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Welcome To The Webinar: S Stems

This webinar discusses the Medicare Access and CHIP Reauthorization Act (MACRA) and its impact on physician payments through the Quality Payment Program (QPP). The QPP consists of two tracks: The Merit-based Incentive Payment System (MIPS) and alternative payment models (APMs). MIPS consolidates existing quality programs and adds a new category on use of certified electronic health record (EHR) technology. Providers will receive payment adjustments based on their MIPS performance scores. The webinar emphasizes planning ahead and using available CMS resources to succeed under MIPS. It also addresses key issues like eligibility, reporting options, and strategies for avoiding penalties in the first year of the program.

Uploaded by

Drake Coleman
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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133 views23 pages

Welcome To The Webinar: S Stems

This webinar discusses the Medicare Access and CHIP Reauthorization Act (MACRA) and its impact on physician payments through the Quality Payment Program (QPP). The QPP consists of two tracks: The Merit-based Incentive Payment System (MIPS) and alternative payment models (APMs). MIPS consolidates existing quality programs and adds a new category on use of certified electronic health record (EHR) technology. Providers will receive payment adjustments based on their MIPS performance scores. The webinar emphasizes planning ahead and using available CMS resources to succeed under MIPS. It also addresses key issues like eligibility, reporting options, and strategies for avoiding penalties in the first year of the program.

Uploaded by

Drake Coleman
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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EMR S stems

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Welcome to the
Webinar

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MIPS
Dos and Donts

#mipsdosanddonts

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In this webinar
MACRA, MIPS & APMs
MACRA: 3 Changes - A new QPP
MIPS Performance Scoring
MIPS Eligibility
MIPS Payment Adjustments
Participation - Pick Your Pace
How to Avoid Penalties?
Individual vs Group Reporting
EHR vs QCDR
Plan Ahead - CMS to the Rescue
Dont Fret - Seek Help
Important To-Do List

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MACRA, MIPS & APMs

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MACRA: 3 Changes - A new QPP


End Sustainable Growth Rate Based Reimbursement

New Framework Rewarding Better Care

Combining Existing Quality Programs into One

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MIPS Eligibility
Providers who have met a minimum volume threshold of Medicare Part B patients or payments.
WHO QUALIFIES AS AN EP?
2017 & 2018 Performance Year:

MDs

PAs

CNSs

CRNAs

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2019 Performance Year: (additional)

NPs

PTs

OTs

SLPs

AuDs

CNMs

LCSW

LCPs

RDNs

MACRA

MIPS

APMs

Adjusts Traditional Fee-For-Service

Participation mandates use of

Measurement Categories:

Certied EMR Technology

Quality of Care (PQRS)


Resource use (VBPM)
Clinical practice improvement
Advancing Care Information
Category (Meaningful Use)

Providers will bare additional nancial risk


Will be exempt from MIPS payment
adjustments and receive 5%
additional incentives.
Examples:
MSSP Track 2 & 3
Next Gen. ACO Model
CPC+

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MIPS Payment Adjustments


+27%

+21%
+15%
+9%
+12%

Potential Adjustment

+7%
+5%

% =

2019

+/ -

Incentive

+4%

Maximum
Adjustments

2020

2021

2022 onward

-4%

Penalties

-5%
-7%
-9%

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MIPS Performance Scoring


Starting Jan. 1, 2017, Medicare Part B eligible

CMS may choose to shift these point values each year, but a

providers (EPs) will be measured annually in four

providers 2017 performance in just two of these categories,

performance categories to derive a MIPS score

MU and Quality, will comprise 85% of their

85%

between 0 and 100.

maximum possible score.


Providers scores will be publically available to consumers
via the Centers for Medicare & Medicaid Services (CMS)
Physician Compare website.

15%

0%
Resource Use

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Clinical Practice
Improvement (CPI)

25%
Advancing Care
Information (Aci)

60%
Quality

Participation - Pick Your Pace

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Participation Pick Your Pace


Andy Slavitt's Pick Your Pace message for MIPS 2017:
No reporting means penalties
Test: minimum reporting to avoid penalties
Partial reporting: 90-day reporting
Ideal reporting: full year
Participation in an Advanced APM Additional 5% bonus

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How to Avoid Penalties?

Chance

Go to Jail Go Directly to Jail,


Do not pass GO, Do not Collect 200

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How to Avoid Penalties?

1
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Quality Measure

OR
Improvement Activity in Each
Category Helps Avoid Penalties

Individual vs Group Reporting


Individual

Group

Data tied to single NPI

Entire group has the same adjustment

Adjustment dependent on individuals own


reporting

Tied to a single TIN


Reporting available via CMS web interface

EHR or CDR based reporting

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Web interface registration deadline - June


30, 2017

EHR vs QCDR
Finalize your reporting platform now Dont wait till 2017
Check if your EMR is ready for reporting on;
chpl.healthit.gov

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EHR vs QCDR
If Your EHR:
Is not certied or is not ready for reporting your measures &
Youre unable to switch EHRs at this stage
Choose a QCDR
CMS approved entity
Introduced for the PQRS program
Collects clinical data for reporting

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Plan Ahead - CMS to the Rescue

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Plan Ahead - CMS to the Rescue


Planning Ahead will Pay Off in 2017
CMS Platform Dedicated to MIPS Planning:
qpp.cms.gov/measures/quality
qpp.cms.gov/measures/aci
qpp.cms.gov/measures/ia

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Plan Ahead - CMS to the Rescue


Search Measures with Keywords
Filter by Priority, Reporting Method and Specialty
Review Selection: Are You Doing Enough?

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Dont Fret - Seek Help


MACRA - $20 Million Each Year for 5 Years
Beginning December 2016
Experienced Organizations Helping Small Practices

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Important To-Do List


Educate your organization, particularly the C-suite, as soon as possible
Estimate your MIPS score using your current MU, PQRS and VBM scores
Optimize MU & PQRS/VBM Quality to maximize the MIPS score (comprise 85% of the
2017 MIPS score)
Evaluate staff, resources and organizational structure, e.g. combine MU & PQRS efforts
under a single leader
Identify 2016 deadlines impacting 2017 MIPS, e.g. Medicare Shared Savings Program
Track 2/3 ACO or NCQA PCMH application deadlines to gain MIPS exemptions or points

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Thank You
(347) 343-2700
webinars@emrsystems.net
www.emrsystems.net
mipsdosanddonts

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