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14 Articles in Volume 18, Issue #2
Ask the Expert: Is there evidence to prescribe cyclobenzaprine long-term?
Challenging the Chronic Pain Personality Profile
Designer Peptide May Prevent Chemo-Induced Neuropathy
Inside the Cancer Pain Research Consortium
Intrathecal Drug Therapy for Cancer-Related Pain
Managing Cancer Pain in an Era of Modern Oncology
Mapping Complex Pain: A Case Study
Medication Overuse Headache: Inaccurate and Overdiagnosed
Pain and Fall Risk in the Elderly
Reporting Quality of Care in Cancer Pain Management
Sharing the Risk: An Update to DEA & Doctors Working Together
The Intensifying Conflict Between Opioid Control and Pain Control
Two Mobile Apps Aim to Target Patient Compliance & Safety
Why Prescribers Need to Adopt Abuse-Deterrent Opioids

Reporting Quality of Care in Cancer Pain Management

New ASCO clinical data registry aims to improve pain practice while helping clinicians’ offices to meet new CMS reporting and reimbursement requirements.

With Stephen Grubbs, MD

The American Society of Clinical Oncology (ASCO) and American Society for Radiation Oncology (ASTRO) continue to add to their quality practice initiatives, most recently, with the launch of a Qualified Clinical Data Registry that may help pain practitioners improve care.

Released in January 2018, the registry grew out of ASCO’s Quality Oncology Practice Initiative (QOPI), established in 2002 to improve the quality of care for patients being treated for cancer. The new registry aims to make it easier for physicians to report quality-related performance metrics, which as of this year are required in more detail by the Centers for Medicare and Medicaid Services (CMS) in order to meet certain reimbursement schedules under the Merit-Based Incentive Payment System (MIPS).

The MIPS payment mechanism is based on performance in quality, resource use, clinical practice improvement activities, and use of Certified Electronic Health Record Technology. Updated 2017 performance data provided by March 31, 2018 will result in a positive, negative, or neutral payment adjustment for qualifying practices in 2019.1 ASCO Vice President of Clinical Affairs Stephen Grubbs, MD, shared the QOPI effort with Practical Pain Management, and its potential impact on patient outcomes, as well as on practices working to treat cancer-related pain.

More Data, More Outcomes

The QOPI system has a library of more than 180 oncology quality measures, including pain management and end-of-life care measures. Practices self-report on a subset of these measures periodically to gauge their quality of care. By comparing their results to corresponding benchmarks, providers may then work to fill any gaps in their quality of care. One means of overcoming these gaps has been for practices to participate in ASCO’s six-month Quality Training Program course (look for a case report in an upcoming PPM issue). Those practices that score high on 24 different measures and successfully pass an audit may receive special recognition via QOPI Certification.

The new MIPS program requires practices to report six quality measures to CMS annually. The QOPI reporting registry aims to further help practices meet these requirements, including the agency’s provisions set forth in its 2018 Final Rule on policy, payment, and quality.2

“CMS now requires practices to report certain quality metrics, and these affect reimbursement schedules,” Dr. Grubbs said. “Going forward, physicians must report on 60% to 90% of all qualifying patients for a particular measure in a given year, not just a sample of qualifying patients that was required in the past. The volume of data submission has increased greatly, and the registry provides a tool for physicians to input this data.” The ASCO/ASTRO registry team then reports the data of participating practices to the government.

With regard to pain management, which is a major component of cancer care, the registry benchmarks practices on whether they are, for example, quantifying pain intensity and whether they have a plan of care for the pain. A new measure added this year addresses whether appropriate follow-up for opioid therapy is being conducted, as well. Each measure aligns with specific markers that physicians typically have in their records, said Dr. Grubbs.

Also new in 2018 is the QDCR’s ability to capture data electronically so that practices no longer have to pull and report data manually (though manual reporting is still available if practices prefer that method). There is a dashboard for each measure with real-time reporting, making continuous practice improvement goals visible and attainable.

What to Expect

It is worth noting, said Dr. Grubbs, that a practice’s year-over-year scores may actually decrease initially. All patient data is now being captured and scored, whereas the prior system was based on only a sample of patients. “A fall in scores will really be a mirage for a performance decline because of the way we are now required to report,” he explained, “but with this additional data, we will begin to pinpoint where practices can improve performance.”

To use the registry, a practice must have one active ASCO or ASTRO member. Details about the QOPI reporting registry are available at https://qcdr.asco.org/signup/Login.aspx.

Last updated on: March 4, 2018
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Mapping Complex Pain: A Case Study
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