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Specialist Spotlight: MIPS and Oncology in the COVID-19 Era

Wednesday, November 04 2020

Cancer patients need timely treatment, but in-person visits can be risky for these often immunocompromised patients. To balance the needs of timeliness and COVID-19 prevention, many oncology practices are now delivering a wider range of services through telehealth. This rapid shift was made possible, in part, by CMS’s expansion of telehealth-eligible services, clinician types, communication modes, and originating sites in response to the COVID-19 public health emergency.

If your practice is now offering a wider range of telehealth services, take a moment to review your MIPS measures, and answer the following questions:

  • Will any of your MIPS measure scores likely go down because people are forgoing visits that can only be delivered in person? If so, you may need to consider reporting on new measures.
  • Could you get credit for services delivered via telehealth? For example, telehealth radiation treatment management is now a billable telehealth service. During these tele-visits, you can earn MIPS points by delivering care consistent with these quality measures:
    • Oncology: Medical and Radiation – Pain Intensity Quantified (Quality ID: 143) Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified.
    • Oncology: Medical and Radiation – Plan of Care for Moderate to Severe Pain (Quality ID: 144) Percentage of visits for patients, regardless of age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy who report having pain with a documented plan of care to address pain. 
  • If you ask your patients about their medications or advance care planning, you could also earn credit towards the following measures and activities collected via telehealth:
    • Documentation of current medications in the medical record (Quality ID: 130) Percentage of visits for patients aged 18 years and older for which the MIPS-eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counter medications, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications’ name, dosage, frequency, and route of administration.
    • Advance care plan or surrogate decision-maker documented in the medical record (Quality ID: 047) Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record or documentation in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan.
    • Advance Care Planning (Improvement Activity: IA_PM_21) Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning.

Regardless of which MIPS measures you select, it is important to work with your electronic health record (EHR) vendor to make sure you receive MIPS credit for services provided via telehealth and accurately document measure data. For a list of all 2020 MIPS measures and activities, visit the Explore Measures and Activities section of the QPP website. To review the list of new telehealth services covered by CMS, click here. For a summary of cancer care transformation during the COVID-19 public health emergency, click here.

Purdue Healthcare Advisors is providing healthcare practices with guidance on how this crisis is impacting telehealth options related to Medicare and Medicaid patients, and what clinics and practices can do to get their telehealth services up and running. On our telehealth page, you'll find basic information, quick reference Medicare/Medicaid COVID-19 guides, tip sheets to give your patients, and phone scripts for your telehealth-related patient outreach.

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