Simple Steps to MIPS Success
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Set yourself up for MIPS success with these simple steps.
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Simple Steps to MIPS Success
- 1. webinar Simple Steps to MIPS Success Presented by Lea Chatham January 18, 2017
- 2. @GoKareo Agenda 2 Agenda 2 • Welcome & Introductions • Simple Steps to MIPS Success • How Kareo Can Help • Your Questions
- 3. @GoKareo 33 How to Participate Today… Type your questions Download today’s resources View today’s presentation
- 4. @GoKareo 44 Connect via Social Connect with us via social media How to connect: 1) Follow @GoKareo on Twitter 2) Follow @LeaChatham on Twitter twitter.com@GoKareo facebook.com/GoKareo linkedin.com/company/kareo
- 5. @GoKareo 55 Speakers Lea Chatham • Senior Content Marketing Manager, Kareo • Nearly 20 years in healthcare and health IT • Speaker and author • Published in leading journals including Physicians Practice, Medical Practice Insider, PAHCOM Journal
- 6. @GoKareo Agenda 6 Agenda 6 • Welcome & Introductions • Simple Steps to MIPS Success • How Kareo Can Help • Your Questions
- 8. @GoKareo 88 What is MACRA MACRA is the rule that created the… QUALITY PAYMENT PROGRAM (QPP) which outlines the Merit-Based Incentive Payment Program (MIPS) and Advanced Alternative Payment Models (APMs)
- 9. @GoKareo 99 High Level Goals Transition provider reimbursement FROM… Fee-for-Service TO… Quality Payment Program (QPP) • Value-based reimbursement Quality of care Cost effectiveness Use of certified electronic technology Practice improvement
- 10. MIPS
- 11. @GoKareo 1111 MIPS Overview • Most providers will participate in MIPS • An eligible clinician is: • Physician (Doctors of Medicine or Osteopathy, Doctors of Dental Surgery or Dental Medicine, Doctors of Podiatric Medicine, Doctors of Optometry, Chiropractors) • Physician assistant • Nurse practitioner • Clinical nurse specialist • Certified Registered Nurse Anesthetist • Eligible Clinicians are defined for years 1 & 2 • Additional categories, PT, OT, etc. may be added in year 3.
- 12. @GoKareo 1212 MIPS Overview • You may be excluded if • First year in Medicare Part B • Low-Volume Threshold • < $30,000 billed to Medicare Part B • < 100 Medicare Part B patients • Advanced APM participant
- 13. @GoKareo 1313 MIPS Timing Timing • Effective January 1, 2017 • Two-year lag time from performance to payment in 2019 • Requirements will be phased over next few years • Created a “Pick your pace” rule allowing a transition period • PQRS and VBPM are gone at the end of 2016. • Medicaid providers participate in both MIPS and Medicaid MU, if: • Providers meet the definition of a MIPS EC, and • Also meet the 30% Medicaid MU participation threshold
- 14. Kareo, Copyright 2015 1414 Scoring for 2017 Percentage of Score 60% 15% 25% 0% Status of Existing Programs Replaces PQRS New Category Replaces MU Replaces Value- Based Modifier Targeted # of Activities for Individuals 6 measures, including one outcome 4 improvement activities 5 mandatory; 9 maximum; bonus credits No data submission; based on claims
- 15. @GoKareo 1515 Pick Your Pace Added to the final rule to give options to smaller practices Potential Adjustment Reporting Period Quality Improvement Activities Advancing Care Bonus + Bonus (up to 12%) Full year 6 measures incl. 1 outcome > 4 activities 5 required, 1-4 additional + bonus Full + Adj. Min 90 days to a Full year 6 measures incl. 1 outcome 4 activities 5 required, 1-4 additional Partial Avoid – Possible + Min 90 days 1 1 5 required measures Test Neutral < 90 days (special circumstance) 1 OR 1 OR 5 required measures Don’t Participate Negative 0 0 0 0
- 16. @GoKareo 1616 Pick Your Pace • Recommend doing as much as possible • Look for things you may already be doing or can make simple changes to do • If doing MU or PQRS, you may already be doing many of these activities • Reminder: You must use a certified EHR
- 17. Kareo, Copyright 2015 1717 Quality • 60% of Composite Score • 6 quality measures, including an outcome measure • Select measures individually or from specialty sets • Certified EHR used for data • All patients must be reported
- 18. @GoKareo 1818 Quality • For Test or Partial 1 quality measure you are probably doing now: - Documentation of Current Medications • For full participation: - 6 measures • 271 measures to choose from • You can sort by specialty and high priority • Choose outcome measures or high priority measures
- 19. @GoKareo 1919
- 20. Kareo, Copyright 2015 2020 Advancing Care • 25 % of Composite Score • 5 required measures (4 for transitional in 2014) Security Risk Analysis e-Prescribing Provide Patient Access Send Summary of Care Request/Accept Summary of Care (not for transitional) • Can submit up to 9 measures • Bonus points for Public Health Reporting • Use of Certified EHR for specific activities adds bonus points
- 21. @GoKareo 2121 Advancing Care • Other Measures for 2017 (2014 Edition) - Health Information Exchange - Immunization Registry Reporting - Medication Reconciliation - Patient-Specific Education - Secure Messaging - Specialized Registry Reporting - Syndromic Surveillance Reporting - View, Download, Transmit
- 22. @GoKareo 2222
- 23. Kareo, Copyright 2015 2323 Clinical Improvements • 15 % of Composite Score • Complete up to 4 improvement activities from a list of 93 potential activities • APMs automatically receive points for participating in the requirements of the APM
- 24. @GoKareo 2424 Improvement Activities • For Test or Partial choose 1 Improvement such as - Depression screening - Diabetes screening - Implementation of antibiotic stewardship program - Tobacco use - Unhealthy alcohol use • For full participation complete 4 or more • Other more common activities - Collection and follow up on patient satisfaction data - Engagement of patients through implementation of improvements in patient portal - Use of groups visit for common chronic conditions - Use of telehealth
- 25. @GoKareo 2525
- 26. @GoKareo 2626 Reporting Options Report by multiple mechanisms Quality Reporting Claims (individual only) Qualified Registry Advancing Care Attestation to CMS (MU website to be reconfigured) QCDR (individuals or groups may connect on their own) CMS Web Interface (group of 25 or more) EHR Improvement Activities Qualified registry CMS attestation site Reporting period January 2, 2018 through March 31, 2018
- 27. What Do You Do Next?
- 28. @GoKareo 2828 Next Steps • Verify using certified EHR • Confirm your EHR is working on 2015 Edition certification for 2018 • Pick your pace • Visit qpp.cms.gov and select your measures • Check to see if your vendor has any added training or assistance for MIPS
- 29. @GoKareo Agenda 29 Agenda 29 • Welcome & Introductions • Simple Steps to MIPS Success • How Kareo Can Help • Your Questions
- 30. @GoKareo 3030 Awards and Rankings Growth awards The speed at which medical practices are moving to Kareo and referring it to other providers. Best places to work Happy, engaged employees stay longer, have more experience and offer better customer service Analyst reviews 3rd party recognition, driven by direct customer feedback, equals trust and credibility
- 31. @GoKareo 3131 Kareo Platform Kareo Clinical • Comprehensive dashboard • Simple charting • Easy ePrescribing • Convenient eLabs • Specialty templates • Electronic Superbill • Integrated Patient Portal • Secure messaging
- 32. @GoKareo 3232 Kareo Platform Kareo Marketing • Marketing and front office automation • Online visibility and SEO • Online appt. scheduling • Email, text & voice recording appt. reminders • Post visit patient reviews • Practice analytics for ROI • Patient communications
- 33. @GoKareo 3333
- 34. @GoKareo 3434 Discover Kareo’s Role • PAHCOM has approved 1 CEU credit. • Each attendee will receive an email today with a link to request certification. Certificates will be mailed within the next few days. • Attendees must be logged into the webinar to receive credit. • You’ll be asked at the end of the webinar if you want a CEU certificate. “…Make Your Practice a Best Practice!”
- 35. @GoKareo Agenda 35 Agenda 35 • Welcome & Introductions • Simple Steps to MIPS Success • How Kareo Can Help • Your Questions
- 36. @GoKareo 3636 How to Participate Today… Type your questions -- Questions After the Webinar -- 888.775.2736 x1 sales@kareo.com
- 37. Connect with Kareo Stop by and say hi! Kareo @GoKareo GoKareo Kareo 3353 Michelson Drive, Suite 400 Irvine, CA 92612 (888) 775-2736
Notas del editor
- In short, MACRA is the rule that created the… QUALITY PAYMENT PROGRAM (QPP) which outlines the Merit-Based Incentive Payment Program (MIPS) and Advanced Alternative Payment Models (APMs) which Adjust MEDICARE PAYMENTS based on a provider’s ability to Quality: improve the care that patients receive Value: reduce the cost of healthcare Efficient: Improve practice processes and procedures Interoperability: use of health IT to improve patient care coordination and population health
- The high level goal, among other things, of MACRA is to transition provider reimbursement FROM The volume-based, fee-for-service program known as the Medicare Sustainable Growth Rate, TO A value-based reimbursement
- The rule acknowledges that Medicaid providers have to do double work here
- Basically PQRS – two distinctions for quality versus PQRS All of the patients must be recorded (80% technically) The information unlike in the past needs to be documented in your EHR
- You can filter measures by specialty Filter by High Priority to get the outcome measures because you can’t sort by outcomes If you can’t do an outcome measure then do a high priority measure and you can get that list For high achievers – their specialty orgs are encouraging you to do more than 6 If you have already been doing 9 quality measure for PQRS then continue doing those 9 Regarding reporting: Easier to report to the registry Claims reporting is not the preferred method with CMS Not sure if it will impact your score either since it would only be Medicare patients and not all patients when reporting G codes
- Here you can see the options for sorting
- Two sets of measures – the difference is what EHR is certified to – 2014 or 2015 edition If 2014 then you use transitional guidelines – ie Kareo is 2014 (11 measures versus 15 in 2015 edition) as a general rule the transitional ones match up to modified stage 2 – we are looking at the transitional or 2014 edition measures 2017 transitional measures
- Here are the other measures Would encourage you to do as many as possible. There is the potential to earn up to 159 points for all measures but it caps at 100 and if get 100 then you get your 25% The one difference here is that there are no thresholds – what you are trying to is achieve as a high a score as possible by doing it with as many patients as possible. To be able to report you need 1 patient but score is based on how many patients you do these activities with. If you report a 0 in any of the 5 areas you are done. You must have something to report for all 5 required measures or you get a 0. For the other measures are what make up yor performance score – will look at what you achieve and assign some points. So lets take medication reconciliation – you get a score based on how many patients you are able to report
- You can download the 11 (0r 15 is you have a 2015 edition EHR) in a CSV file with the descriptions
- Some of these are very complex and may require additional support but there are several that are simpler, you may already be doing or almost Depression, diabetic screenings, etc. There should be 4 things on this list that you are already doing or could easily add. Some of the more complex but doable Examples: Rx Drug Monitoring Program Care coordination agreements Glycemic management services 24/7 access to eligible clinicians
- You can sort the list by domains – groupings of similar objectives. Like care coordination, just expanded practice access. You can select medium or high weighted options – high gets 20 points, medium gets 10 points. To get the full 15% - Key is to document! You need 60 points – so 4 medium priority won’t get you there
- Claims reporting is discouraged because providers need to make sure that they are documenting everything in an EHR, as well as reporting them on claims. (QUALITY only) Qualified Registries are good for our customers, as we will provide them with a report with the information that they need to entered into the registry. Also have a partnership with Covisint (QUALITY and Improvement Activities) Attestation to CMS is the second way our customer will need to attest (Advancing Care and Improvement Activities) QCDR and Web Interface – need to be arranged by provider – usually through their professional organizations EHR – we do not, nor will we have a direct connection to CMS. You are going to have to use multiple methods for reporting this first year because CMS hasn’t developed one tool for communicating it all. Try to do it in as streamlined a way as possible We suggest Qualified registry and CMS attestation site.
- Allows for offices to communicate with their patients via email and text, create custom email templates, and send mass communication to preset and custom patient groups. Patients will now be able to respond to any automated communication they receive from their healthcare provider's office via text and email.
- Kareo has received extensive industry recognition, including the Deloitte Technology Fast 500, Inc. 5000 and Black Book’s #1 Integrated EHR, Practice Management and Billing Vendor.