million hearts model data registrymhmodel-controlgroup-documentlibrary.cms.gov/files...mh model...

Centers for Medicare & Medicaid Services

Million Hearts® Model Data Registry

“How-to” User Manual for Control Group Participants

Updated June 2018

CMS XLC Table of Contents

Table of Contents

Table of Contents ....................................................................................................... 2

1. Introduction to the MHM Data Registry ............................................................... 3

2. Getting Access and Logging In ............................................................................ 3

2.1 Roles within the MHM Data Registry ............................................................ 4

2.2 Logging in ............................................................................................... 4

3. How to Enroll Beneficiaries in the MHM Data Registry ..................................... 8

3.1 Manual Data Entry ........................................................................................ 8

3.2 Bulk Upload using a Data Template............................................................ 11

3.3 Bulk Upload Using an EHR File .................................................................. 15

4. How to Submit Data for Annual Visits ............................................................... 17

4.1 How to Manually Enter Annual Visit Data for one Beneficiary .................... 18

4.2 How to Enter Annual Visit Data for Multiple Beneficiaries in Bulk ............... 18

4.3 How to Upload Annual Visit Data for Multiple Beneficiaries from your EHR 18

5. How to Add, Edit, or Delete Practices and Provider Data ............................... 19

5.1 How to Manage Practice Data .................................................................. 19

5.2 How to Manage Provider Data .................................................................. 20

6. New Medicare Cards and the Medicare Beneficiary Identifier ........................ 22

6.1 New Medicare Cards and MBI Formatting .................................................. 22

6.2 MBI in the MHM Data Registry Interface .................................................... 23

6.3 Entering Patient Data Manually With MBI ................................................... 24

6.4 Entering Beneficiary Data via Excel Upload with MBI ................................. 25

6.5 Entering Beneficiary Data via CCDA Export using MBI .............................. 27

6.6 Next Steps ................................................................................................... 27

7. How to Learn More .............................................................................................. 27

MHM Data Registry User Guide ii Million Hearts® Model Data Registry

MHM Data Registry User Guide 3 Million Hearts® Model Data Registry

1. Introduction to the MHM Data Registry

Roles within the MHM Data Registry

The Million Hearts® Model (MHM) Data Registry is an interactive, web-based platform that facilitates the exchange of beneficiary data between CMS and Million Hearts® (MH) Model participants throughout the model. Submitting demographic and clinical data for your eligible beneficiaries through the MHM Data Registry will drive key processes. The data you enter into the MHM Data Registry is the data source for the calculation of incentive payments you receive and the government’s evaluation of long- term model outcomes.

The MHM Data Registry will allow you to complete four key activities during the model:

1. Enroll beneficiaries in the MH Model: Submit eligible beneficiaries for enrollment throughout the model by entering demographic and clinical data collected during in-person visits.

You can enroll beneficiaries at any time after the Model ‘goes live’ starting on January 3,

2017

2. Submit beneficiary data throughout the Model: Continually enter data for your enrolled beneficiaries to fulfill model requirements.

You must enter data for each enrolled beneficiary at the ‘anniversary’ visit once a year.

This document will discuss how to complete these important model activities in detail. If you would like to learn more about these processes in a hands-on, simulated environment, you are encouraged to complete the “Using the MHM Data Registry in Practice” web-based training, which was released by the MH Model Team in November 2016.

2. Getting Access and Logging In

Each individual who plans to access the MHM Data Registry will need to complete the MHM Data Registry access request process, which includes three primary steps:

1. Register for an EIDM Account: Visit the CMS secure portal and register as a new user to create an Enterprise Identity Management (EIDM) account (if you already have an EIDM account, then you may skip this step).

2. Request Innovation Center Access: Use your new EIDM credentials to log into the portal and complete identity proofing and install multi-factor authentication, and request access to the Innovation Center (IC).

3. Request Access to the MHM Data Registry: Once granted IC access, enter the IC and request access to the MH Model Data Registry, selecting the appropriate user role based on what function you will be serving in the model, e.g. practitioner or practice administrator.

http://mhmregistrywbt-control.cms.gov/


Logging in

Information on how to complete this process is detailed in the MHM Data Registry Access Request Quick Reference Guide, which was distributed by the Model Team in November 2016 via email. Please contact the MH Model Help Desk for more information or find additional guides at the following CMS web page: https://portal.cms.gov/wps/portal/unauthportal/faq.

2.1 Roles within the MHM Data Registry

Depending on their role in your organization, individuals should select a user role when they register for MHM Data Registry access: Practitioner, Practice Administrator, or MH Practice Contact. See the figure below for information about the available actions of each role within the MHM Data Registry:

MHM Data Registry User Roles

Practitioner

Practice Administrator

MH Practice Contact

Which team members should have User Roles?

Clinical Staff

Administrative Staff

and Care Team Members

Designated MH Model

Points of Contact

What can each User do in the MHM Data Registry?

Enter beneficiary information either through manual entry or bulk EHR upload

Only for their own NPI

For any NPI in their organization


Modify beneficiary data before it is locked




Delete beneficiaries from the user interface




Add and delete providers from their organization



Approve Practitioner and Practice Administrator Users


For more information about user role selection and registering for access, please contact the MH Model Help Desk (see Section 6 for contact information).

2.2 Logging in

1. Once you have access, type or copy/paste the following URL into your browser:

https://portal.cms.gov

2. Sign in to the portal using your EIDM username and password

3. Review the Terms & Conditions and click “Agree”

4. Click “Login”

https://portal.cms.gov/wps/portal/unauthportal/faq


Logging in

5. After logging in, select the ‘Innovation Center’ from the My Apps page

6. You will also be able to contact the Innovation Center application support by using the dropdown on

the lower right-hand side, if needed


Logging in

7. Once you are in the Application Console, click ‘Launch MHDR’ which will take you directly to the MHM Data Registry

8. When you arrive at the MHM Data Registry you will first be prompted to select the practice for which you

are entering or viewing data if you have multiple practices within your Participant Organization


Logging in

9. You will then be taken to the Data tab by default. This tab is where you will complete the majority of your activities in the MHM Data Registry. If you have any technical issues or questions while in the MHM Data Registry, you may view FAQs in the FAQ tab or create a help ticket in the Support tab at the far right.

(Note: the Administration tab will only appear to those registered with the Practice Administrator or MH Practice Contact role described in Section 2.1)


3. How to Enroll Beneficiaries in the MHM Data Registry

Manual Data Entry

Your organization should enter new visit data for all beneficiaries you think will be eligible, according to the eligibility criteria outlined in your Onboarding Packet. By entering data in the Registry for a new beneficiary at or after an in-person visit, you are submitting their record for enrollment. All completed data are pulled by an automated process at the end of each month, and validated against Claims data. CMS then aligns the appropriate, eligible beneficiaries to your organization for the purposes of the model.

You can submit demographic and clinical data to enroll eligible beneficiaries in three ways:

1. Manual Data Entry: Submit data for one patient at a time by manually typing in each demographic and clinical value collected in an in-person visit. (This can be done during the actual visit, or retroactively, up to one performance period after the six-month performance period in which the visit occurred, as long as the visit itself occurred on or after January 3, 2017).

2. Bulk Upload Using a Data Template: Submit data for multiple beneficiaries and/or multiple visits by populating a template provided by the MHM Data Registry with data from your organization’s records.

3. Bulk Upload Using an EHR File: Upload a CCDA file exported from your EHR that contains

data for multiple beneficiaries and/or multiple visits.

Regardless of how you enter data, your submission must include the following values for each beneficiary:

Beneficiary MBI or HICN

First and Last Name

Date of Birth

Race and Ethnicity

Gender

Date of visit

Provider NPI

Systolic Blood Pressure

Cholesterol (Total, HDL, LDL)*

Current smoker (Yes/No)

History of Diabetes (Yes/No)

History of Atrial Fibrillation (Yes/No)

Current statin treatment (Yes/No)

Current aspirin therapy (Yes/No)

Hypertension treatment (Yes/No)

*The MBI, or Medicare Beneficiary Identifier, is the new Medicare identifier that can be used instead of or in addition to HICN in the MHM Data Registry.

*Note on Cholesterol Data Collection: Due to the limited number of cholesterol tests allowed under Medicare, cholesterol is the only data element that may be submitted from a previous in- person visit, even before the MH Model. Cholesterol for baseline visits can go back 5 years, and cholesterol for annual visits can go back 1 year. If past cholesterol data is not available, the MH Model allows 2 additional months after the in-person visit date to obtain cholesterol results.

3.1 Manual Data Entry

Each time you log in to the MHM Data Registry, you will land on the Data tab by default. To manually enter data for one beneficiary at a time, complete the following steps within the Data tab:

1. Click Enter Beneficiary Data under the “Manually Enter Individual Beneficiary Data” tile

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2. Enter demographic and clinical data for the beneficiary according to the most recent clinical visit (as long as it takes place after the model begins in January 2017).

Note: If you are a provider, your NPI will be auto-populated. If you are a Practice Administrator,

you must select a provider’s NPI on whose behalf you are entering visit data.

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3. Once you have entered all data points, click Complete. You will be prevented from

submitting the form if any fields are not filled in. If you would like to, you can save the form and complete it later.

4. You will be prompted to certify the accuracy of the information entered; once you certify, you will be brought back to the Data tab. You should see the beneficiary’s updated record in the “My Participant Organization Data” table at the bottom.

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3.2 Bulk Upload using a Data Template

If your organization chooses to submit data for multiple beneficiaries and/or multiple clinical visits at one time, you will have the option of populating a template provided in the MHM Data Registry. Follow the steps below to complete this process:

1. In the Data tab, select Upload Spreadsheet under the “Upload File for Multiple Beneficiary Data” tile

2. On the next page, you can download the bulk upload materials including a Beneficiary and Visit data template and a Definition File to guide your data entry.

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3. Once you have downloaded the Beneficiary Template and the Visit Template, populate the documents with the data you wish to upload. The beneficiary template contains demographic data only; the visit template includes clinical values.

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Note: The templates contain a ‘Delete Indicator’ field. If you would like to delete beneficiary data in bulk, you can change values of a previously populated template to ‘Y’ in the Delete Indicator field then upload it to delete data from the Registry. If you are uploading new beneficiaries, or uploading updated data for beneficiaries already in the registry, make sure the Delete Indicator field says ‘N.’

4. Save the populated file(s) to your computer.

5. Return to your web browser (still on the Upload Beneficiaries page) and select the appropriate button to upload the template you wish to submit. Please note: you can submit both a Beneficiary File and a Visit File at the same time or in any order.

6. Click ‘Select Beneficiary Files’ and/or ‘Select Visit Files.’ Using the pop-up window, browse for the populated template you previously saved to your computer and select it for upload.

Note: Simply selecting the file from your computer does not mean it is uploaded to the Registry; it appears on the Registry screen to show you it is ready to upload. You must then click ‘Upload Files’ at the bottom of the screen.

7. Once you’ve selected your desired files and they appear ready for upload on your screen (with the word ‘Remove’ below), select Upload Files at the bottom right of the screen to begin the file upload.

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8. In the Certificate of Accuracy and Attestation pop-up window, read all information and certify that the data is correct by clicking Confirm.

9. Wait for the progress bar to turn green and read ‘Complete.’ This means your upload was successful.

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Note: If your file fails to upload and the progress bar remains red and shows a number of ‘Errors’, then click the ‘Error log’ which will open a window that lists the errors (e.g., HICN or MBI is missing for beneficiary). You can also click ‘Error File’ which will open up the same populated template you uploaded, but only containing the beneficiary record(s) with the error(s). Fix the error(s) in this Error File, save to your computer, and upload again to the Registry using the same process.

3.3 Bulk Upload Using an EHR File

You can upload demographic or clinical beneficiary data in bulk using a file exported from your organization’s EHR. This requires exporting the data in a standard CCDA format from your E.H.R. system.

1. Extract a CCDA zip file from your EHR with the desired parameters and save to your computer. This file should contain demographic and/or clinical data. For further instruction on how to export this file from your EHR, view the resources highlighted in Step 3 below.

2. On the Data tab, click Upload EHR File in the Upload Standard EHR Format tile.

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3. On the next page, you can download resources at the top of the page to guide your CCDA

file extraction from your EHR.

4. On this same page, similar to the Bulk upload process, click ‘Upload Zip Files’ in the Upload EHR Files section.

5. Once the pop-up appears, browse for the zip file containing the CCDA data file extract from your EHR. Do not unzip the file before uploading it into the Registry.

6. Once the file is ready for upload, click ‘Upload files’ at the bottom of the screen and confirm the accuracy of the data. Then the upload will begin, and you can track the status using the progress bar which should turn green once complete.

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7. Wait for the progress bar to turn green. Then exit or click ‘Return to Beneficiary Registry’ to return to the Data tab.

Note: If your file fails to upload and the progress bar remains red and shows a number of ‘Errors’; then click the ‘Error log’ which will open a window that lists the errors (e.g. HICN or MBI is missing for beneficiary). You can also click ‘Error File’ which will open up the same populated template you uploaded, but only containing the beneficiary record(s) with the error(s). Fix the error(s) in this Error File, save to your computer, and upload again to the Registry using the same process.

4. How to Submit Data for Annual Visits

As a MH Model Control Group participant, you are required to submit updated clinical data for each of your enrolled beneficiaries annually during his or her Anniversary Window. A beneficiary’s Anniversary Window spans 10-14 months following the date of enrollment data submission or previous annual visit.

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Data can be submitted to the Registry manually or via bulk or EHR file upload. Follow the steps below for each of these options.

4.1 How to Manually Enter Annual Visit Data for one Beneficiary

1. Locate a given beneficiary in the ‘My Participant Organization’ section toward the bottom of the Data tab. You will know if a beneficiary is ready for an anniversary visit by referencing the ‘Anniversary Date’ column and looking for the symbol that indicates ‘Beneficiary is Within Anniversary Window.’

2. Click the gear symbol in the Actions column at the far right of the beneficiary list.

3. Then click ‘Edit Beneficiary’ or ‘Add a Visit’ if available. This will open a new beneficiary visit form where you can enter clinical values for the anniversary visit. Make sure that the date field is populated with the date of the visit, not the date the data is entered (if after the visit date).

4. Now use the same process as outlined in Section 3.1 for entering and saving values.

4.2 How to Enter Annual Visit Data for Multiple Beneficiaries in Bulk

You may use the same process as outlined in Section 3.2.

4.3 How to Upload Annual Visit Data for Multiple Beneficiaries from your EHR

You may use the same process as outlined in Section 3.3.

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5. How to Add, Edit, or Delete Practices and Provider Data (Practice Administrator or Practice POC role only)

Those with the Practice Administrator or Practice POC role in the Registry will be able to manage the data of their organization including adding, editing, and deleting providers aligned to their organization. Follow the steps below to complete this process.

Also note that Control Group participant organizations are permitted a maximum of 20 eligible participating providers.

5.1 How to Manage Practice Data

1. Navigate to the Administration tab.

2. Select Edit Practice in the ‘Actions’ drop-down.

3. Edit basic practice data and click Save.

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5.2 How to Manage Provider Data

1. Navigate to the Administration tab

2. Click the ‘Actions’ drop down and select ‘Manage Providers’.

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Adding a Provider to Your Organization

1. Click ‘Add Provider’ to add a new provider.

2. Enter provider data and click ‘Add’. Please note: the NPI that you enter will be validated by CMS against the NPPES database. Only enter an NPI that is valid and assigned to a provider within your practice.

Deleting a Provider from Your Organization

If you would like to remove a provider from the MHM Data Registry but there are currently beneficiaries assigned to that provider, please submit a Help Desk ticket to [email protected] with an encrypted file containing the list of MBI and/or HICNs aligned to the NPI that is being removed and provide the alternate NPI for the records. After emailing the encrypted file and receiving your ticket number, call the Help Desk with the associated password and provide the ticket number for reference. The MH Model Team will manually move these beneficiaries for you so that you can delete the provider.

If there are no beneficiaries assigned to a departing provider, you can remove the provider from your practitioner list by referencing the instructions below.

1. Delete a provider by clicking the ‘Actions’ drop down in the provider list and selecting ‘Delete’.

mailto:[email protected]

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6. New Medicare Cards and the Medicare Beneficiary Identifier

6.1 New Medicare Cards and MBI Formatting

The Medicare Beneficiary Identifier (MBI) will be clearly different from the HICN and RRB number. It will be 11-characters in length and made up of only numbers and uppercase letters, with no special characters. Each MBI is unique, randomly generated, and the characters are "non-intelligent," which means they don't have any hidden or special meaning. New Medicare Cards will look like the image below. Please note that the dashes in the MBI are there to make it easier to read and are not actually entered into systems.

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Every MBI will be formatted according to the following standards: Position 1: Numeric value (1 through 9) Position 2: Alphabetic value (A…Z; minus (S, L, O, I, B, Z) Position 3: Alpha-numeric value 0 through 9 or A through Z minus (S, L, O, I, B, Z) Position 4: Numeric value (0 through 9) Position 5: Alphabetic value (A…Z; minus (S, L, O, I, B, Z ) Position 6: Alpha-numeric value 0 through 9 or A through Z minus (S, L, O, I, B, Z) Position 7: Numeric value (0 through 9) Position 8: Alphabetic value (A…Z; minus (S, L, O, I, B, Z Position 9: Alphabetic value (A…Z); minus (S, L, O, I, B, Z) Position 10: Numeric value (0 through 9) Position 11: Numeric value (0 through 9)

Example MBI: 9A02CE3FK38

6.2 MBI in the MHM Data Registry Interface

Beginning April 1, 2018, instead of the HICN column, the beneficiary grid on the Data Registry page will have a HICN/ MBI column. Beneficiaries will be displayed with either HICN or MBI, based on the identifier you use for them when you manually enter or excel upload beneficiary data. If beneficiaries were entered using the HICN, their HICN's will display in the HICN/MBI column. If beneficiaries were entered using the MBI, their MBI's will display in the HICN/ MBI column.

For all beneficiaries using HICN, you must initiate a transition from HICN to MBI by December 31, 2019 for the beneficiary individually via an option on the drop-down below the actions gear next to each beneficiary or via a third excel upload file found on the drop-down menu next to Print Beneficiary Grid on the data homepage. This feature will be available for use by Monday April 16th, 2018.

Once you have initiated the transition, the Registry will remove the HICN from that record and you must use the MBI going forward. You cannot use a beneficiary’s HICN to enter new data after December 31, 2019.

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6.3 Entering Patient Data Manually With MBI

Beginning on April 1, 2018, beneficiaries will start receiving their new Medicare Cards, and you will be able to transition to using MBI instead of HICN in the MHM Data Registry. After April 1, 2018:

If you have a new beneficiary, simply enter their data into the Beneficiary & Clinical Information form using whichever identifier they provide (HICN or MBI). The image below illustrates the updated Beneficiary & Clinical Information form where you can enter HICN or MBI.

If an existing beneficiary comes in with a new Medicare card, and an MBI, you

must transition the beneficiary to MBI before adding a visit on their Beneficiary & Clinical Information in order to transition them to MBI.

o To manually initiate a transition : 1. Click on Transition to MBI under the actions for the beneficiary.

2. Enter the MBI for the beneficiary in the text box and click on save.

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6.4 Entering Beneficiary Data via Excel Upload with MBI

The excel upload process will also be modified in order to accommodate MBI. After April 1, 2018:

If you have a new beneficiary, upload the beneficiary and visit files using

whichever identifier they provide (HICN or MBI). The image below illustrates

the updated files where you can enter HICN or MBI.

If an existing beneficiary comes in with a new Medicare card and an MBI, you must fill out the MBI Update File (shown below) in addition to

uploading their visit file in order to transition them to MBI.

o To fill out the transition file: 1. Click on Transition Beneficiaries to MBI link under Perform Bulk Actions.

2. Download the Data Template file.

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3. After you have downloaded it, fill in a row on the transition file for each

beneficiary that you want to transition to MBI using both the HICN and

MBI and upload the file to the MHM Data Registry

4. Fill in the visit file using MBI instead of HICN and upload the Visit and

MBI Update files together, ensuring that you used the same

beneficiaries in both files. Once the upload completes, the uploaded

beneficiaries will not only have their visit data added, but will also

display an MBI in the beneficiary grid instead of HICN.

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6.5 Entering Beneficiary Data via CCDA Export using MBI The CCDA zip file upload process will also accommodate MBI use after April 1, 2018.

If you have a new beneficiary, extract a CCDA zip file from your EHR using whichever identifier the beneficiary provides (HICN or MBI). You can find the object identifier (OID) information regarding the MBI field in the CCDA Processing Requirements document on the upload CCDA page.

If an existing beneficiary comes in with a new Medicare card and an MBI, you must transition them to MBI manually or via excel upload first before you can upload their visit data via CCDA export. Once the transition is completed, transitioned beneficiaries will display an MBI in the beneficiary grid instead of HICN.

Once you have transitioned beneficiaries, you may upload a CCDA extract zip file using MBI instead of HICN. Once the upload completes, the uploaded beneficiaries will not only have their visit data added, but will also display an MBI in the beneficiary grid instead of HICN.

6.6 Next Steps

Beneficiaries will begin receiving their new Medicare cards including MBI on April 1, 2018. From this point on, you should start using MBIs in the Registry. When beneficiaries come in for follow-up visits, encourage your providers to ask them if they have a new Medicare card. If they do, initiate the transition for these patients in the Registry. After December 31, 2019, you can no longer use HICNs for new data and must use MBIs.

Please refer to the following resources located in the Control Group Document

Library for even more information: 1. Recording, talking points, and slides from the MBI Webinar on March 21, 2018 2. MBI FAQs

7. How to Learn More

Using the MHM Data Registry will allow you to meet MH Model requirements and contribute to MH Model outcomes. If you have questions about how to use the MHM Data Registry, please see the FAQs and helpful information on the FAQ and Support tabs along the top of the page.

You can also contact the MH Model Help Desk at 844-711-2664, option 3 or at [email protected]. Please include your organization’s LOI in your request if possible.

For more information and helpful resources, visit the Control Group Document Library at http://mhmodel-controlgroup-documentlibrary.cms.gov/.

mailto:[email protected]

http://mhmodel-controlgroup-documentlibrary.cms.gov/

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