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Verana Health · Medicare quality reporting

A Medicare quality platform clinicians would recommend.

Reporting software that turned a dense compliance workflow into something clear and trustworthy.

Dense, but readable
Medicare quality reporting

A Medicare quality platformclinicians would recommend.

01Selection
02Completeness
03Validation
Verana Quality Reporting Help Center Sample Userquality.lead@example-practice.org
Quality MeasuresMIPS SubmissionQRDA Registry
partner
Back to Summary
Provider :Dr. Elena Park NPI :1234567801 TIN :876543211 Performance Duration :  01-01-2023 to 12-31-2023
QCDR
Quality PI IA
0Measure Selected(Select at least 6 measures inclusive of one outcome measure if data is available or one high priority measure.)
0Measures Meeting 20 Cases(All measures should meet the minimum required 20 patient cases.)
0Outcome/
High-Priority Measure Selected(You must select a minimum of 1 outcome measure if there is data or 1 high priority measure.)
Estimated Quality Points
0 + 0 = 00.0/60
PointsBonusTotal
Estimated Quality Weight
0/30
All
Registry ID
Quality IDMeasure TitleMeasure Types NumDenData
Completeness Excl
Excpt Performance Points
QCDR
QCDR 55Visual Acuity Improvement Following Cataract Surgery and Minimally Invasive Glaucoma SurgeryView STRATA Measures (3) High PriorityOutcome8635,392+Add
Data0
016.004.5
QCDR
QCDR 55-1Visual Acuity Improvement Following Cataract Surgery and Minimally Invasive Glaucoma Surgery2,9683,710+Add
Data0
080.0010.0
QCDR
QCDR 55-2Visual Acuity Improvement Following Cataract Surgery and Minimally Invasive Glaucoma Surgery2,0943,807+Add
Data0
055.008.0
QCDR
QCDR 55-3Visual Acuity Improvement Following Cataract Surgery and Minimally Invasive Glaucoma Surgery2,1473,904+Add
Data0
055.008.0
QCDR
QCDR 397Melanoma ReportingTopped Out3,0375,521+Add
Data0
055.008.0
eCQM
117Diabetes: Eye Exam3,9534,941+Add
Data0
080.0010.0
eCQM
012Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation2,3974,359+Add
Data0
055.008.0
eCQM
128Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan2,3115,135+Add
Data0
045.007.1
QCDR
QCDR 2Endophthalmitis Following Cataract Surgery4,2885,360+Add
Data0
080.0010.0
Data Last Updated On 09-30-2023
Data Completeness score of 70% or more needed to get measure points.
Profile Details and Validation
TIN Details
Eligibility
DRCF
TIN Details
Provider Name : Elena ParkNPI : 1234567801
Enter value
Enter value
Enter Date
Enter Date
TIN, NPI, Date must match the CMS1500 form. Update fields and submit again.
Upload CMS1500 Form
Select FileAction
CMS1500file.pdf
TIN, NPI and date in the CMS-1500 form do not match the TIN entered above. Update fields and submit again.
The TIN matches the CMS1500 form.

A Medicare quality platform clinicians would recommend.

Measure selection with requirements and scoresData completeness with the 70% thresholdTax ID checked against the claims form

* Screens updated for this portfolio. Names and data are not real.

A yearly compliance task that shows up as daily work

Each year, clinicians report quality measures to Medicare, and part of their payment depends on the score. It is a compliance obligation that shows up as a daily workflow problem. I designed it so teams always knew what to do next and could submit with confidence.

I moved design ahead of the sprint. I started holding onboarding sessions for developers on each new feature a sprint ahead of the build, and refined the designs from their input before anything was coded. When it came time to build, we moved fast: development cycles went from four weeks to two, and we hit the Medicare deadline. Research also showed that private practices and academic centers used the product differently, and that split reframed the product direction.

I designed the quality dashboards with input from the boards of two specialty societies.

Verana Health Medicare quality reporting interface showing Registry Quality Measures and Individual Submission workflows
Verana Quality ReportingHelpSample Userquality.lead@example-practice.org
Registry Quality MeasuresMIPS SubmissionQRDA Registry
partner
Northside Eye Care
All Locations (8)
All Clinicians (6)
None applied
Year to date
Show Measures
With Data
Search
FiltersDownload
Measure ID Measure
TypesBenchmarkPerformance Status
Use of High-Risk Medications in Older AdultseCQM 238High Priority
Registry avg: 2%
CMS benchmark: 3.38%
0%Open
Complications After Cataract SurgeryQCDR 54Outcome
Registry avg: 1%
CMS benchmark: 1.58%
0%Not Tracking
Documentation of Current Medications in the Medical RecordeCQM 68High Priority
Registry avg: 92%
CMS benchmark: 88.5%
99.99%Open
Diabetes: Eye ExameCQM 117
Registry avg: 82%
CMS benchmark: 54.86%
94.21% Verified
Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure by 15%QPP 141High PriorityOutcome
Registry avg: 88%
CMS benchmark: 85.64%
93.16%Open
Tobacco Use and Help with Quitting Among AdolescentsQPP 402
Registry avg: 85%
CMS benchmark: 94.67%
88.89%Open
Registry Quality Measures / Measure Details

Diabetes: Eye Exam

Measure ID: 117Measure Type: eCQMMeasure Specialty: OphthalmologyMeasure Criteria: Process

Percentage of patients 18 to 75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period.

View Measure Specifications
Northside Eye Care
All Locations (8)
All Clinicians (6)
Retina Group
Year to date

Performance Rate

Numerator − Numerator ExclusionDenominator − Denominator Exclusion − Denominator Exception
=
3,872 − 04,110 − 0 − 0
=
Registry avg: 82%
CMS benchmark: 54.86%
0.00%
Performance by clinician6 clinicians · Retina Group
ClinicianNPILocationNumeratorDenominatorRate vs. benchmarkPerformanceStatus
Dr. Elena Park1234567898Downtown81284296.4% Above benchmark
Dr. Marcus Reed1345678909Downtown69173793.8% Above benchmark
Dr. Priya Shah1456789010Lakeside65571891.2% Above benchmark
Dr. Owen Hart1567890121Lakeside60465092.9% Above benchmark
Dr. Lena Ortiz1678901232Northgate58860796.9% Above benchmark
Dr. Noah Brooks1789012343Northgate52255693.9% Above benchmark
Make the signal easy to find. Every measure shows its benchmark next to its score, and opening one keeps the same filters, so people move from the list into one measure’s results without losing their place. Synthetic data.

Make the next step obvious

Clear status on every measure, so teams can see what is done, what is at risk and what needs attention now.

Show everything, but structure it so the important signals rise to the top.

Verana Quality ReportingHelpSample Userquality.lead@example-practice.org
Registry Quality MeasuresMIPS SubmissionQRDA Registry
partner

MIPS Submission

To start the MIPS submission process, please select from the following options:

Northside Eye Care
2023
Individual
Submit as an individual

An individual is defined as a single clinician identified by their

  • Individual National Provider Identifier (NPI)
  • Tied to a single Taxpayer Identification Number (TIN).

If you report only as an individual

  • You will report measures and activities for the practice(s)/TIN(s) under which you are MIPS-eligible and be assessed across all 4 performance categories at the individual level.
  • Your payment adjustment will be based on your Final Score derived from the 4 MIPS performance categories.
Submit as Individual
Group
Submit as a group

A group is defined as a single TIN with 2 or more clinicians (of which at least one clinician within the group must be MIPS eligible) as identified by their NPI, who have reassigned their Medicare billing rights to a single TIN.

If you report only as a group

  • You must meet the definition of a group at all times during the performance period and aggregate the group’s performance data across the 4 MIPS performance categories for a single TIN.
  • Each MIPS-eligible clinician in the group will receive the same payment adjustment based on the group’s performance across all 4 MIPS performance categories.
Submit as Group
MIPS Submission / Individual Submission
Individual
Northside Eye Care
2023
Search
Default Validation
Name & NPITINEligibilityDRCF StatusValidationQualityPIIATotal Score
James Nguyen1234567898 876543211EligibleSignedCompleted30/3025/2515/1570.00SubmitView Submissions
Patricia Wells1987654321 876543211EligibleSignedCompleted28/3025/2515/1568.40Re-submitView Submissions
Robert Patel1456789012 876543211EligibleSignedValidation24/3020/2515/1559.00SubmitView Submissions
Maria Lopez1567890123 876543211EligibleSignValidation--------SubmitView Submissions
Daniel Kim1678901234 876543211Not eligible------------SubmitView Submissions
Aisha Brown1789012345 Add TINVerifySignValidation--------SubmitView Submissions
Items per page: 6Showing 1 - 6 of 6 items1 of 1 pagesPreviousNext
Section Submission
Select section(s) to submit:
QualityPromoting InteroperabilityImprovement Activities
Provider Name : James NguyenNPI : 1234567898TIN : 876543211DRCF : Signed
QualityPIIATotal Score
30/3025/2515/15 --.--
CancelContinue
Submission Checklist

You are about to submit your data to CMS. Please ensure the following for best submission results:

  • You have reviewed and completed applicable submission categories (Quality, PI, and IA). If you are submitting for Quality, you have selected six or more Quality measures to submit.
  • You verified your submission will be under NPI - 1234567898.
  • You verified your submission will be under TIN - 876543211.

If any of these points are inaccurate, exit this modal and make the correction prior to continuing.

Attestation
I verify that the data reported is true and accurate to the best of my knowledge.
BackSubmit
Submitted to CMS for James Nguyen.
From choosing a path to submitting. Teams see how the practice is submitting and whether each clinician qualifies before they start. Sections are added one at a time as the score builds, and a final checklist confirms everything before it goes to CMS. Synthetic data.

Put the rule next to the decision

People used to leave the page to look up the data completeness rule, so I put it right where the number is entered.

Verana Quality Reporting Help Sample Userquality.lead@example-practice.org
Quality MeasuresMIPS SubmissionQRDA Registry
partner
Back to Summary
Provider :Dr. Elena Park NPI :1234567801 TIN :876543211 Performance Duration :  01-01-2023 to 12-31-2023
QCDR
Quality PI IA
0Measure Selected(Select at least 6 measures inclusive of one outcome measure if data is available or one high priority measure.)
0Measures Meeting 20 Cases(All measures should meet the minimum required 20 patient cases.)
0Outcome/
High-Priority Measure Selected(You must select a minimum of 1 outcome measure if there is data or 1 high priority measure.)
Estimated Quality Points
0 + 0 = 00.0/60
PointsBonusTotal
Estimated Quality Weight
0/30
All
Registry ID
Quality IDMeasure TitleMeasure Types NumDenData
Completeness Excl
Excpt Performance Points
QCDR
QCDR 55Visual Acuity Improvement Following Cataract Surgery and Minimally Invasive Glaucoma SurgeryHide STRATA Measures (3) High PriorityOutcome8635,392+Add
Data0
016.004.5
QCDR
QCDR 55-1Visual Acuity Improvement Following Cataract Surgery and Minimally Invasive Glaucoma Surgery2,9683,710+Add
Data0
080.0010.0
QCDR
QCDR 55-2Visual Acuity Improvement Following Cataract Surgery and Minimally Invasive Glaucoma Surgery2,0943,807+Add
Data0
055.008.0
QCDR
QCDR 55-3Visual Acuity Improvement Following Cataract Surgery and Minimally Invasive Glaucoma Surgery2,1473,904+Add
Data0
055.008.0
Data Last Updated On 09-30-2023
Input data completeness for measure by clicking on hyperlink.
Data Completeness score of 70% or more needed to get measure points.
Add Population Data

To calculate data completeness for MIPS, divide the number of eligible patient encounters by the total possible patient encounters, and multiply by 100%. Threshold is 70%.

Data Completeness=(Data Points CapturedTotal Eligible Data Points)x100%
Data Points Captured:  Performance Met  +  Performance Not Met  +  Denominator Exception
Type in the Data Completeness for QCDR 55.
%
CancelSave
Data completeness, explained where it is entered. Data completeness is the share of eligible patients a practice reports on. The formula and the 70% minimum sit inside the dialog, and a score below the threshold is flagged in the table with the reason one hover away.
90NPS, from about 200 users surveyed after launch
~3,000clinicians reported to Medicare through it
2specialty registries

Nearly 3,000 clinicians across two specialty registries submitted their Medicare data through the platform, the first year practices could choose from every available measure.

What I’d carry forward. Compliance tools don’t need less information. They need a clear order, so the next step is always obvious.

Next case
Retina Market Analytics