Value Based Care University Quality Measures Review

In healthcare, providers face a daily challenge in the balance of acute care and care of chronic conditions. The Center for Medicare and Medicaid Services has a standard set of metrics that they request providers to meet each year in the care of their patients. In addition, each payer has established quality metrics that they request for providers to meet for each patient population enrolled in a value based care program. These metrics collectively represent a measurement system for quality of care delivered to patients. The goal of meetings these quality metrics is for our patients to stay health and to manage their chronic conditions. It is critical that providers know which metrics apply to these patient populations, what the definitions are, and how to close the care gap. This CME will also cover recommendations and strategies to help providers close these care gaps.

Activity Information

How to Claim Credit

You may claim credit after watching this activity.

You will be redirected to the BCM DCPD credit management site when claiming credit and may be asked to register or log in.

Needs Statement

In healthcare, providers face a challenge when it comes to enhancing risk scores for improved patient care within Value-Based Care. This challenge has a direct impact on the quality of care patients receive. It's evident that providers need to gain knowledge about effective risk score enhancement but encounter difficulties in applying these strategies in their daily practice. To address these challenges, this presentation aims to guide providers in utilizing the risk adjustment model, understanding documentation requirements, recognizing the components of risk scores, and reviewing high-yield codes. The goal is to empower providers to deliver more patient-centered care within the Value-Based Care framework while overcoming these obstacles.

Educational Objectives

At the conclusion of the session, the participants should be able to:

  • Identify the quality metrics required by the Center for Medicare and Medicaid services for patient care.
  • Discuss the 20 quality metrics focused on by the Clinically Integrated Network for FY2024.
  • Apply strategies to help patients in achieving their goals within a subset of the Clinical Integration Network key quality measures and benchmarks.
  • Identify the documentation requirements within the medical record necessary to meet Center for Medicare and Medicaid Services standard metrics for screenings.
  • Identify the required diagnosis coding for entry into the Electronic Health Record to meet the Center for Medicare and Medicaid Services standard metrics.

Target Audience

Professional Categories

  • Physicians
  • Nurses
  • Other Health Professionals

Specialties

  • Family and Community Medicine
  • Internal Medicine

Interest Groups

  • Primary Care
  • Quality Improvement and Patient Safety

Activity Evaluation

Evaluation by questionnaire will address program content, presentation, and possible bias.

Educational Methods

  • Lectures

Accreditation/Credit Designation

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Baylor College of Medicine and Texas Health Network CIN. Baylor College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Baylor College of Medicine designates this enduring material activity for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Activity Director

  1. Angela Nunnery, M.D.

    Angela Nunnery, M.D.

    Assistant Professor of Family and Community Medicine
    Baylor St. Luke’s Medical Group

Term of Approval

April 1, 2024 through April 30, 2026. Original release date: April 1, 2024.

Disclosure Policy

Baylor College of Medicine (BCM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education (CME) for physicians. BCM is committed to sponsoring CE activities that are scientifically based, accurate, current, and objectively presented.

In accordance with the ACCME Standards for Commercial Support, BCM has implemented a mechanism requiring everyone in a position to control the content of an educational activity (i.e., directors, planning committee members, faculty) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships at the time of the activity or within 24 months prior.

In addition, BCM has requested activity faculty/presenters to disclose to participants any unlabeled use or investigational use of pharmaceutical/device products; to use scientific or generic names (not trade names) in referring to products; and, if necessary to use a trade name, to use the names of similar products or those within a class. Faculty/presenters have also been requested to adhere to the ACCME's validation of clinical content statements.

BCM does not view the existence of financial relationships with commercial interests as implying bias or decreasing the value of a presentation. It is up to participants to determine whether the relationships influence the activity faculty with regard to exposition or conclusions. If at any time during this activity you feel that there has been commercial/promotional bias, notify the Activity Director or Activity Coordinator. Please answer the questions about balance and objectivity in the activity evaluation candidly.

All of the relevant financial relationships listed for these individuals have been mitigated.

Disclosures

The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:

Presenters

  1. Tracy Maddox, J.D., M.S.N., R.N. Placeholder Image

    Tracy Maddox, J.D., M.S.N., R.N.

    Division Director, Care Management
    CHI St. Luke’s Health, CommonSpirit Health

    Disclosure:

    Nothing to disclose.

  2. Angela Nunnery, M.D.

    Angela Nunnery, M.D.

    Assistant Professor of Family and Community Medicine
    Baylor St. Luke’s Medical Group

    Disclosure:

    Nothing to disclose.

Activity Director

  1. Angela Nunnery, M.D.

    Angela Nunnery, M.D.

    Assistant Professor of Family and Community Medicine
    Baylor St. Luke’s Medical Group

    Disclosure:

    Nothing to disclose.

Planning Committee Members

  1. Megan Harkey, M.H.A. Placeholder Image

    Megan Harkey, M.H.A.

    Vice President - Clinically Integrated Network
    CommonSpirit Health

    Disclosure:

    Nothing to disclose.

  2. Royd Hernandez, M.H.A. Placeholder Image

    Royd Hernandez, M.H.A.

    Division Director, Data Analytics
    CommonSpirit Health

    Disclosure:

    Nothing to disclose.

  3. Angela Nunnery, M.D.

    Angela Nunnery, M.D.

    Assistant Professor of Family and Community Medicine
    Baylor St. Luke’s Medical Group

    Disclosure:

    Nothing to disclose.

  4. Tracy Maddox, J.D., M.S.N., R.N. Placeholder Image

    Tracy Maddox, J.D., M.S.N., R.N.

    Division Director, Care Management
    CHI St. Luke’s Health, CommonSpirit Health

    Disclosure:

    Nothing to disclose.

  5. Tyler Peavy, M.H.A.

    Tyler Peavy, M.H.A.

    Director, Clinical Integration Networks
    CommonSpirit Health

    Disclosure:

    Nothing to disclose.

Presenters:

Tracy Maddox, J.D., M.S.N., R.N.

Division Director, Care Management CHI St. Luke’s Health, CommonSpirit Health
Angela Nunnery, M.D.

Angela Nunnery, M.D.

Assistant Professor of Family and Community Medicine Baylor St. Luke’s Medical Group

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