Quality improvement is a major
initiative for the Centers for Medicare and Medicaid Services
(CMS). With the passing of the Affordable Care Act in March 2010,
there is an increased interest in providing quality healthcare for
Medicare and Medicaid beneficiaries. Thus, it is imperative that
CMS collect data for measuring and evaluating the quality of care
provided to PACE participants and to establish PACE quality
strategies and benchmarks for PACE organizations. This request is
for requiring PACE organizations to enter Level I and Level II data
into the CMS's Health Plan Monitoring System (HPMS) (an electronic
data entry system) for purpose of analyzing quality of care. Once
PACE organizations are entering Level I and Level II data into
HPMS, CMS will be able to analyze results for each organization and
the PACE program as a whole. We can then use that analysis to
develop a quality improvement strategy for PACE.
There are several data quality
changes (see Appendix A for a list of this iteration’s quality
data) which have no impact on our currently approved burden
estimates. The changes were made to mimic industry terminology and
standards. More specifically, there was a name change from
Prospective enrollees to Denials, there was no change in the
intent, however we HPMS to capture the same information. For
Census, this information was collected in the HPMS but was not
listed under as a certain individual title and therefore the
technology within the HPMS system allowed for a title to be created
in the system for the number POs in a PO (which is called census).
While Immunizations has always been collected, it was inadvertently
omitted from the currently approved information collection request.
Unusual incidents and Reporting requirements/all reporting is not a
new requirement, it’s the old terminology relating to Level I and
Level II as Unusual incidents. Additionally, we are: (1) Adjusting
our estimated number of respondents from 100 POs to 120 POs. (2) We
are adding three (Falls, Falls with Injury and Pressure Ulcer
Prevalence) PACE Quality measures adopted from the NQF. (3) While
the number of data categories is unchanged, this iteration adds 50
Level I entries and 85 Level II entries. The adjustment is in
response to public comment. (4) Based on previous and current
public comments we are adjusting Level I response time from 0.25 hr
to 2.0 hr. (5) Correcting our calculation for the number of
responses which should amount to: # POs x annual frequency of
reporting. (6) We propose to collect all PACE quality data into
HPMS. Currently, Level I data is entered into HPMS as a narrative
for each requirement. The change includes entering all PACE quality
data collected in HPMS from a pick list/drop down selection
format.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
Form CMS-10525 Quality Measure(s) Data Entry
CMS-10525 - Supporting Statement A [rev 12-20-2016 by OSORA PRA].docx
Quality Measure(s) Data Entry