22 Days til MIPS Data Submission! Get Ready!

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1 Countdown to MIPS* Data Submission Webinar Series 22 Days til MIPS Data Submission! Get Ready! Christine Lalios Kuykendall, BS, RHIA, CPHQ, IM Health Informatics Specialist Health Services Advisory Group (HSAG) *Merit-based Incentive Payment System March 9, 2018

2 To Submit Questions Via Q&A: 1. Click the [Q&A] option at the top right of the presentation. 2. The Q&A panel will open. 3. Indicate that you want to send a question to the HSAG QPP Service Center. 4. Type your question in the box at the bottom of the panel. 5. Click [Send]. 2

3 Objectives At the completion of this training, the attendee will be able to: Identify key 2017 MIPS data submission requirements. Recognize the performance thresholds for 2017 MIPS submission. Apply strategies for a successful 2017 MIPS data submission. 3

4 Acronyms Used In Today s Presentation Acronym Definition ACI APM CEHRT CMS CE EDIM EHR EOB HPSA IA JSON Advancing Care Information Alternative Payment Model Certified Electronic Health Record Technology Centers for Medicare & Medicaid Services Continuing Education Enterprise Identity Management System Electronic Health Record Explanation of Benefits Health Professional Shortage Area Improvement Activity JavaScript Object Notation Acronym Definition MFA MIPS MU NPI PCMH PQRS QCDR QPP QRDA TIN VBPM XML Multi-Factorial Authentication Merit-based Incentive Payment System Meaningful Use National Provider Identifier Patient Centered Medical Home Physician Quality Reporting System Qualified Clinical Data Registry Quality Payment Program Quality Reporting Document Architecture Tax Identification Number Value-based Payment Modifier Extensible Markup Language 4

5 Today s Presenter Christine Lalios Kuykendall, BS, RHIA, CPHQ, IM Health Informatics Specialist HSAG 5

6 Key 2017 Data Submission Requirements Are you eligible? Check your QPP eligibility on the CMS lookup tool at Do you qualify under Special Status? Do you have an EIDM account? Are your username and password active? If your username and password are inactive, take action now! Call the Helpdesk at Create an EIDM account if you don t have one. Refer to Learning Forum Friday 10/20/2017 webinar slides and/or recording for instruction. Access the Enterprise Identity Data Management (EIDM) User Guide. Call the QPP Helpdesk at

7 Important MIPS Submission Deadlines: Calendar Year 2018 Type of Submission March 16 8:00 p.m. ET CMS Web Interface submissions March 31 8:00 p.m. ET Qualified Registry Qualified Clinical Data Registry EHR/Data submission vendor submissions Group Size Typically larger groups of 25 eligible clinicians Typically smaller groups of 25 or individual clinicians 7

8 MIPS Reporting Deadlines: Ten Things To Do and Know 1. Visit the QPP website and click on [Sign-in] for data submission feature. 2. Check that your data is ready to submit. 3. Have your CMS EIDM credentials ready or create account. 4. Sign in to the QPP submission portal. 5. Begin submitting your data in the portal early. 6. The data submission feature will recognize you and connect with your NPI-associated Tax ID number. 8

9 MIPS Reporting Deadlines: Ten Things To Do and Know (cont.) 7. Group practices reporting options. a) Can report as group and/or individual b) The data submission feature will save all group and individual and data entered and CMS will use the data resulting in the higher score. 8. Update your data up to the deadline. 9. Submit data as often as you like before the deadline. 10. There are step-by step CMS instructions on how to submit MIPS data. Are you on the QPP Listserv? If you aren t, visit enter your address at the bottom of the page and click [Subscribe]. 9

10 QPP Attestation Portal Known Issues Note: Even if there is a known issue, enter your data into MIPS CMS portal anyway. Clinicians listed in the portal that are no longer with the practice, missing clinicians, or duplication of clinicians: CMS is aware of some of the issues and working to resolve them. Call the CMS QPP Service Center at Be sure your practice s PECOS file is up to date Improvement Activities score not doubling for small practices: CMS is aware and working to resolve the issue as soon as possible. QRDA 3 File Upload Issue CMS is working with EHR Vendors to resolve issues on the vendor side. Use latest EHR version and stay in touch with your EHR Vendor 10

11 2017 Data Submission Requirements: Quality (60%) Accountable Care Organization (ACO) Consideration Enter Reporting Timeframe Group vs. Individual Reporting Reporting Method Will Determine Your Action in QPP Attestation Portal Claims (individual clinicians only) Qualified Registry/Qualified Clinical Data Registry EHR QRDA functionality, XML file upload Data Submission Vendor (DSV) CMS Web Interface (group only, 25+) Includes APMs (i.e. ACOs) CAHPS for MIPS Survey CMS-Approved Survey Vendor 11

12 2017 Data Submission Requirements: ACI (25%) Reweighting consideration Reweighting is based on your designation. ACO consideration Is the ACO reporting for you or are you responsible? Reporting timeframe Enter any 90 day period or for a full year. Use the timeframe that shows your best performance. Reporting method will determine your action in QPP attestation portal: Attestation (manual entry of EHR measures) Qualified Registry/Qualified Clinical Data Registry EHR CMS Web Interface (by group only, 25+)* Excludes APM Entities *needed to enroll as a group by 6/30/17 12

13 2017 Data Submission Requirements: IA (15%) Reporting Method Manual Reporting Qualified Registry Qualified Clinical Data Registry EHR Action Enter reporting timeframe of reporting and choose which IA to report on Confirm that your Registry is submitting for you Using an EHR to complete an IA gives you bonus points for the ACI section Some EHR vendors offer submissions of IAs for clinicians Note: If a clinician is a member of an ACO, he/she will receive full credit for this section. Verify if the clinician is an active member with the ACO. 13

14 2017 MIPS Performance Requirements: Quality Six Measures Include one outcome measure Include a high priority measure if no applicable outcome measure is available Bonus Opportunities Submit additional outcome measure Submit additional patient experience measure 50% data completeness Submit additional high priority measure Use CEHRT end-to end to submit to CMS 14

15 2017 MIPS Performance Requirements: ACI Option 1 ACI Objectives and Measures Report five base measures Option ACI Transition Objectives and Measures* Report four base measures *Most will use Option 2 since either 2014 or 2015 EHR edition can be used Bonus Opportunities Syndromic Surveillance reporting Specialized Registry reporting Electronic Case reporting Public Health Registry reporting Clinical Data Registry reporting Use CEHRT to complete certain improvement activities from IA section 15

16 2017 Performance Requirements: IA Report 40 points Groups of >15 clinicians Two high-weighted activities (20 points each) Four medium-weighted activities (10 points each) Groups of 15 clinicians One high-weighted activity (40 points each) Two medium-weighted activities (20 points each) Combination of high and medium activities (to equal 40 points total) 16

17 Year 2019 Adjustments Based on Year 2017 Performance The total number of MIPS points scored will determine the type of adjustment you will receive. This table indicates the correlation between points scored and adjustment rates. MIPS Scoring Range (Points) Adjustment Parameters Positive 4% adjustment Eligible for exceptional performance bonus Minimum + 0.5% bonus Positive adjustment Not eligible for exceptional performance bonus 3 Neutral adjustment 0 4% negative adjustment 17

18 Strategies for Successful Submission Keep EIDM account active Start your submission process early Take advantage of bonus opportunities Use timeframes that show best performance Compare individual vs. group performance Make changes as needed Continuous submission 18

19 Strategies for Successful Submission (cont.) Make use of automatic feedback and scoring Look for submission trophy in each section Save submission documentation as verification Submit by March 16, 2018: 8:00 p.m. ET deadline Web Interface Submit by March 31, 2018: 8:00 p.m. ET deadline Remember: All records should be retained for six years and three months. That s how far back you can be audited. 19

20 Strategies for Successful Submission (cont.) Communicate with staff Achieve continuous improvement by: Involving all staff. Setting internal goals. Working toward bonus points. Striving for exceptional performance. 20

21 Supporting Documentation Keep all your supporting documentation, including copies of: EHR reports. Claims (EOBs). IA records. Data submitted to Qualified Registry or QCDR. Remember: All records should be retained for six years and three months. That s how far back you can be audited. 21

22 Key Takeaways The data submission portal will close soon! Don t wait until the deadline date. Visit the data submission portal as many times as you want. Remember: There is no Save button. Your data is autosaved up to the character. Once your data is entered, take a second look Make sure data is entered for all applicable categories. Your total MIPS score may be artificially lower if your reporting method for the Quality category is Claims, Qualified Registry, QCDR, or Web Interface. Review your category scores and look for your trophies. 22

23 HSAG QPP Service Center Available 23

24 QPP Technical Assistance Resource Guide 24 Source: CMS

25 Next Learning Forum Friday Event: April 13, 2018 Spring into Action Using Your 1st Quarter Data For additional event topics and registration information, please visit: Topics and dates are subject to change, so please check the webpage for up-to-date information. 25

26 Resources Instructional video: Merit-based Incentive Payment System (MIPS) data submission 1/2/2018 Submitting 2017 Transition Year Data to the Quality Payment Program Fact Sheet: Program/Resource-Library/QPP-2017-Data-Submission- Factsheet.pdf Physician Compare Website: CMS Quality Payment Program Website Subscribe to the QPP ListServe 26

27 Resources (cont) Medicare Learning Network Learning Management System Booklet (LMS) FAQs Learning-Network-MLN/MLNProducts/Downloads/LMPOS- FAQs-Booklet-ICN pdf Associations Offering Credit for MLN Events and Training Learning-Network-MLN/MLNGenInfo/CE-Associations.html 27

28 CMS Announcements Apply to Participate in the 2018 CMS Study on Burdens Associated with Reporting Quality Measures to receive IA credit for 2018: Visit to begin your application Applicants will be notified by of their status in spring of Visit the CMS website or for more information about the study. Applications for this study will be accepted through March 23, *Medicare Administrative Contractor

29 CMS Announcements: Upcoming Webinar How to Prepare for MIPS Cost Scoring: Practical Advice for Solo Practitioners and Small Group Practices Two sessions are being offered: Tuesday, March 20, 2018, 11 a.m. Noon ET Register at Thursday, March 22, 2018, 7 8 p.m. ET Register at Join this session to: Recognize how cost scores will be calculated by CMS. Identify the factors most heavily impacting the cost score you will receive. 29 *Medicare Administrative Contractor

30 HSAG Quality Initiatives Spotlight The QPP Quest HSAG Digest Seeking quality improvement best practices Behavioral Health Initiative Alcohol and Depression screenings among Medicare beneficiaries Reimbursable screenings MIPS IA 2018 Million Hearts Hypertension Control Challenge It s not too late to administer flu shots! 30

31 Join HSAG QPP Community Mailing List! In the body of the , please include: Organization Name First and Last name address City State 31

32 CE Approval This program has been pre-approved for 1.0 CE unit for the following professional boards: National Board of Registered Nursing (Provider #16578) Florida Board of Clinical Social Work, Marriage & Family Therapy and Mental Health Counseling Board of Nursing Home Administrators Board of Dietetics and Nutrition Practice Council Board of Pharmacy Please Note: To verify CE approval for any other state, license, or certification, please check with your licensing or certification board. 32

33 CE Credit Process 1. Register at in HSAG s Learning Management Center (LMC). 2. Once you have registered in the LMC, you must complete the evaluation that will appear in WebEx at the conclusion of the webinar. a. Following the event, please do not close the WebEx evaluation window. You will not be able to access the evaluation and request CE if you close the window. b. CEs are only available to attendees that participate in the live event. c. If for some reason you completed the evaluation and do not have the link to the new user registration, please refer to Step #1 or contact Debra Price at dprice@hsag.com for CE certificate questions. 33

34 CE Credit Process: Existing User To login to your existing LMC account visit 34

35 CE Credit Process (cont.) Following the conclusion of the webinar, you will also receive a Thank You for Attending using the address provided during registration. You will be requested to register in the HSAG Learning Management Center (LMC). This is a separate registration from WebEx. Please use your personal so you can receive your certificate. Your organization may have firewalls up that block our certificates. 35

36 CE Certificate Problems If you do not immediately receive a response to the that you signed up with in the Learning Management Center, you have a firewall up that is blocking the link that was sent. Please go back to the New User link and register your personal account. Personal s do not have firewalls. 36

37 QPP Participation Poll Thanks for Attending HSAG QPP Technical Assistance Line Toll free: Monday Friday 8 a.m. to 8 p.m. ET HSAG QPP Support: HSAGQPPSupport@hsag.com 37

38 HSAG QPP Technical Assistance Line Toll free: Monday Friday 8 a.m. to 8 p.m. ET HSAG QPP Support: HSAGQPPSupport@hsag.com 38

39 This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for Arizona, California, Florida, Ohio, and the U.S. Virgin Islands, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. QN-11SOW-D

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