Health plans and providers — submit Audited Clinical Quality measures
Once your test files have been approved by FinThrive, please turn your attention to the following milestones:
April 24: Send your data to your auditor
Health plans and self-reporting POs: send your data files to auditors for review before final submission to FinThrive. No audit is required for POs submitting Advanced Care Information e-Measures for the AMP Commercial HMO program.
May 5: Submit your data to FinThrive
Submit to FinThrive Healthcare via email at AMP@finthrive.com by 5pm PDT
Health plans and self-reporting POs: submit your auditor-locked data files to FinThrive.
POs who only submit e-Measures for use in AMP Commercial HMO: submit your data files to FinThrive.
Please see the AMP Program Guide for the detailed data submission timeline on page 12.
Health plans — Onpoint submission deadlines
April 14: Sign off on Enhanced Validation Report I (EVR I)
The EVR represents an essential part of IHA’s holistic approach to data quality by providing plans a glimpse into trends in their claims data to catch issues further upstream. Health plans received the EVR I report with instructions for review and sign off via email on March 16th. Please feel free to reach out to the AMP Client Success Manager if you have any questions or concerns.
April 28: Submit Q1 2023 data files and Annual Member Identifier file
Health plans have until April 28 to submit Q1 2023 data files and the 2022 Annual Member Identifier file.
Q1 2023 data submission should include monthly eligibility between January 1, 2023 and March 31, 2023 and all claims paid or changed through March 31, 2023 that have not been previously submitted.
The Annual Member Identifier file should include eligible members enrolled for at least one day between 1/1/22–12/31/22 and are included in your eligibility file submissions (no continuous enrollment criteria apply).
Please see the AMP Program Guide for the detailed data submission timeline on page 12.
Review updated AMP Technical FAQs
IHA recently released new guidance related to submitting the Prenatal Immunization Status (PRS-E) testing measure to FinThrive for MY 2022.
When reporting the data type stratifications for the PRS-E testing measure for AMP MY 2022, there may be instances when an organization may identify members who meet the denominator criteria through one data source (e.g., EHR or HIE), but may not use the same data source to identify members who meet the numerator criteria. This may result in having denominators for the data type stratifications that are lower than the numerators for those same data type stratifications.
The Atlas is a free, publicly available tool that measures how healthcare is performing, by geography and product type. Our latest Atlas release includes performance information for commercial insurers and Medicare Advantage to help improve care and reduce disparities. It also provides benchmarks by region and insurance type to enable performance tracking over time.
MY 2021 Atlas results are now available. Visit atlas.iha.org to see healthcare cost and quality insights and view tutorials to help you use the tool. For health plans, log in to compare and download your health plan’s results with all-plan aggregated data across California.
Last chance to register: Introduction to Value-Based Care for Physicians Webinar
Ready to improve the quality of your encounter data? On April 20, join the California Medical Association Physician Services Organization and IHA for a webinar on value based care for physicians. You’ll learn how to:
Improve accurate, complete, and timely documentation to represent a patient’s total health status.
Use value-based care coding to more accurately represent the care, services, and equipment provided.
Assess available data to manage patient health and reduce costs.
Physicians will earn a maximum of 1.0 AMA PRA Category 1 CreditsTM
Webinar: Introduction to Value-Based Care for Physicians
OPA Health Care Quality Report Cards, 2022–2023 Edition
The California Office of the Patient Advocate (OPA) is pleased to announce the preview period for updates to the 2022–2023 Edition Health Care Quality Report Cards — Commercial and Medicare. The preview period is scheduled to begin in early May.
Organizations will be sent a link to access the OPA Stakeholder page prior to the Preview Period. To be added to OPA’s mailing list, send an email to OPAReportCard@ncqa.org.
2023 IHA Stakeholders’ series
We’re bringing a whole new approach to IHA stakeholders’ conference for 2023. Instead of a single, annual conference, we’re introducing the 2023 Stakeholders’ Series. You’ll still get industry, program, and IHA-wide insights, but in a more tailored and timely way. This AMP newsletter is the launch of the series.
Stay tuned for more to come!
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