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Learning Collaborative
 
December 20th, 2023
 
 
The Dish
The Dish provides a quarterly update to stakeholders who are subscribed to receive updates about the MQii Learning Collaborative.
 
 
 
 
 

At a Glance

  • Expanded version of the Global Malnutrition Composite Score (GMCS) on the Measures Under Consideration (MUC) list
  • GMCS training recording and slides available on MQii website
  • Share your progress or reach out with any questions to your MQii Point of Contact
  • Please also inform us about any transitions in leadership, requested topics for future events, or additional events of interest to share with other members
 
 
SPOTLIGHT: Expanded Version of the GMCS Under Consideration by CMS

Thanks largely to the support of MQii members, the Global Malnutrition Composite Score (GMCS) was adopted in the hospital inpatient quality reporting program (IQR) program beginning with the 2024 performance year focused on the Medicare-age populations of 65 and older. Since the measure’s approval by CMS, Avalere and the Academy of Nutrition and Dietetics have worked to modify and maintain the measure through the Annual Update process as well as educate various stakeholder audiences about the measure and reporting opportunity. Following a request from CMS, Avalere and the Academy have created an updated version of the measure (by making what is known as a “substantive change”) that assesses care provided to all adults, rather than just those above age 65.

On December 1, 2023, CMS released the 2023 Measures Under Consideration (MUC) List of quality measures being considered for adoption into its payment programs. We are pleased to share that the updated version of the GMCS that reflects all adults ages 18+ was included in this list. CMS has now opened the 21-day public comment period, with comments due by December 22, to allow stakeholders to provide feedback and recommendations on measures on the list. You can submit your comments to CMS using the online form or document upload option accessible on the Partnership for Quality Measurement website.
 
 
 
 
 

WHAT'S AROUND THE CORNER?

 
 
Learn and Network at Upcoming Conferences
View additional upcoming external events (such as conferences and webinars) on our MQii Learning Collaborative calendar.

Consider Opportunities to Share Your MQii Project and Findings 

The following list of conferences may be of interest to you or your team. We encourage you to look at the event websites, review submission criteria, and consider sharing your research with various audiences. Please reach out with any questions or for assistance in pulling together submission materials.

 
 

NUTRITION POLICY UPDATES

CMS Finalized Inclusion of Food Insecurity and Nutrition Risk Improvement Activity into 7 MVPs for 2024

In November, CMS released its final 2024 Medicare Physician Fee Schedule (MPFS) rule, which included updates to the Merit-Based Incentive Payment System (MIPS). Under MIPS, CMS developed a new, voluntary, reporting option called MIPS Value Pathways (MVPs). MVPs provide tailored measure and improvement activity sets relevant to certain specialties or medical conditions to ensure meaningful participation in MIPS and advance quality care. We are pleased to announce that CMS finalized the inclusion of the MQii-developed Food Insecurity and Nutrition Risk Improvement Activity (IA_AHE_9) into the following MVPs:
  • Value in Primary Care (includes chronic disease management and promoting wellness)
  • Focusing on Women’s Health
  • Advancing Care for Heart Disease
  • Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes
  • Rehabilitative Support for Musculoskeletal Care
  • Optimal Care for Kidney Health
  • Quality Care in Mental Health and Substance Use Disorders
CMS also noted it will consider the inclusion of additional quality measures and improvement activities through the MVP maintenance process and future rulemaking. Those interested can submit recommendations for MVPs on a rolling basis here.
 
 
 
 
 
 
 

Learning Collaborative Member Resources and Recognition

Commission on Dietetic Registration (CDR) GMCS Training

Free Virtual Program: Selecting and Implementing the Global Malnutrition Composite Score
CDR is providing a free 4.5-hour virtual program focused on the GMCS to acute care RDNs, NDTRs, and others interested in addressing malnutrition in acute care. Participants will have the opportunity to learn more about the GMCS and its implications in quality care, empower themselves and others to support implementation of the GMCS, and lead malnutrition initiatives and programs to improve heath equity and quality of care. For more information, see the program flyer or reach out to [email protected].

Quarterly Spotlight on Malnutrition: Advancing Quality and Strengthening Interdisciplinary Collaboration (Part I)
This 1-hour complimentary session is now available on the CDR website. The presentation includes a deep dive into the fundamentals of quality improvement, including how credentialed practitioners can use quality improvement principles to elevate care standards. It also features a case study of a specific example of these principles in action in a dialysis treatment facility. A CPEU certificate is also available for those interested.

GMCS Training Recording Available

Thank you to everyone who joined us on November 7 for a training for Learning Collaborative members about data collection and tracking related to the GMCS. After a brief history and background about the GMCS, two Learning Collaborative member hospital systems that are tracking data related to the GMCS and working toward internal measure performance calculations or reporting to CMS through the Hospital IQR Program beginning in 2024 (or a future year) shared their experiences and recommendations. The Learning Collaborative Training recording can be found here, along with the presentation slides.

Congratulations to Members

Congratulations to Learning Collaborative member Kelly Danis from the University of Pittsburgh Medical Center (UPMC) for being honored with an Excellence in Practice Award from the Academy of Nutrition and Dietetics at this year’s Food & Nutrition Conference Expo. These awards “recognize outstanding nutrition and dietetics practitioners who have demonstrated innovation, creativity, and leadership in a specific area of practice.”


NPFE: Putting it All Together

It is always good to review…Where to start to check if a patient is at risk for malnutrition and then what next?

  • Begin with a validated nutrition screen, such as the MST (Malnutrition Screening Tool), that can be completed by a trained healthcare professional. Ensure your facility has a nutrition screen in place and offer brief education sessions with nursing, if needed, to aid in completion rates.
  • If the nutrition screen is positive for being at risk for malnutrition, then the registered dietitian nutritionist (RDN) should complete a nutrition assessment providing a nutrition diagnosis, nutrition etiology, and evidence (i.e., signs and symptoms) that supports the nutrition diagnosis. The nutrition plan should also include the intervention, monitoring and evaluation plan as appropriate. As part of the nutrition assessment, the RDN can utilize the Academy/ASPEN indicators to diagnose malnutrition (AAIM) to identify if the patient meets criteria to diagnose malnutrition.
    • The 6 malnutrition indicators to assess are: inadequate energy intake, weight loss, muscle wasting, subcutaneous fat loss, fluid accumulation (nutrition-related), reduced grip strength. In order for the RDN to assess the last four indicators, the RDN should have the knowledge, training, and comfort to perform a nutrition focused physical exam (NFPE).

To learn more about how to obtain NFPE skills and the Academy’s Live Virtual NFPE Hands-on Training Workshops, visit www.eatrightpro.org/nfpe or email [email protected].

 
 
 
 
 
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