviewing feedback reports.
- Email the CliiSyncPLUS team, Scott Mash (smash@ohiponline.org) or Cathy Costello (ccostello@ohiponline.org), for guidance.
Payment Reform Initiatives
Use CliniSync services to electronically connect with the medical neighborhood to facilitate team-based, quality care required by performance-based payment reform models.
Learn how CliniSync helps you with Patient-Centered Medical Home requirements and other patient-centric initiatives.
- Access a single community record of your patients’ encounters with other CliniSync hospitals and providers including related results and reports.
- Receive patients’ lab results, radiology and transcribed reports directly into your EHR or use your EHR to exchange secure email with other providers to coordinate care.
- Receive a notification when your patient goes to the Emergency Department or is admitted to the hospital, discharged or transferred to another facility.
- Report data to public health registries or contribute care summaries to the HIE for other treating providers to access.
- Get guidance on practice transformation, health IT tools optimization, MU requirements, audits, quality measure reporting and more.
- Sign up for secure email capability and gain access to a statewide provider DIRECTory that includes DirectTrust email addresses of other providers at no charge.
Use CliniSync to support your Accountable Care Organization, episode-based payment initiatives and other shared savings and risk arrangements.
CliniSync Services can:
- Expedite payment of claims through immediate notification to health plans why a member was admitted or seen in ER
- Comply with Medicaid’s 24-hour ER notification requirement automatically
- Reduce onsite health plan nurse or your staff time to collect information for case management or prior authorization purposes
- Facilitate and support your ACO, episode-based payment initiatives and other shared savings/risk arrangements
- Send timely discharge summaries to initiate efficient post-admission care support and minimize re-admissions
- Help your patients by alleviating the manual coordination of information between you and their insurer
Resources
For Patients:
For Providers:
Ohio Academy of Family Physicians:
Use CliniSync to support your Accountable Care Organization, episode-based payment initiatives and other shared savings and risk arrangements.
CliniSync Services can:
- Expedite payment of claims through immediate notification to health plans why a member was admitted or seen in ER
- Comply with Medicaid’s 24-hour ER notification requirement automatically
- Reduce onsite health plan nurse or your staff time to collect information for case management or prior authorization purposes
- Facilitate and support your ACO, episode-based payment initiatives and other shared savings/risk arrangements
- Send timely discharge summaries to initiate efficient post-admission care support and minimize re-admissions
- Help your patients by alleviating the manual coordination of information between you and their insurer
Familiarize yourself with State of Ohio initiatives involving payment reform.
Ohio’s State Innovation Model (SIM) Grant
Ohio’s State Innovation Model (SIM) grant awarded in December 2014 seeks to improve Ohio’s population health while supplementing CMS’ work on payment reform by creating new payment models for Medicaid,
Medicare-Medicaid dual eligibles and private payers. The SIM
model builds on the work of the Patient-Centered Primary Care Model as well as Cincinnati’s Comprehensive Primary Care Initiative (CPCI), funded in 2012 by Centers for Medicare and Medicaid Innovation (CMMI) to scale payment transformation statewide.
E-Prescribing of Controlled Substances
Did you know…it’s legal to e-prescribe controlled substances in Ohio?
While you may have heard otherwise, it’s legal to e-prescribe controlled substances in Ohio, as well as all other states. Here is information on how the providers involved at various points in the e-prescribing process can meet the Drug Enforcement Administration’s (DEA) requirements to successfully e-prescribe controlled substances:
- Ohio improves but lags behind national average in EPCS
- Here is a flyer for physicians and other prescribers.
- This is a flyer for institutional organizations, such as clinics and hospitals.
- Here is a flyer for pharmacists!
- Read an introductory story on the work of the Ohio E-Prescribing Task Force.