MohsAIQ is the national data registry of the American College of Mohs Surgery. MohsAIQ, pronounced "mosaic," stands for MohsAdvancing and Improving Quality. It supports the ACMS mission to promote and advance the highest standards of patient care with respect to Mohs surgery and dermatologic oncology. Ultimately, the registry will help the ACMS and its members demonstrate the value of Mohs surgery as patient-centered and highly effective. MohsAIQ will provide meaningful data about patients and physician performance in order to improve outcomes and maximize results under new payment models.
Benefits
Assess and improve quality
Participating in the registry will give you and your institution or practice the tools you need to assess and improve the quality of Mohs treatment. You will be able to track outcomes over time and view real-time results across patients within your practice or institution, or benchmarking against de-identified results from national peers.
Meet CMS reporting requirements
MohsAIQ is an approved Qualified Clinical Data Registry (QCDR) which means it can be used for reporting under the Merit-based Incentive Payment System to satisfy CMS reporting requirements. MohsAIQ is the only MIPS solution designed exclusively for Mohs surgeons, and for your institution or practice to use MohsAIQ to fulfill the requirements of MIPS for the 2020 reporting year.
Generate new clinical knowledge
The robust data within MohsAIQ will serve as a working foundation to drive research, publications, and innovation for the specialty.
Advance the Mohs specialty
Participating in MohsAIQ is will strengthen and advance the specialty by providing a knowledge base to draw upon and review surgical methods and best patient practices.
Grow institutional recognition
By supporting the participation of Mohs surgeons in MohsAIQ, your institution will become recognized as a leader in driving quality in skin cancer care through registry-based quality improvement initiatives.
Increase insurance network stability
MohsAIQ will have the ability to run reports that can address payer issues and increase the stability of the Mohs specialty in the nation’s insurance networks.
How to Enroll
Participation in the MohsAIQ registry is available to all ACMS members. Here's how to get started:
Click the 'Download enrollment form' button below to open a single, fillable PDF form that includes legal documents. Once it opens in your web browser, download it to your computer and fill in the blank fields electronically. Return the completed form to the ACMS via email at registry@mohscollege.org.
Participants will be sent training links for authorized staff and will be ready to start participating in MohsAIQ.
If you have any questions about the enrollment form or process, please contact Tammy O'Connell, CEHRS, at registry@mohscollege.org or call (414) 347-1103.
News and Resources
December 23, 2020
MohsAIQ Registry approved for 2021 MIPS Reporting
The ACMS is pleased to announce the MohsAIQ registry is approved for a third year as a Qualified Clinical Data Registry by the Centers for Medicare and Medicaid Services for the 2021 reporting year under the Merit-based Incentive Payment System. MohsAIQ is the only reporting solution designed exclusively for Mohs surgeons to fulfill MIPS requirements. MohsAIQ was previously approved as a QCDR for the 2019 and 2020 calendar years and will report 2020 cases for participating MohsAIQ users by March 31, 2021 deadline.
"As an academic facility, we are pleased to contribute to the MohsAIQ registry and its user-generated dataset which demonstrates the effectiveness of Mohs surgery fosters clinical research and improves patient outcomes. With the help of members of the Mohs College, we can continue to advance our specialty through this extraordinary pursuit."
Dr. David Chen, University of Vermont Medical Center, VT
Surgeons and institutions who participate in MohsAIQ will have the opportunity to maximize their MIPS performance in 2021 and optimize reimbursement payments in 2023 if they report through two different modalities; i.e. an electronic health record and a QCDR. ACMS members have ten (10) QCDR measures available to report to CMS through MohsAIQ and can attest to quality improvement activities and the registry is able to transmit your QRDA III files for Promoting Interoperability.
The CMS-approved MohsAIQ measures for Calendar Year 2021:
ACMS2 Closing the Mohs Surgery Referral Loop: Transmission of Surgical Report
ACMS3 Antibiotic Prophylaxis for High-Risk Cardiac / Orthopedic Cases prior to Mohs micrographic surgery-Prevention of Overuse
ACMS4 Surgical Site Infection Rate - Mohs Micrographic Surgery
ACMS5 Documentation of high-risk Squamous Cell Carcinoma Stage in Mohs
ACMS8 Limit quantity of opioids prescribed for pain management in patients following MMS
ASPS22 Coordination of care for anticoagulated patients undergoing reconstruction after skin cancer resection
ASPS24 Visits to ER or urgent care following reconstruction after skin cancer resection
ASPS27 Avoidance of post-operative systemic antibiotics for office-based Closures and reconstruction after skin cancer Procedures
ASPS28 Continuation of Anticoagulation Therapy in the Office-based Setting for Closure and Reconstruction after Skin Cancer Resection Procedures
ASPS29 Avoidance of Opioid Prescriptions for Closure and Reconstruction After Skin Cancer Resection
Learn more about the Quality Payment Program here.
August 10, 2020
Flexible Options for MIPS Reporting for 2020 Performance Year
Due to the Covid-19 pandemic, CMS has introduced flexible options for MIPS reporting for the 2020 Performance Year. As a reminder the 2020 MIPS Performance Year includes data from January 1, 2020 through December 31, 2020; the submission deadline is in March 2021; and the results of the 2020 Performance Year will be reflected in the 2022 payment adjustments. The updated MIPS reporting options offered by CMS due to the Covid-19 pandemic include the following:
Submitting a hardship application to request reweighting and consideration of one or more MIPS measurement categories for 2020
Submitting a hardship application to opt-out of all MIPS categories for 2020
We encourage you to carefully examine the information from CMS in this link as well as the information found here, which has detailed information related to the 2020 Quality Payment Program Exception Applications. We strongly urge you to consider the following points as you select the option that best suits your circumstances:
Some individuals may qualify for automatic extreme and uncontrollable circumstances and, as such, do not need to submit an application
If you submit data for a single performance category that has been reweighted, the data submission will override the performance category reweighting and you will receive a MIPS final score based on the data submitted
An individual, group, or virtual group must be scored on at least two performance categories to earn a MIPS final score greater than the performance threshold
This 9-minute webinar will help you to understand the CMS Improvement Activities (IA) Program, a component of MIPS, and will guide you through the IA submission process in MohsAIQ. Prior to your MIPS submission, you will need to determine if you meet the criteria for hardship due to the COVID-19 pandemic or other circumstances. CMS has provided an Extreme and Uncontrollable Circumstances Exception for MIPS submission of the performance categories. Reviewing information at https://qpp.cms.gov/mips/exception-applications#extremeCircumstancesException-2020 will help you decide whether you meet any of these hardship circumstances. By filling out the application, if you qualify, you are choosing to forgo submission of one or more of the performance categories depending on how you have been affected by the COVID-19 pandemic. Your decision regarding this hardship exception is important to know prior to making your selections in MohsAIQ. This 2020 IA shortlist shows what we believe to be the 19 most relevant IA’s for Mohs Surgeons. It is suggested that IA’s be selected and initiated prior to October 2020 in order to have the required 90 days of participation.
March 31, 2020
MIPS & MohsAIQ, A Guide to MIPS Participation in Performance Year 2020
This four-page guide, prepared by the National Registry and Outcomes Committee, will assist you with your participation and understanding of the MIPS program for 2020.
The ACMS is pleased to announce the MohsAIQ registry has been approved for a second years as a Qualified Clinical Data Registry by the Centers for Medicare and Medicaid Services for the 2020 reporting year under the Merit-based Incentive Payment System. MohsAIQ is the only reporting solution designed exclusively for Mohs surgeons to fulfill MIPS requirements. MohsAIQ was previously approved as a QCDR for 2019 and will report 2019 cases for participating MohsAIQ users by March 31, 2020 deadline.
“My staff and I have found it easy to integrate the data input for MohsAIQ into our daily routine. MohsAIQ is essential to promote the quality, efficacy, benefits and usefulness of Mohs surgery. I encourage all members of the Mohs College to participate in this important endeavor for our specialty and its future.” – Dr. Jonathan Bingham, Great Falls Clinic, MT
Surgeons and institutions who participate in MohsAIQ will have the opportunity to maximize their MIPS performance in 2020 and optimize reimbursement payments in 2022 if they report through two different modalities; i.e. an electronic health record and a QCDR. ACMS members now have a total of ten (10) QCDR measures available to report to CMS through MohsAIQ and can attest to quality improvement activities.
The MohsAIQ measures are:
ACMS1 Adherence to MMS Appropriate Use Criteria
ACMS2 Closing the referral loop
ACMS3 Antibiotic prophylaxis for high risk/orthopedic cases prior to MMS
ACMS4 Surgical site infection rate
ACMS5 Non-opioid pain management following MMS
ACMS6 Management of perioperative anticoagulation with MMS
ACMS7 Documentation of high-risk SCC tumor stage in MMS record
ASPS148 Coordination of care for anticoagulated patients undergoing reconstruction
ASPS150 Visits to ER or urgent care following reconstruction after skin cancer resection
ASPS146 Avoidance of post-operative systemic antibiotics for office-based reconstruction after skin cancer
MohsAIQ Worksheet
This worksheet is meant to capture the current minimal ‘required information’ to be entered into the registry. Administrators and staff are encouraged to add additional information as well to MohsAIQ. The optional form is designed as a tool to relay information if the surgeon prefers to have staff enter cases. The surgeon may circle the correct responses and then a staff person can easily enter the information into MohsAIQ. If you haven’t started putting in cases this is the way to get started!
January 14, 2019
MohsAIQ Registry approved for 2019 MIPS Reporting
The ACMS is pleased to announce the MohsAIQ registry has been approved as a Qualified Clinical Data Registry by the Centers for Medicare and Medicaid Services for the 2019 reporting year under the Merit-based Incentive Payment System. MohsAIQ is the only reporting solution designed exclusively for Mohs surgeons to fulfill MIPS requirements.
The specialty-specific measures unique to MohsAIQ include:
Adherence to Mohs Micrographic Surgery Appropriate Use Criteria
Closing the Mohs Surgery Referral Loop: Transmission of Surgical Report
Surgical Site Infection Rate – Mohs Micrographic Surgery
Antibiotic Prophylaxis for High Risk Cardiac / Orthopedic Cases prior to Mohs micrographic surgery – Prevention of Overuse
Learn more about the Quality Payment Program here.
ArborMetrix, based in Ann Arbor, Michigan, is the vendor partner selected by the ACMS to develop and help administer MohsAIQ. ArborMetrix was founded by internationally-recognized surgeons and uses a technology platform purpose-built to support medical specialty society registries. It has provided custom registries for the American Society of Anesthesiologists, the Americas Hernia Society Quality Collaborative, the American Association of Endocrine Surgeons, the Pediatric Cardiac Critical Care Consortium, and other organizations.
MohsAIQ will leverage ArborMetrix’s flexible technology infrastructure, advanced analytics, and interactive dashboards to support quality improvement initiatives and clinical research leading to the identification of best practices. ArborMetrix aims for ACMS members and others who participate to be able to use MohsAIQ to satisfy quality reporting requirements from the Centers for Medicare and Medicaid Services’ (CMS) Quality Payment Program (QPP), under the Merit-based Incentive Payment System (MIPS) starting in 2019. ArborMetrix will be supporting the College’s self-nomination as a Qualified Clinical Data Registry for 2019.
What is MohsAIQ?
The Mohs Advancing and Improving Quality (MohsAIQ) registry, powered by ArborMetrix, supports the ACMS mission to promote and advance the highest standards of patient care with respect to Mohs surgery and dermatologic oncology. The registry will help the ACMS and its members demonstrate the value of Mohs surgery as patient-centered and highly effective. MohsAIQ will provide meaningful data about your patients and your performance so you can improve outcomes and maximize results under new payment models.
What is the cost and who may participate in MohsAIQ?
Participation in MohsAIQ is available to ACMS members in the United States, and is a benefit of ACMS membership. There is no cost to participate in the registry.
What data will be collected in the registry?
The registry will collect information commonly found in the op report/progress notes for Mohs surgery cases only. Non-Mohs cases are not to be included in the registry. All Medicare and non-Medicare cases may be entered. Branching logic makes it more efficient to enter information therefore it is difficult to give an actual number of fields entered per case as it is dependent on complexity. The Patient Health Information collected is First Name, Last Name, DOB and medical record number. This is collected so that records can be matched if at a later date there is a complication or recurrence. Any reports generated from MohsAIQ will contain ONLY de-identified information. Mohs-specific performance measures are being developed.
What reports and features does the registry provide?
MohsAIQ’s suite of features and reports will make it easy for you to see how you are performing, identify and implement best practices, improve care, and optimize CMS quality reporting. You will come away with answers to key questions such as:
How am I performing on key quality and process adherence measures?
Am I excelling or lagging on these key quality and process adherence measures compared to my practice overall? Comparative peer groups? ACMS surgeons overall?
In what areas of my practice are there the greatest opportunities to improve quality and/or processes?
MohsAIQ will especially deliver:
Interactive, real-time analytics and reports on an intuitive, web-based, HIPAA-compliant interface
Clinical relevance with specialty-specific measures
Clinical depth through the ability to drill down to see patient-level details
How do I sign up to participate in MohsAIQ? Click here to complete the Enrollment form including legal documents.
Do I need IRB approval to participate in the MohsAIQ Regitry?
The Office for Human Research Protections (OHRP) has confirmed that institutions including practice groups, hospitals, or other clinical care providers, that are providing data to a clincal data registry are not engaging in human subject research; thus do not need IRB review and approval. For more information, see the letter from the Physician Clinical Registry Coalition requesting clarifications by the OHRP related to the application of the Common Rule to clinical data registries and the OHRP response to this letter.
Do I have to enter all my cases?
The ACMS encourages all cases to be entered to populate the MohsAIQ database. The MohsAIQ Registry is approved by CMS to transmit data for 2020 to comply with the Quality Payment Program, Merit-Based Incentive Program. For 2020, MohsAIQ participants are required to submit at least 70% of their cases to satisfy CMS requirements.
How much time does it take to enter a case into MohsAIQ?
Currently it takes 2-4 minutes to enter a case. The ACMS will be exploring interfacing with key EHR vendors to hopefully establish some efficiencies with streaming data in the future. Cases can be entered that day or once a week on a certain day. Past cases also may be entered.
How will I submit data to MohsAIQ?
Physicians and practices will provide data to the registry in a number of ways, which include manual data entry and EHR integration.
The ACMS and ArborMetrix, the College’s technology and analytics partner for the registry, are actively working to establish partnerships with the EHRs most commonly used by Mohs surgeons. Once a partnership is established with your EHR vendor, ArborMetrix will work with you and your EHR to submit data directly from your EHR to MohsAIQ. Your institution or practice will incur any fees imposed by the EHR for this direct connection.
Although the amount of manual entry may be decreased with a direct EHR interface, there will likely still be some manual entry due to the detail the registry is collecting.
The shared goal of the ACMS and ArborMetrix is to minimize interruptions to your workflow while maximizing the quality of the data in the registry to make sure it is of highest value to you and other Mohs surgeons.
Can non-physician personnel enter data into the registry?
Yes, other healthcare professionals such as nurses and medical assistants will be able to enter data in MohsAIQ on your behalf.
Is the data I provide secure and confidential?
Yes, MohsAIQ is compliant with the Health Information Portability and Accountability Act of 1996 (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH) Act. The information you provide will only be available to you. It will be de-identified in any and all reports accessible by others participating in MohsAIQ.
Do I have to add cases into MohsAIQ EVERY month?
Yes, CMS requires that you submit at least one Mohs case each month for a least one quality measure. CMS is advocating from continual submission.
Can I use MohsAIQ to fulfill CMS requirements under MIPS?
Later this year, ACMS will be self-nominating MohsAIQ for approval by the Centers for Medicare and Medicaid Services (CMS) as a Qualified Clinical Data Registry (QCDR) for reporting under the Merit-based Incentive Payment System. The College’s goal is for MohsAIQ to be the only MIPS solution designed exclusively for Mohs surgeons -- and for your institution or practice to use MohsAIQ to fulfill the requirements of MIPS for the 2019 reporting year.
What are the issues surrounding CMS reporting through a group vs. as an individual?
For 2019, CMS is, in fact, proposing to consider measures reported across different data submission mechanisms. So for instance, if you reported 2 measures via claims and 4 measures via QCDR (Qualified Clinical Data Registry), CMS would combine those measures to determine whether you satisfied the 6 measure reporting requirement and to tally your total quality category score. However, under this proposal, if the same measure is reported across multiple mechanisms, CMS will not combine the data for a single measure. They will use data from the mechanism that produced the highest performance. While CMS does not say this outright, it sounds like reporting via two different QCDRs would be permitted and that the data would be combined to satisfy the quality category so long as the measures reported by each QCDR are different measures.
There is no way to formally "elect" to participate in MIPS as a group. A group would simply start submitting data as a group. If you're using a registry, they will ask you at what level you would like to report. If you're submitting data to CMS on your own through the QPP data submission portal, then you will essentially check a box to indicate whether the submission is on behalf of a group or individual. Keep in mind that for 2018, claims-based reporting is not available for group-level reporting (only individual-level reporting). Also keep in mind that if a TIN (Tax Identification Number) reports as a group, but an individual clinician opts to also participate separately as an individual, CMS will calculate an overall MIPS score for both the group practice and the individual and use whichever is more favorable when determining the payment adjustment for that individual NPI.
There are multiple benefits to group reporting; namely the economies of scale. For example, when reporting quality measures, a group is only responsible for reporting on 60% of the group's applicable patient population. That means that if you're in a multi-specialty practice and select a specialty-focused measure, the practice can meet the 60% threshold without every single clinician in the practice reporting the measure (only clinicians that provide services/have patients to which that measure applies would need to report on the measure). In a TIN with 20 individual clinicians, if that practice did not report as a group, all 20 clinicians would be required to satisfy the quality reporting requirements on their own. There are also benefits to group reporting with regard to the Improvement Activities category. So long as a single individual in the group satisfied the requirements of the Improvement Activity, the group as a whole can take ownership of that activity and attest to satisfying that activity as an ENTIRE group (versus the 20 individual clinicians in the group needing to independently attest to completion of the required number of Improvement Activities).
What percentage of cases do I have to add to MohsAIQ for the 2020 data submission?
For 2020, CMS requires that at least 70% of cases be entered into the QCDR (MohsAIQ); in 2019 the requirement was 60%.
When is the deadline to have 2020 cases entered into MohsAIQ?
The MohsAIQ technology vendor, Arbormetrix, requires that 2020 cases be entered and finalized into MohsAIQ by February 28, 2021. Arbormetrix will complete a data quality audit prior to submitting data to CMS. Submission will occur on or before March 31, 2021.
Can I attest to Improvement Activities in MohsAIQ?
Yes, MohsAIQ enables you to select and attest to those Improvement Activities that you have participated in for at least 90 consecutive days. Clinicians can accumulate as much as 15 points through IA activities that will be added to overall MIPS scores.
Has the COVID-19 impacted the 2019 MIPS submission date?
Yes, although CMS has extended the deadline to April 30, 2020. Arbormetrix submitted data on the original deadline of March 31, 2020.
How can I check that CMS has received my MIPS data?
Clinicians can go to their qpp.cms.gov account to confirm CMS receipt.
COVID-19 Related FAQs
The COVID-19 pandemic has caused significant hardships for my practice. What concessions are available to me from CMS? CMS has provided an Extreme and Uncontrollable Circumstances Exception for MIPS submission of the performance categories. Reviewing information here will help you decide whether you meet any of these hardship circumstances. By filling out the application, if you qualify, you are choosing to forgo submission of one or more of the performance categories depending on how you have been affected by the COVID-19 pandemic.
How do I update the users access to MohsAIQ?
Unfortunately, with the effects of the virus on practices, it has become necessary for some practices to have some staffing changes. Please let us know which MohsAIQ users should be deleted or added to the system. If a worker is on furlough/laid off with an expectation to return to work, they may remain in the MohsAIQ system. Send access changes to registry@mohscollege.org.
Contact
If you have questions or comments about MohsAIQ, contact Tammy O’Connell, CEHRS, the ACMS Administrative Manager, National Registry and Quality, at registry@mohscollege.orgor call (800) 500-7224.
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ArborMetrix, based in Ann Arbor, Michigan, is the vendor partner selected by the ACMS to develop and help administer MohsAIQ. ArborMetrix was founded by internationally-recognized surgeons and uses a technology platform purpose-built to support medical specialty society registries. It has provided custom registries for the American Society of Anesthesiologists, the Americas Hernia Society Quality Collaborative, the American Association of Endocrine Surgeons, the Pediatric Cardiac Critical Care Consortium, and other organizations.