Advance care planning is a patient making decisions about the healthcare in Advance. In this manner their wishes are known should the become incapable of expressing themselves a the time of a medical crisis. These are decisions to make based upon the individual’s personal values, preferences, and discussions with their loved ones.
This measure does not apply to patients that are younger than 65 or patients that are in hospice care. When scoring Measure 47, these patients will neither count for nor against you. To ensure that hospice patients are excluded from the measure, simply mark the hospice modifier on the bill.
For patients that are aged 65 or older, you need to sit down with them and ask if they have done any advance care planning during this process you have the opportunity to educate the patient about Advance Care Planning.
To meet the measure, you have to ask if they have an advance care plan and they need to answer. The answer can be:
- • The have some form of Advance Care Plan in Place
- • The patient does not have a plan.
- • The patient does not wish to discuss an Advance Plan. (for any reason)
Meeting the measure is all about asking the question and documenting the patients response.
This can be a sensitive question and care needs to be taken when approaching this issue so that you do not upset or alienate your patients. Developing a process of asking the question and education of your staff on how to approach this issue with concern, care and empathy is vital to being successful when implementing this measure.
The creation of this process and documentation of the process happens to be a medium-weight Improvement Activity.
The doctor does not have to be the one to discuss advance care planning the. This activity is probably best assigned to an individual or individuals who are best and demonstrating empathy with patients and are good communicators. Spend some time educating your staff on how to address advanced care planning with patients. Cover potential barriers or discomforts that either your staff or patients may experience with having this conversation. By having this process in place, not only does it take something off your plate, it also allows you to address Improvement Activity: Advance Care Planning
The advance care plan DOES NOT need to be reviewed annually to meet the numerator criteria. If their personal beliefs preclude them from advance care planning, you do not want to ask the patient again as it will potentially harm the doctor patient relationship. If you have documented that the patient has an advance care plan in place you may want to confirm it is still in place you are not required to do so. If, previously they stated they did not have one and you provided them with educational information, it would be appropriate to ask the question again.
Every measure is worth up to 10 points. While this measure is easy for you to meet, it means it is also easy for other providers to meet. Historically providers do well on this measure which makes it more stringent for you to earn a full 10 points on this measure. To score a full 10 points, you need to get 100% performance score. You cannot miss a single patient. The metrics on the measure this year have become stricter and if you miss a single patient or score 99.99%, you can earn a maximum of 8 points.
Our goal is to get 60/60 points in quality measures. You have to report on 6 measures. If you are a small practice, you get an additional 6 bonus points. By scoring an average of 9 on the six measures and adding the 6 points, you get the full 60 points.
Contact Registry Clearinghouse at info@registryclearinghouse.com or schedule a meeting to learn more about how Registry Clearinghouse can help you.
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