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The Dish provides a quarterly update to participating sites enrolled in the MQii Learning Collaborative.
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AT A GLANCE
- Attend the upcoming December 20 Coffee Break if you have questions regarding your malnutrition quality improvement efforts or want to discuss new or continuing malnutrition initiatives
- Check out our new webpages about resources for food insecurity and nutrition risk and the corresponding MIPS Improvement Activity and please share any feedback or additional resources
- Current Tier 1 (or data-sharing) members should send a signed amendment to continue with data-sharing and new Tier 1 members should sign and send a full agreement
- Tier 2 members who are interested in transitioning your membership should let us know and consider signing the full participation agreement
- Share your progress or reach out with any questions to your MQii Point of Contact. Please also let us know about any transitions in leadership, requested topics for future events, or additional events of interest to share with other members
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SPOTLIGHT: NEW MIPS IMPROVEMENT ACTIVITY FOR CY 2022
As announced in our 2 most recent Coffee Breaks, we are pleased to share that our MQii-submitted Merit-Based Incentive Payment System (MIPS) Improvement Activity will be available for reporting in the 2022 Quality Payment Program via the CY 2022 Medicare Physician Fee Schedule final rule. The MQii Leadership Team has created new webpages and a corresponding clinical decision-making tool regarding screening for both food insecurity and nutrition risk on our website. This new IA is intended to support all clinicians to better screen for and treat these conditions simultaneously to improve patient health. For your reference, here is more information about MIPS and Improvement Activities. The Academy of Nutrition and Dietetics has also developed a new Practice Tip for dietitians addressing food insecurity among their patients. Let us know if you have any questions about how to report on this and engage your fellow providers. We look forward to supporting our Learning Collaborative members in leading implementation of these initiatives to better address and prevent food insecurity and malnutrition as supported by this important regulatory change.
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WHAT'S AROUND THE CORNER?
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Coffee Break: “Implementing an EHR-Based, Nurse-Administered Malnutrition Screening” | Monday, December 20, 2021, at 11:00 AM ET
We will discuss the process of implementing a nurse-administered MST screening, embedded in the EHR, as was completed and is currently being evaluated by dietitians in the Phoenix VA Health Care System (in partnership with members of the MQii Leadership Team).
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As a reminder, you can access member-only content, including webinar recordings and slides, a calendar of upcoming events, and archived Dish newsletters, on the MQii Member Area. The login information is: Username: MQii Password: MQiiLC2018!
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Telehealth Webinar
The Academy is hosting an upcoming webinar on January 7, 2022, titled “Tackling Telehealth from Policy to Practice.” Attendees will learn about the Academy’s new telehealth policy stance, details about how the Academy is advocating to enhance patients’ access to nutrition care through strong telehealth policies at the state and federal levels, and current federal legislative and regulatory proposals related to telehealth. Many of you contributed to our survey on dietitians’ use of telehealth last year (as shared in this FNCE poster and publication) and we know you are interested in learning more and optimizing care offered virtually, so we encourage you to attend and learn more if your schedule allows.
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Nutrition and Dietetics Advocacy Summit
Registration for the Academy’s 2022 Nutrition and Dietetics Advocacy Summit, to be held virtually from January 25–27, 2022, is now open. This year’s summit will include comprehensive trainings on medical nutrition therapy (MNT) expansion and child nutrition. Expanding access to care from dietitians for Medicare beneficiaries with chronic conditions (who may not otherwise have access to MNT) presents an important opportunity to improve their quality of care and health outcomes; it also enables more prominent contributions from the expertise and leadership of dietitians.
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Opportunities to Share Your MQii Project and Findings
The following list outlines several upcoming conferences that may be of interest to Learning Collaborative members. We encourage you to look at the event websites, review submission criteria, and consider sharing your research with the various audiences. Please reach out with any questions or for assistance in pulling together submission materials. You may also view additional upcoming external events (such as conferences and webinars) on our MQii Learning Collaborative calendar.
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NUTRITION POLICY UPDATES
Congressional Action on Food, Nutrition, Hunger, and Health
Senators Cory Booker and Mike Braun and Representative Jim McGovern recently introduced legislation that would authorize a White House Conference on Food, Nutrition, Hunger, and Health. This conference would bring together the government, healthcare system representatives, farmers, and individuals with experience addressing the needs of food insecure individuals in the US. The conference would ultimately aim to identify innovative and viable solutions at the government, healthcare system, and community levels to improve health by addressing nutrition issues. The Academy commended the proposed legislation in its press release summarizing the effort.
Additionally, the Senate Agriculture Subcommittee on Food and Nutrition, Specialty Crops, Organics, and Research held a hearing on November 2, 2021, titled “The State of Nutrition in America.” The hearing featured a panel of academic nutrition experts from across the country to speak about the complex food and nutrition challenges in America. The MQii team is pleased to see this strong bipartisan leadership in Congress and emerging priorities of improving the food system, reducing food insecurity, and addressing nutrition-related health issues in the US.
CMS Begins Reviewing Hospital Malnutrition Coding Compliance
CMS’ Supplemental Medical Review Contractor will begin audits to evaluate inpatient malnutrition coding compliance. This audit was recommended by the Officer of the Inspector General (OIG) after a 2020 report found that hospitals overbilled Medicare by $1 billion through incorrect severe malnutrition diagnoses on inpatient claims. The task force released a joint statement on the malnutrition hospital coding review. Similarly, OIG also just announced it will audit Medicaid inpatient hospital claims with severe malnutrition. More information about coding for malnutrition in the inpatient setting can be found on the Academy’s website. The Academy and other professional association partners continue to collaborate to help the Department of Health and Human Services, the OIG, and CMS to understand best practices for diagnosing, documenting, and coding for malnutrition. At the same time, it remains critical for Learning Collaborative members to work with multidisciplinary care team members to provide clear and comprehensive documentation, with specific and consistent supporting criteria, for malnutrition diagnoses. Questions and/or feedback about these audits can be directed to Marsha Schofield at the Academy.
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NUTRITION IN THE NEWS
At the 2021 Tokyo Nutrition for Growth Summit earlier this month, the Biden-Harris administration announced plans to spend $11 billion over the next 3 years to end global malnutrition. During this meeting, USAID Administrator Power also shared highlights from the new US Government Global Nutrition Coordination Plan 2021–2026 that will coordinate the work of 7 US government agencies seeking to scale evidence-based approaches to improve nutrition. Among other programs combatting malnutrition across the globe, these funds will be used to drive policy action to advance nutrition security in the US and expand data availability and use to help decisionmakers better understand the burden of malnutrition burden and track progress towards key milestones. As these are also key initiatives for the MQii and our Learning Collaborative members, we are pleased to share this news of our country’s leadership and action addressing malnutrition.
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MALNUTRITION RESEARCH
Several publications and posters focused on malnutrition and quality improvement have been released over the past few months. Those relevant to the nutrition care process and quality improvement have been added to the Malnutrition Evidence Library on our website for your easy reference.
- “Veterans Affairs Malnutrition Screening Quality Improvement Study: Measuring Impact on Patterns of Care,” presented at IHI Forum 2021 (including 2 authors from the MQii Leadership team)
- “Nutrition-Related Policy Fundamentals for Supporting Older Adults in the Community During a Pandemic: Lessons from COVID-19,” in the Journal of Elder Policy (including 1 author from the MQii Leadership Team and 1 from our Advisory Committee)
- “To Advance Health Equity, Measure Hospital Malnutrition Care,” in Health Affairs Blog (including 1 author from our Advisory Committee)
- “Comprehensive Application of the Malnutrition Quality Improvement Initiative (MQII) Toolkit to Pediatric Malnutrition Care,” in the Journal of the Academy of Nutrition and Dietetics (including 1 author from our Advisory Committee)
- “Malnutrition in Hospitalized Adults: A Systematic Review,” by AHRQ
- “Recovery Focused Nutritional Therapy across the Continuum of Care: Learning from COVID-19,” in Nutrients (including 1 author from our Advisory Committee)
- “Research Opportunities to End Hunger, Food and Nutrition Insecurity,” a response to an NIH Request for Information by the Academy
- “Pilot Trial of Remote Monitoring to Prevent Malnutrition After Hepatopancreatobiliary Surgery,” in BMC Nutrition (including 1 author from our Leaning Collaborative)
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LEARNING COLLABORATIVE PARTICIPANT RESOURCES
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For Data-Sharing Members: Call for Data and Updated Performance Report Calendar*
Tier 1-level participants in the Learning Collaborative have the opportunity to contribute data on the malnutrition electronic clinical quality measures (eCQMs) and patient outcomes to be benchmarked (anonymously) at the aggregate Learning Collaborative level. The performance benchmark report provides insights to each enrolled hospital on its performance on the 4 malnutrition eCQMs as well as length of stay and 30-day readmissions based on its reported data. For multi-year participants, the benchmark report shows your average performance on the 4 eCQMs as well as patient length of stay and 30-day readmissions for malnourished patients and its evolution over time. Additional indicators can provide insights regarding the provision of nutrition care to COVID-19 patients.**
We are working to standardize the process and timeline for our data-sharing members to submit their data and receive their performance feedback and performance benchmark reports. You can view the new calendar on our Member Area page that we intend to follow to accept your data and send you reports beginning in 2022. Note that data are due by February 1, 2022, to be part of the second 2021 MQii Performance Benchmark Report*. Please email us if you would like to contribute data prior to the deadline to participate in the performance feedback benefits outlined above.
*This request is only relevant to Tier 1 participating hospitals who have signed a Tier 1 participation agreement.
**This assumes sufficient minimum cases are available in the data reported to calculate performance indicators.
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NFPE: Putting It All Together
Did you know that the Academy’s 3rd edition NFPE Pocket Guide is now available on the EatRightStore? This new edition provides clinicians with tools for malnutrition and micronutrient assessment, documentation, and coding. It includes detailed descriptions of physical exam and micronutrient exam findings to help guide clinicians interpret levels of muscle and fat wasting, signs of micronutrient deficiencies and toxicities, and assessment of edema; it also includes an updated lab assay table. Updated images throughout the guide depict degrees of wasting spanning from well-nourished to severe loss for the muscle and fat regions critical to NFPEs as well as new images depicting micronutrient deficiencies. Pages are laminated to facilitate frequent use.
To learn more about how to obtain NFPE skills and how to attend the Academy’s live, virtual, hands-on NFPE training workshops (including several sessions this winter), visit www.eatrightpro.org/nfpe or email [email protected].
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On behalf of the entire MQii Team, we wish you a happy and healthy holiday season! We look forward to working with you in 2022.
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