Page 12 - Volume 69 Number 2
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MPRO Update – April 2017
By James Mitchiner, MD, MPH
MPRO has been the CMS contractor overseeing and working to improve the quality of care for Medicare and Medicaid recipients in Michigan since its incorporation in 1984. MPRO and sister organi- zations across the country hold contracts as “quality improvement organizations” to work on a variety of initiatives to improve the health of the population. Since much of this work goes on behind the scenes, I thought it would informative for Bulletin readers to know about the programs that are currently being carried out by MPRO statewide. I therefore asked Jim Mitchiner, who is the MPRO medical director and a WCMS board member, to provide a summary of these important MPRO initiatives. Here is his report. – Editor
High Blood Pressure Detection. MPRO is collaborat- ing with the Michigan Department of Health and Human Services (MDHHS) in conducting blood pressure compe- tency workshops in primary care offices and some OB/ GYN offices, with the goal of improving identification of adults with undiagnosed hypertension. We have trained more than 130 medical assistants so far.
 This effort addresses one component of the Na- tional Quality Strategy: Prevention and Treatment of Leading Causes of Mortality. It is estimated that 14 million Americans have uncontrolled hyperten- sion and are not aware of their elevated blood pressures. Effective screening, targeted at medical assistants in physician offices, will help to reduce that number.
Early Cancer Detection. MPRO is working with ambula- tory care providers to promote early detection for lung cancer, colorectal cancer and breast and cervical cancers.
 Every primary care office should be promoting early detection of treatable cancers. MPRO staff (nurses and quality improvement [QI] specialists) will provide assistance to physician office staff to develop screening protocols for patients at risk for these cancers, enhance documentation and report- ing to third party payers of screening activities through the electronic health record (EHR), and instituting referral processes.
Reducing Disparities in Diabetes Care. As part of its 5-year contract with the Centers for Medicare and Medicaid Services (CMS), MPRO sponsors diabetes self-management workshops that encourage diabetics to take charge of their health. This no-cost program, referred to as the Diabetes Personal Action Toward Health (PATH), is six weeks long and offered to adults with type 2 diabetes and their caregivers. Workshops
take place in a community setting or at provider offices. Since 2014, MPRO has helped educate more than 800 diabetic Medicare beneficiaries in Michigan.
 This effort is focused on promoting diabetes self-education for patients and, in particular, reducing disparities in diabetic education and control among vulnerable minorities. The goal is to improve clinical outcomes, such as reduced hemoglobin A1c levels, better control of lipid levels and blood pressures, weight reduction, increased eye and foot exams, and reduced lower extremity amputation rates.
Adult Immunizations. MPRO also has a contract to col- laborate with local public health departments to increase the overall rate of adult immunizations against influenza and pneumonia, and to reduce immunization disparities among racial and ethnic minorities. We have established the St. Clair County Adult Immunization Coalition to
help improve that county’s low immunization rates. The coalition meets on a quarterly basis to share best practices and includes county health department staff and local healthcare providers across the care continuum.
 Two keys to improving immunization rates are helping practices implement standing orders
for vaccinations and documenting their success
in Michigan’s online immunization registry, the Michigan Care Improvement Registry (MCIR). Since many adults get their shots at community pharma- cies, MPRO will also be working with pharmacies to improve their rate of reporting to MCIR.
High Quality, Value-Based Care. MPRO’s QI and health information technology (IT) staff are working with physician offices to help clinicians succeed in the new Merit-Based Incentive Payment System (MIPS). Sup- port includes educational resources, updates on report- ing requirements/deadlines and technical assistance.
 As CMS continues its push toward greater value and quality in the Medicare program, physicians, beginning this year, will be required to document efforts to improve quality while holding down costs. The enactment of MACRA (the Medicare Access and CHIP Reauthorization Act of 2015) will now require physicians to report on quality mea- sures, utilization of IT tools, practice improvement and cost reduction efforts in order to earn financial incentives while avoiding penalties. Since many of the MIPS requirements are highly technical, MPRO staff (QI and IT specialists) can assist office staff to help their practices become compliant.
12 Washtenaw County Medical Society BULLETIN APRIL / MAY / JUNE 2017

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