Decoding the iQIES Transition: What to Expect and How to Prepare

CMS recently began migrating Minimum Data Set (MDS) submissions and reporting to a new system —  the internet Quality Improvement and Evaluation System (iQIES) — on April 17, 2023. Since then, all skilled nursing facilities have been required to transition to iQIES to continue submitting important MDS information.

In the latest episode of PointClickCare’s podcast, Collision Point, Jackie Nordhoff, RN, BSN and Genice Hornberger, Directors of Regulatory Affairs at PointClickCare, were joined by Cynthia Morton, Executive Vice President at ADVION, to discuss the implications of this MDS transition and how providers can best prepare.

Why is CMS doing this? What is the goal?

CMS elected to implement these global changes to improve the privacy and security of patient health information — a rising priority within healthcare as secure patient data becomes increasingly important to value-based care objectives and IT professionals see an uptick in cyber-attacks.

“This effort by CMS to move to a more secure and modern platform is very welcome,” Jackie, Genice, and Cynthia all agreed.

How will these changes impact LTPAC facilities in particular?

MDS assessments are critical to the business of long-term care providers and skilled nursing facilities (SNFs) in that they drive reimbursement for Medicare and Medicaid in many states. Genice explained, “Facilities get reimbursed by Medicare for their Medicare A patients, but they also get reimbursed by Medicaid in some states using the MDS. And so, it’s really important that these MDSs are completed in a timely manner, not only for care planning and driving that resident’s care, but also from a reimbursement perspective.” 

How is this shift affecting PointClickCare and its customers? And how is PointClickCare helping customers stay compliant?

It’s crucial that all SNF providers take action to prepare for this transition. Not only has PointClickCare made it a top priority to educate the SNF market on these changes, but we’ve also spent the last several months rebuilding our MDS auto-submission process to align with the new iQIES platform and ensure that we can continue to streamline the process for customers. Alternatively, manually submitting MDS assessments and tracking the status of these assessments can be a time consuming and error-prone process, resulting in regulatory compliance issues and delayed reimbursement.

What are some of the first steps that providers should take in anticipation of this shift?

One of the most important steps that providers should take is to determine who their ‘Provider Security Official’ — or the person who will act as the manager of all iQIES accounts and access for that facility — will be. This individual will be responsible for approving any additional users or vendors within the facility.

Another important step will be to approve additional users, including third-party vendors like PointClickCare. “This second step is crucial, because it will allow us to build the actual automation to submit for those assessments, and that’s something our team has been working on over the last six months,” explained Genice. 

Where can technology take post-acute partners in the future?

PointClickCare and ADVION have spent the last several months working closely with CMS to help educate them on the specific roles that EHR vendors play in long-term post-acute care settings, including automation to help streamline operations. This way, CMS can provide the tools and the resources these vendors need to build a workflow for the new MDS site.

“CMS has got to understand that there are IT needs out there with lead times for programming, and the need for testing environments,” Cynthia emphasized. “This advocacy is really, really important to have CMS understand where we are, so that they can give us the lead time that is necessary, so testing and education can happen out in the field.”

The three agreed that the iQIES transition was a great opportunity to educate CMS on where technology is playing an important role today, and how vendors can continue to partner with CMS in the future to benefit providers and their patients. The hope is that this advocacy will enable more technology advancements in the sector down the line — an initiative with high importance in the LTPAC space.