Strategic Radiology practices performed well in the first year of the CMS Quality Payment Program—100% of the SR practices that submitted data (representing 19 TINS) received a positive update, and 95% achieved the exceptional bonus. That compares well with the broader universe of participating practices, of which 93% achieved positive updates, 71% achieved the exceptional bonus, 2% achieved a neutral adjustment, and 5% received a negative update.

“Groups are continuing to improve each year,” reports Lisa Mead, RN, MS, CPHQ, CHPC, executive director, SR Patient Safety Organization (PSO).  “Under PQRS the groups had plenty of time to work on templates and radiologist education of the measures. As MACRA rolled out, SR practices were able to transition, and with their participation in the SR quality programs and implementation of programs locally, easily document their improvement activities.”

 Through Mead’s efforts, Strategic Radiology is committed to assisting groups in participating and earning positive adjustments in the Quality Payment Program. Each year SR provides a summary of the program and how each group can adjust to the changes. Throughout the year, Mead conducts webinars on the program and distributes links to important information, spreadsheets with measures including template language and tips for improving performance. Consulting services also are available if groups need to address individual issues. 

Strategic Radiology also offers access to Premiere Qualified Registry as a preferred vendor for CMS submission, and membership in the SR-PSO qualifies as a project in the Improvement Activities category. Coalition-wide comparison reports of results are used to facilitate discussion on categories where groups could improve performance.

According to Mead, SR groups are well prepared to participate in the QPP. “The biggest stumbling blocks are making sure practices continually address performance and monitor any documentation issues,” Mead notes. “Sharing the results and best practices with radiologists are critical for success. This is not a billing department program—this requires a focus from the quality committees and the physicians to work with billing to make sure the efforts to improve quality are captured in coding.”

Looking Ahead

At 1.88%, the bonus was considerably lower than the anticipated +4%. Due to the numerous exclusions for the first year, participation was not broad enough to keep the pool balanced, but this will change in 2018 and 2019, with fewer practices eligible for exclusions.

Mead advised that radiology expects more measures to be topped out. “Without new measures being developed that meet radiology needs, groups will find it harder to pick relevant measures and have the opportunity to obtain the highest decile points,” she explains. “The cost category may become an additional hurdle as it becomes part of the formula. Practices will need to address how to work across the continuum of care to decrease costs and work with CMS to make sure appropriate attribution of beneficiaries is occurring.”

Mead is waiting to receive benchmarks for the 2019 measures before she will weigh in on whether 2019 will be more or less difficult for radiology groups, but she is confident in SR groups’ commitment to quality. “SRmember practices demonstrate their commitment to quality care and service through their dedication to collaborating towards best practice and raising the bar across radiology,” Mead says. “Better Medicine Together is real for our practices.”

For a look at how SR practices compared to the larger pool of medical practice participants and a list of the measures and activities reported, download the Strategic Radiology 2017 CMS Quality Payment Program Performance Summary.