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AQUA News 2020 Issue I

A Spotlight on Urology–Specific Measures Available in the AQUA Registry

Articles

How AQUA Measures Are Created

In keeping with the American Urological Association’s mission of promoting the highest standards of urological clinical care through education, research and the formulation of health care policy, the Science & Quality Division of the AUA is dedicated to the development of evidence-based, urology-specific performance measures. These quality measures are used primarily in the AQUA Registry for AQUA participants to facilitate their quality improvement and the advancement of urologic care in areas such as urologic oncology, female urology, male sexual health and endourology.

AUA's measurement aims include the following:

  • To develop measures that address a performance gap and are meaningful and relevant to patients, urologists and other decision-makers
  • To focus on outcomes and promote quality improvement, efficiency and effectiveness in urologic care
  • To reduce the administrative burden associated with data collection

AUA emphasizes the National Quality Strategy’s six priorities (patient and family engagement, patient safety, care coordination, population/public health, efficient use of healthcare resources, and clinical processes/effectiveness) for measure selection and utilizes the following criteria to develop and evaluate measures:

  • Importance to measure: evaluates the evidence to support a measure and the potential variation in performance across providers
  • Scientific acceptability: assesses the reliability and validity of the measure
  • Feasibility: assesses the availability of the data and the burden involved with collecting the measure information
  • Usability and use: evaluate if a measure can be appropriately used for accountability and quality improvement
  • Related and competing measures: assesses if the measure is duplicative of other measures and identifies the need for harmonization

Recently, the AUA established a Measures Evaluation Panel to guide its efforts in developing and evaluating quality measures. The panel welcomes your feedback from the perspective of an AQUA participant. Please contact us at Quality@AUAnet.org or 410-689-4026 and tell the AUA what areas you would like us to explore for future measure development, measures you select for reporting, why you select these measures, how feasible they are to capture from electronic health record systems, or anything else about the measures that you feel is important. Thank you for helping us improve the AQUA Registry.


Five AQUA Measures Receive CMS Benchmarks

The AQUA Registry is a "one-stop-shop" for urologic care providers to satisfy Centers for Medicare and Medicaid Services (CMS) Quality Payment Program (QPP) requirements for the Merit-based Incentive Payment System (MIPS). A major benefit of using the AQUA Registry for MIPS reporting is the opportunity to track and report on urology-specific measures. Over the past few years, the AUA and other urology-focused registries developed such measures to create additional value to the reporting process for urologic providers. The challenge with all new measures is to establish benchmarks, which means these measures must meet the reporting minimum requirements set by CMS. A measure must be used by a minimum of 20 providers for at least 20 cases each within a given 12-month reporting period within the same calendar year to receive the designation of a CMS benchmark. Measures without CMS benchmarks receive a 3-point base value, whereas established measures with established benchmarks are worth a score of anywhere between 3 and10 points.

For the 2020 MIPS performance year, the AQUA Registry supports a total of 61 quality measures. For the first time, five urology-specific measures offered by the AQUA Registry have received historical benchmark status from CMS. These measures include AQUA8, AQUA15, AQUA18, AQUA26 and MUSIC11, and could gain the eligible professional up to 10 points each in the 2020 reporting year.

Participation in the AQUA Registry, at the Elite level, allows practices to report on quality measures and attest for the Promoting Interoperability (PI) and Improvement Activities (IA) categories. The deadline to subscribe at the Elite level for 2020 MIPS reporting is July 1, 2020. To learn more about how AQUA can assist with your reporting needs, contact AQUA@AUAnet.org.


The AQUA Registry Has Been Approved as a Qualified Clinical Data Registry (QCDR) for the 2020 Reporting Period

For the fifth consecutive year, AUA’s AQUA Registry has been approved by CMS as a Qualified Clinical Data Registry (QCDR), offering more quality measures than ever before. For the 2020 reporting year, the 61 quality measures include 17 non-QPP (urology-specific), 25 QPP and 19 eCQM (electronic clinical quality) measures. The CMS-approved non-QPP measures address conditions such as prostate cancer and castration-resistant prostate cancer (CRPC), benign prostatic hyperplasia (BPH), urinary stones, azoospermia, bladder cancer, and hypogonadism. The QCDR designation is critical to the success of the AQUA Registry’s efforts to support its participants in fulfilling the reporting requirements set forth by CMS.


2018 QPP Performance Results

In January 2020, the Centers for Medicare & Medicaid Services (CMS) released the 2018 Quality Payment Program (QPP) performance results. The findings showed that 98% of eligible clinicians participating in 2018 MIPS nationwide, will receive either a neutral or positive payment adjustment in 2020, which is an increase from 95% in 2017.

The high-quality performance continued even though CMS raised the overall positive performance threshold from 3 points in 2017 to 15 points in 2018. Positive payment adjustments remain modest in part because, under the MACRA law, payment adjustments must be budget-neutral. CMS expects that as future positive performance thresholds increase, there will be a smaller distribution of positive payment adjustments; therefore, the payments to exceptional performers will increase.


Selecting Priority Measures on the AQUA Registry Dashboard

The AQUA Registry now offers over 60 quality measures. In order to expedite your dashboard delivery, the AUA asks practices to select priority measures, which are the measures that are most important to the practice. On the dashboard, priority measures are designated by a tag detailing the status of the data mapping review (exploration, verification, awaiting practice clarification, measure verified, measure operational or measure non-operational).

The table below details the specifics of a priority measure.

Priority Measures
Practice Level
Identifies the measures that are most important to the practice and those that will be mapped and refreshed regularly on practice’s dashboard
Selected one time annually. To change a priority measure, a Service Desk ticket is required.
Designated by a tag detailing the status of the measure (open, exploration, verification, awaiting practice clarification, measure verified, measure operational or measure non-operational)

As a part of the 2020 Practice Setup (renewal) process, the AUA asked practices to select their list of priority measures by January 27, 2020. If you have missed this deadline, the measures chosen in 2019 carried over for 2020. If you wish to change your priority measures, you will need to contact FIGmd or submit a service ticket request, and the change will need to be approved by both the AUA and FIGmd. Please note that any changes to your 2020 priority measure list will delay the delivery timelines for your AQUA Registry Dashboard.

You are no longer able to log into your AQUA Registry Dashboard and select or deselect priority measures by using the favorite heart icon. The heart icon has been repurposed and now designates a subset of the priority measures, which are used internally by the individual user to quickly identify and track those priority measures that are of particular interest.

Additional information detailing the differences between priority and favorite measures is available through the Help feature on your practice’s dashboard.


Customer Service Survey

Customer Service Survey

In January 2020, the AQUA Registry Team distributed a customer service survey to all AQUA participating practices. Results from the survey are highlighted below:

  • The majority of AQUA Registry practices access their dashboards at least once a month
  • The key areas for which AQUA practices would like to see more measures are prostate cancer, bladder cancer, benign prostatic hyperplasia and overactive bladder/incontinence
  • Overall, practices are satisfied with the AQUA Registry

All survey respondents were entered into a raffle for a chance to win a lovely gift tower from Harry & David, pictured on the right. We would like to congratulate our prize winners and hope they are enjoying the treats with their colleagues.

Prize Winners:

Lowcountry Urology Clinics (Charleston, SC)
Cullman Urology, PC (Cullman, AL)

Thank you to everyone who responded to the survey. Your feedback is instrumental in enhancing the AQUA Registry experience for all participants. Please feel free to provide feedback on your AQUA Registry experience at any time by sending an email to AQUA@AUAnet.org.


Important Dates

2020
APR 01 2020 AQUA Registry Recruitment Begins
APR 07 Virtual Demonstration of the AQUA Registry Dashboard — Webinar 3:00 pm (EDT)
APR 30 2019 MIPS Submission Closes
JUN 30 Virtual Demonstration of the AQUA Registry Dashboard — Webinar 11:00 am (EDT)
JUL 01 Deadline to Subscribe to the AQUA Registry at the Elite level for 2020 MIPS Reporting

Tips & Tricks


2019 Reporting Changes that Are Expected to Continue in 2020

PI Bonus Measures:The Centers for Medicare & Medicaid Services (CMS) revamped the Promoting Interoperability (PI) measures. To satisfy the Public Health and Clinical Exchange measure, MIPS participants must report to two different public health agencies or clinical data registries. The AQUA Registry, as a QCDR, may be used to satisfy one of the requirements. Review the 2019 Promoting Interoperability Quick Start Guide for additional information on how to get started.

2020 Physician Fee Schedule Final Rule: The top 10 things urologists should know about 2020 MIPS.

2020 Payment Adjustment Fact Sheet: A reference that provides an overview of MIPS payment adjustments, determined by MIPS performance in 2018, which will affect payment for services in the 2020 calendar year.

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