Preventative Care and Screening: Influenza Immunization CMS Quality - PowerPoint PPT Presentation

Preventative Care and Screening: Influenza Immunization CMS Quality ID 110 Kelley Montague RN, BSN Quality Improvement Advisor TCPi- GLPTN

Influenza MIPS Quality Measures: Childhood Immunization Status- Quality ID 240 Preventative Care and Screening: Influenza Immunization- Quality ID 110 Value Driven.Health Care. Solutions. 2

Did You Know? Value Driven.Health Care. Solutions. 3

Did You know? Since 2010 the CDC estimates that annually influenza has resulted in: • between 9.2 million and 60.8 million illnesses • between 140,000 and 710,000 hospitalizations • between 12,000 and 56,000 related deaths For the 2015-2016 influenza season, CDC estimates that the influenza vaccination prevented: • 5.1 million influenza illnesses • 2.5 million influenza-associated medical visits • 71,0000 influenza-associated hospitalizations • between 3,000 and 12,000 deaths https://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm https://www.cdc.gov/flu/about/disease/2015-16.htm Value Driven.Health Care. Solutions. 4

Did you know? CDC report June 8,2018- CDC Reported Flu Deaths in Children Exceeds Seasonal High • Another pediatric flu-related death reported that week- Total 172 for the 2017-2018 Flu Season • 80% of these deaths occurred in children who had not received a flu vaccination this season. • 2017- 2018 season is described by the CDC as a “high severity season” • 2009 H1N1 pandemic 358 pediatric deaths • 2012-2013 season was similar to the 2017-2018- H3N2 predominated • H3N2 predominate flu seasons are typically associated with more severe outcomes https://www.cdc.gov/flu/spotlights/reported-flu-children-deaths.htm Value Driven.Health Care. Solutions. 5

Did You know? CDC Reports for the 2017-2018 Influenza Season: • Overall High severity season • A (H3N2) predominate season • Third overall high severity season since 2003-2004 • First classified high severity for all age groups • Mortality (P&I) remained above epidemic threshold for 16 consecutive weeks, peaking at 10.8% https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a4.htm Value Driven.Health Care. Solutions. 6

Did You know? https://www.odh.ohio.gov/en/seasflu/Ohio-Flu-Activity Value Driven.Health Care. Solutions. 7

Did You know? https://www.odh.ohio.gov/en/seasflu/Ohio-Flu-Activity Value Driven.Health Care. Solutions. 8

MEASURE SPECS For Preventative Care and Screening: Influenza Immunization

Preventative Care and Screening: Influenza Immunization Measure Description: Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization Denominator: All patients 6 months and older seen for a visit during the measure period Numerator: Patients who received an influenza immunization OR who reported previous receipt of an influenza immunization Value Driven.Health Care. Solutions. 10

Preventative Care and Screening: Influenza Immunization Denominator Encounter Criteria (Eligible Cases) Patients age >/= 6 months seen for a visit between October 1 and March 31 AND Patient encounter during January thru March and/or October thru December with eligible CPT or HCPCS (See next slide for CPT or HCPCS) Value Driven.Health Care. Solutions. 11

Preventative Care and Screening: Influenza Immunization Encounters Meeting Criteria for Denominator 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241*, 99243*, 99244*, 99245*, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 90945, 90947, 90951, 90952, 90953, 90954, 90955, 90956, 90957, 90958, 90959, 90960, 90961, 90962, 90963, 90964, 90965, 90966, 90967 90968, 90969, 90970, 96160, 96161, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99381*, 99382*, 99383*, 99384*, 99385*, 99386*, 99387*, 99391*, 99392*, 99393*, 99394*, 99395*, 99396*, 99397*, 99401*, 99402*, 99403*, 99404*, 99411*, 99412*, 99429*, 99512*, G0438, G0439 Found addition added 99242* WITHOUT: Telehealth Modifier: GQ, GT, 95, POS 02 Value Driven.Health Care. Solutions. 12

Preventative Care and Screening: Influenza Immunization Denominator Exclusions: None Numerator Exclusions: Not applicable Denominator Exceptions G8482: • Documentation of medical reason(s) for not receiving influenza immunization (eg, patient allergy, other medical reasons) • Documentation of patient reason(s) for not receiving the influenza immunization (eg, patient declined, other patient reasons) • Documentation of system reason(s) (eg, vaccine not available, other system reasons Value Driven.Health Care. Solutions. 13

Preventative Care and Screening: Influenza Immunization Numerator Can be Met G8482 by: Submitting administration of an influenza vaccination OR Patient reporting receipt of the current season’s influenza immunization If the performance of the numerator is not met, an eligible clinician can submit a valid denominator exception for not having administered an influenza vaccination. Value Driven.Health Care. Solutions. 14

How CMS Scores this Measure If you successfully report a measure for less than 60 percent of your patients, you will earn points based on your practice size: • Small practices (≤ 15 clinicians) will receive 3 points, • Larger practices (> 15 clinicians) will receive 1 point. If you successfully report a measure for at least 60 percent of your patients, but do not report at least 20 cases, you will receive 3 points. If you report this measure for at least 60 percent of applicable patients and on at least 20 patients during a reporting period, you will earn points based on the decile that corresponds to your performance rate. Value Driven.Health Care. Solutions. 15

Benchmarks Value Driven.Health Care. Solutions. 16

EDUCATIONAL MATERIAL For Preventive Care and Screening: Influenza Immunization

Vaccine Information Statement Inactivate Influenza Vaccine (8/7/2015) Value Driven.Health Care. Solutions. 18

Educational Material Value Driven. Health Care. Solutions. 19

ODH- Educational Pamphlet Value Driven.Health Care. Solutions. 20

ODH- “Kids Get Flu Too” Value Driven.Health Care. Solutions. 21

You can Order Influenza Educational Material Value Driven.Health Care. Solutions. 22

CDC Information Value Driven.Health Care. Solutions. 23

GUIDANCE FOR IMPROVING MEASURE For Preventive Care and Screening: Influenza Immunization

Improving Influenza Vaccination Through Office Efficiency for Practice Administering Flu Vaccine Begin administering vaccine as soon as it arrives (usually the first part of August) Value Driven.Health Care. Solutions. 25

Be Creative ▪ CMS recognized immunizations given after August 1 for the 2018-2019 Flu Season ▪ Educate and train staff on the influenza vaccine so they feel empowered to answer patients questions and educate them on the importance of receiving the flu vaccine ▪ Send secure portal message to notify patients that the vaccine has arrived ▪ Send education on why patient’s should get immunized via portal message ▪ Create a home web page around influenza and how they can be immunized at your practice (e.g. times and dates of clinics or addition office hours to accommodate ▪ Send text message to patient’s that the flu vaccine has arrived and with dates and times of clinics ▪ Create a message on the TV Monitor in the waiting room or have posters in the waiting room ▪ Have an influenza message on the practices “On Hold Message” Value Driven.Health Care. Solutions. 26

Be Creative ▪ Place educational material in the waiting rooms and exam rooms. Not just to remind those that are there for appointments to receive their flu vaccination but for them to take home and remind them to get their other family members in for vaccination ▪ Offer flu vaccination clinics for your patients- some practices even provide drive-thru clinics for their patients ▪ Open an hour earlier and stay open an hour later for patient’s to receive vaccinations without an appointment on their way to and from work ▪ Ensure that influenza immunizing is a part of every patients planned visit for the day ▪ Have morning huddles to discuss the patients that have not had their vaccinations and the strategy to encourage vaccination Value Driven.Health Care. Solutions. 27

Improving Influenza Vaccination Through Office Efficiency for Practice Administering Flu Vaccine Begin Administering vaccine as soon as it arrives If your practice administers influenza vaccination does your practice have a Standing Order for Administering the Influenza Vaccination? Value Driven.Health Care. Solutions. 28

ODH- Standing Orders for Administering Influenza Vaccine to Adults Value Driven.Health Care. Solutions. 29

Improving Influenza Vaccination Through Office Efficiency for Practice Administering Flu Vaccine Begin Administering vaccine as soon as it arrives If your practice administers influenza vaccination does your practice have a Standing Order for Administering the Influenza Vaccination? Use a Patient Checklist Screening Tool to assist in Screening for Contraindications Value Driven.Health Care. Solutions. 30

Screening Checklists for Contraindications to Influenza Vaccines Value Driven.Health Care. Solutions. 31