CMS Quality Payment Program: Performance and Reporting Requirements
|
|
- Tabitha Higgins
- 6 years ago
- Views:
Transcription
1 CMS Quality Payment Program: Performance and Reporting Requirements Session #QU1, February 19, 2017 Kristine Martin Anderson, Executive Vice President, Booz Allen Hamilton Colleen Bruce, Lead Associate, Booz Allen Hamilton 1
2 Speaker Introduction Kristine Martin Anderson, MBA Executive Vice President Booz Allen Hamilton Add Speaker Photo Here Colleen Bruce, JD Lead Associate Booz Allen Hamilton 2
3 Conflict of Interest Kristine Martin Anderson, MBA Has no real or apparent conflicts of interest to report. Colleen Bruce, JD Has no real or apparent conflicts of interest to report. 3
4 Agenda Quality Payment Program (QPP) Overview Advanced Alternative Payment Models (Advanced APMs) Merit-based Incentive Payment System (MIPS) Participation Payment Adjustment Composite Performance Score Measure Selection Performance Feedback Next Steps 4
5 Learning Objectives 1. Review the MIPS quality reporting requirements for EHR users 2. Identify performance thresholds for APM requirements 3. Explain how alternative payment model quality measure sets that do not qualify as a QPP APM (for example, CMS ACO 1's from 2016) align with the MIPS quality measure sets 5
6 An Introduction of How Benefits Were Realized for the Value of Health IT The QPP advances use of health IT overall by encouraging providers to use EHRs, and also through specific components of the program, such as the Advancing Care Information. The QPP will support all five kinds of value of Health IT. 6
7 QPP Overview Aims of the QPP: Care improvement through focus on better outcomes, decreased provider burden, and preservation of independent clinical practice Adoption of Alternative Payment Models that align incentives across health care stakeholders Advancement of existing Delivery System Reform efforts The QPP rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS 7
8 Advanced Alternative Payment Models (Advanced APMs) Advanced APMs allow physicians and other clinicians to deliver coordinated, customized, high-quality care to their patients within a streamlined payment system. Advanced APMs must: Require participants to use CEHRT Provide for payment for covered professional services based on quality measures comparable to those in the quality performance category under MIPS Either require that participating APM entities bear risk for monetary losses of a more than nominal amount, or be a Medical Home Model expanded under section 1115A(c) of MACRA 8
9 Advanced Alternative Payment Models (Advanced APMs) Qualifying APM participants (QPs) are eligible clinicians (ECs) in an Advanced APM who have a certain percentage of patients or payments through an advanced APM. QPs are excluded from MIPS and receive a 5% incentive payment per year beginning in 2019 through QPs will receive the annual 5% lump-sum bonus based on their Medicare Part B payments from the previous year s claims. This bonus will be in addition to the incentive paid through existing contracts with the Advanced APM. Beginning in 2026, QPs will qualify for a 0.75% increase in your Medicare Part B PFS payments. Two thresholds for the level of participation in Advanced APMs to become a QP: Medicare Option Applicable beginning in payment year 2019 based on Part B payments for covered professional services or counts of patients furnished covered professional services under Part B All-Payer Combination Option Applicable beginning in payment year 2021, utilizes the Medicare Option as well as an EC s participation in Other Payer Advanced APMs 9
10 Merit-based Incentive Payment System (MIPS) The MIPS program consolidates components of three existing programs to ease clinician burden: PQRS Quality Performance and Improvement Value Modifier Resource Use Meaningful Use Advancing Care Information MIPS adds a fourth component to promote ongoing improvement and innovation in clinical activities Clinical Practice Improvements MIPS offers clinicians the flexibility to demonstrate performance through activities and measures that are most meaningful to their practice 10
11 Participation Eligible clinicians (ECs) who are not QPs (i.e. EC who does not participate in an APM) must participate in MIPS in 2017 or face a 4% penalty in 2019 MIPS ECs include: Clinicians billing at least $30,000 to Medicare Part B who do not participate in a qualified APM 11
12 Participation During the 2017 transition year, ECs have four options for participation in the QPP: No Participation Test Participation Partial Participation Full Participation Failure to submit any data in 2017 will result in a 4% negative payment adjustment ECs submitting the minimum amount of 2017 data to Medicare (e.g., one quality measure or one improvement activity at any point in 2017) will avoid the negative payment adjustment (payment adjustment of 0%) ECs who submit data for a 90-day period in 2017 may earn a neutral or small positive payment adjustment (positive payment adjustment up to 4%). ECs submitting a full year of data in 2017 may earn a moderate positive payment adjustment (positive payment adjustment up to 10%). 12
13 Payment Adjustment Application of payment adjustments under PQRS, VM, and EHR- MU will sunset Dec. 31, 2018 MIPS and APM incentive payments begin January 1, 2019, based on performance in 2017 Under MIPS, eligible clinicians can receive positive, negative or zero payment adjustment APM Participants can receive a 5% incentive payment for 6 years CMS will apply the MIPS payment adjustment at the TIN/National Provider Identifier (NPI) level 13
14 Payment Adjustment Maximum Adjustments for MIPS through
15 Composite Performance Score To calculate a single MIPS composite performance score, CMS will factor in performance in four weighted categories on a point scale: 15
16 Composite Performance Score To calculate a single MIPS composite performance score, CMS will apply the following weights: Performance Category Quality 60% 50% 30% Cost 0% 10% 30% Clinical Practice Improvement Activities 15% 15% 15% Advancing Care Information 25% 25% 25% 16
17 Quality Performance Score MIPS quality measures will be collected January 1, December 31, 2017 and submitted to CMS by March 30, 2018 for the 2019 payment adjustment Individual ECs, small groups, and specialists may report measures via: Claims Qualified Clinical Data Registries (QCDR) Registries CERT Large groups (25 ECs or more) can report measures using the CMS Web interface EXCEPTION: The CMS Web Interface can only accept Medicare patient quality data. If a group does not have an adequate sample of Medicare patients, they must report using one of the small group reporting methods 17
18 Quality Performance Score In 2017, individual or small practice ECs have options for reporting quality measures: Failure to report will result in a 4% negative payment adjustment Reporting one quality measure for 90 consecutive days will allow the EC to avoid a negative payment adjustment in FY19 Reporting six quality measures including one outcome measure (or one specialty-specific measure set), for 90 consecutive days will allow the EC to avoid a negative adjustment or gain a small positive adjustment Reporting six quality measures including one outcome measure (or one specialty-specific measure set,) for the full reporting year (January 1- December 31, 2017) may earn the EC a moderate positive payment adjustment Successful participation in an approved APM will produce a moderate positive payment adjustment and an additional 5% bonus 18
19 Quality Performance Score If the EC chooses to report more than the minimum: MIPS ECs will receive 1-10 achievement points for each scored quality measure based on performance compared to applicable measure benchmarks Minimum case requirements for quality measures are 20 cases, with the exception of the all-cause readmission measure which has a minimum case requirement of 200 cases CMS totals scores for the 6 required quality measures submitted along with bonuses to determine the total Quality Performance Score 19
20 Quality Performance Score Large groups must register by June 30, 2017 to use the CMS Web Interface for administration of the CAHPS for MIPS survey Groups of 25 or more MIPS-eligible clinicians must report on all 15 measures included in the CMS Web Interface, which align with the MSSP Level 1 Quality Measure Set Large groups must report on the first 248 consecutively ranked beneficiaries in the sample for each measure/module If the sample of eligible assigned beneficiaries is less than 248, then the group must report on 100% of assigned beneficiaries Groups must capture quality performance data for the full calendar year (January 1, 2017-December 31, 2017) The CMS Web Interface submission will occur during an eight-week period following the close of the performance period, and will begin no earlier than January 1 and end no later than March 31 20
21 Cost Performance Measures CMS does intend to calculate performance on cost measures in 2017, but will provide this information to clinicians in performance feedback Beginning in 2018, the cost performance category contribution to the final score will gradually increase from 0% to 30% 21
22 Clinical Practice Improvement Most QPP participants will be required to attest that they completed up to four improvement activities for a minimum of 90 days each Groups with 15 or fewer participants or eligible clinicians in a rural or health professional shortage area must attest to completion of two improvement activities for a minimum of 90 days Participants in certified patient-centered medical homes, comparable specialty practices, or an APM designated as a Medical Home Model will automatically earn full credit for clinical practice improvement 22
23 Clinical Practice Improvement Examples of clinical practice improvement activities include: Engagement with a Quality Innovation Network-Quality Improvement Organization, which may include participation in self-management training programs such as diabetes Routine and timely follow-up to hospitalizations, ED visits, and stays in other institutional settings, including symptom and disease management, and medication reconciliation and management Empanel (assign responsibility for) the total population, linking each patient to a MIPS eligible clinician or group or care team After an improvement activity's first year in use, CMS will evaluate the activity to see if and when the activity is suitable for pubic reporting 23
24 Advancing Care Information MIPS ECs are required to report five measures for the Advancing Care Information Performance Category Reporting on all five required measures will earn the clinician 50%. Reporting on the optional measures will allow the clinician to earn a higher score. For 2017, a bonus score will be awarded for improvement activities that utilize CEHRT and for reporting to public health or clinical data registries. Measure sets will depend on the EC s version of CEHERT (i.e., 2014 or 2015) 24
25 Advancing Care Information Advancing care information measures include: At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using CEHRT For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or provider 1. Creates a summary of care record using CEHRT; and 2. Electronically exchanges the summary of care record. 25
26 Bonus Points Bonus points are available when two or more high priority measures are reported The following categories of measures will qualify for a bonus: Outcomes (2 points) Patient Experience (2 points) Reported appropriate use, patient safety, efficiency, and care coordination measures (1 point) Bonus will not exceed 5% of the total quality score Bonus points are available for using CEHRT systems to capture and report measures 26
27 Bonus Points Groups participating in the AHRQ Quality Consumer Assessment of Health care Providers and Systems (CAHPS) for MIPS will receive a bonus point In absence of a relevant outcome measure, CAPHS participation meets the requirement to report at least one high priority measure For the performance period, groups participating in the CAHPS for MIPS survey measures must use a CMS approved survey vendor to transmit survey measure data 27
28 Measure Selection Quality measures will be selected annually through a call for quality measures process, and a final list of quality measures will be published in the Federal Register by November 1 of each year Only measures submitted before June 1 of each year will be considered for inclusion in the annual list for the performance period beginning two years after the measure is submitted CMS will establish an Innovation Center quality measure review process for measures that are not NQF-endorsed or included on the final MIPS measure list 28
29 Measure Selection The QPP emphasizes the application of outcome-based measures, as well as global measures (e.g., global outcome measures and population-based measures) for purposes of quality performance improvement In future years, CMS hopes to create a balanced portfolio that includes outcome measures and introduces efficiency measures CMS is particularly interested in developing outcome measures for chronic conditions (such as diabetes care and hypertension management) as it is difficult to measure the many factors that affect the care and outcomes of patients with chronic conditions 29
30 Performance Feedback In the initial years, CMS will provide performance feedback to participating providers on an annual basis In future years, CMS aims provide performance feedback on a more frequent basis, and provide feedback on the performance categories of improvement activities and advancing care information Performance feedback will be made available using a web-based application 30
31 Next Steps for Providers Empanel and risk adjust patients. Identify highest risk patients and tailor care based on risk level. Standardize care delivery and promote adherence to clinical best practice through the use of clinical decision support BPAs. Monitor bundle utilization and outcomes through the use of analytics dashboards. Review interventions, workflow, and bundle utilization when performance stagnates. Leverage patient portals to change patient behavior for chronic disease management. Select CQMs that will best achieve the goals of the program while improving patient care. 31
32 Sources 81 FR Department of Health and Human Services, Centers for Medicare and Medicaid, Executive Summary: Medicare Program; Merit-Based Incentive Program (MIPS) and Alternative Payment Model (APM) Incentive Under Physician Fee Schedule, and Criteria for Physician-Focused Payment Models (October 14, 2016) Frequently Asked Questions: Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) (December 2016) 32
33 Questions Questions? Contact Colleen Bruce, Lead Associate, Booz Allen Hamilton Remind attendees to complete online session evaluation 33
Kate Goodrich, MD MHS. Director, Center for Clinical Standards & Quality. Center for Medicare and Medicaid Services (CMS) May 6, 2016
Kate Goodrich, MD MHS Director, Center for Clinical Standards & Quality Center for Medicare and Medicaid Services (CMS) May 6, 2016 THE MEDICARE ACCESS & CHIP REAUTHORIZATION ACT OF 2015 Quality Payment
More informationHere is what we know. Here is what you can do. Here is what we are doing.
With the repeal of the sustainable growth rate (SGR) behind us, we are moving into a new era of Medicare physician payment under the Medicare Access and CHIP Reauthorization Act (MACRA). Introducing the
More informationOverview of Quality Payment Program
Overview of Quality Payment Program Policies for 2017 & 2018 Performance Years The Medicare program has transformed how it reimburses psychiatrists and other clinicians for providing services, under the
More information2017 Transition Year Flexibility Improvement Activities Category Options
The Physicians Advocacy Institute s Medicare Quality Payment Program (QPP) Physician Education Initiative 2017 Transition Year Flexibility Improvement Activities Category Options 1 P a g e Ad MEDICARE
More informationMACRA Implementation: A Review of the Quality Payment Program
MACRA Implementation: A Review of the Quality Payment Program Neal Logue, Kirk Sadur Centers for Medicare and Medicaid Services, Region IX, September 15, 2017 Disclaimer This presentation was prepared
More informationThe Quality Payment Program Overview Fact Sheet
Quality Payment Program The Quality Payment Program Overview Background On October 14, 2016, the Department of Health and Human Services (HHS) issued its final rule with comment period implementing the
More informationHere is what we know. Here is what you can do. Here is what we are doing.
With the repeal of the sustainable growth rate (SGR) behind us, we are moving into a new era of Medicare physician payment under the Medicare Access and CHIP Reauthorization Act (MACRA). Introducing the
More informationUnderstanding Medicare s New Quality Payment Program
Understanding Medicare s New Quality Payment Program Your introduction to MACRA and getting started with MIPS 1 Understanding Medicare s New Quality Payment Program 2016 Mingle Analytics. All Rights Reserved.
More information2017 Transition Year Flexibility Advancing Care Information (ACI) Category Options
The Physicians Advocacy Institute s Medicare Quality Payment Program (QPP) Physician Education Initiative 2017 Transition Year Flexibility Advancing Care Information (ACI) Category Options Ad 1 P a g e
More informationAdvancing Care Information- The New Meaningful Use September 2017
Advancing Care Information- The New Meaningful Use September 2017 ACO Announcements Reminders: ACO Notifications PECOS-Maintain active enrollment 2017 Patient Prospective Lists Upcoming provider/office
More information2017/2018. KPN Health, Inc. Quality Payment Program Solutions Guide. KPN Health, Inc. A CMS Qualified Clinical Data Registry (QCDR) KPN Health, Inc.
2017/2018 KPN Health, Inc. Quality Payment Program Solutions Guide KPN Health, Inc. A CMS Qualified Clinical Data Registry (QCDR) KPN Health, Inc. 214-591-6990 info@kpnhealth.com www.kpnhealth.com 2017/2018
More informationStrategic Implications & Conclusion
Kelly Court Chief Quality Officer Wisconsin Hospital Association Brian Vamstad Government Relations Consultant Gundersen Health System Overview and Key Takeaways of the Medicare Quality Payment Program
More informationWELCOME. Kate Gainer, PharmD Executive Vice President and CEO Iowa Pharmacy Association
WHAT IS MACRA? WELCOME Kate Gainer, PharmD Executive Vice President and CEO Iowa Pharmacy Association WELCOME Anthony Pudlo, PharmD, MBA, BCACP Vice President of Professional Affairs Iowa Pharmacy Association
More informationMACRA and MIPS. How Medicare Meaningful Use and PQRS are Changing
MACRA and MIPS How Medicare Meaningful Use and PQRS are Changing Link to recorded session: https://attendee.gotowebinar.com/recording/1305549490878052097 Presenting Today: Molly Goodhart Joined Quatris
More informationMACRA Quality Payment Program
The American College of Surgeons Resources for the New Medicare Physician System Table of Contents Understanding the... 3 Navigating MIPS in 2017... 4 MIPS Reporting: Individuals or Groups... 6 2017: The
More informationMIPS Program: 2018 Advancing Care Information Category
MIPS Program: 2018 Advancing Care Category The 2018 Quality Payment Program (QPP) Year Two final rule continues to implement the programs authorized under the Medicare and CHIP Reauthorization Act of 2015
More informationStage 3 and ACI s Relationship to Medicaid MU Massachusetts Medicaid EHR Incentive Program
Stage 3 and ACI s Relationship to Medicaid MU Massachusetts Medicaid EHR Incentive Program September 19 & 20, 2017 Today s presenters: Brendan Gallagher Thomas Bennett Agenda Stage 3 Meaningful Use (MU)
More informationFrom Surviving to Thriving in the QPP World
From Surviving to Thriving in the QPP World Today s Objectives Brief MACRA Overview Where are we going?: Advanced Alternative Payment Models (APMs) Where are we now? Merit Incentive-Based Payment System
More informationQUALITY PAYMENT PROGRAM
NOTICE OF PROPOSED RULE MAKING Medicare Access and CHIP Reauthorization Act of 2015 QUALITY PAYMENT PROGRAM Executive Summary On April 27, 2016, the Department of Health and Human Services issued a Notice
More informationMACRA and the Quality Payment Program. Frequently Asked Questions Edition
MACRA and the Quality Payment Program Frequently Asked Questions 2018 Edition What is MACRA?...3 What is the Quality Payment Program?...3 How do payments work under the QPP?...3 What is at risk under
More informationThe Quality Payment Program: Overview & Roles and Responsibilities
The Quality Payment Program: Overview & Roles and Responsibilities National Tribal Health Conference Susy Postal DNP, RN-BC Chief Health Informatics Officer September 27, 2017 INDIAN HEALTH SERVICE / OFFICE
More informationMACRA Quality Payment Program
The American College of Surgeons Resources for the New Medicare Physician System Table of Contents Simple Steps to Determine If MIPS Applies to Your Practice Situation... 3 5 Understanding the... 6 7 Big
More informationMACRA Frequently Asked Questions
Following the release of the Quality Payment Program Interim Final Rule, the American Medical Association (AMA) conducted numerous informational and training sessions for physicians and medical societies.
More informationMACRA, MIPS, and APMs What to Expect from all these Acronyms?!
MACRA, MIPS, and APMs What to Expect from all these Acronyms?! ACP Pennsylvania Council Meeting Saturday, December 5, 2015 Shari M. Erickson, MPH Vice President, Governmental Affairs & Medical Practice
More information2016 MEANINGFUL USE AND 2017 CHANGES to the Medicare EHR Incentive Program for EPs. September 27, 2016 Kathy Wild, Lisa Sagwitz, and Joe Pinto
2016 MEANINGFUL USE AND 2017 CHANGES to the Medicare EHR Incentive Program for EPs September 27, 2016 Kathy Wild, Lisa Sagwitz, and Joe Pinto Agenda Meaningful Use (MU) in 2016 MACRA and MIPS (high level
More informationMaximizing Your Potential Under MIPS Oregon MACRA Playbook Conference
Maximizing Your Potential Under MIPS Oregon MACRA Playbook Conference June 22, 2017 Michael J. Sexton, MD Catherine I. Hanson, JD COI Disclosure To assure the highest quality of CME programming, the OMA
More informationSVS QUALITY AND PERFORMANCE MEASURES COMMITTEE (QPMC) New Member Orientation
SVS QUALITY AND PERFORMANCE MEASURES COMMITTEE (QPMC) New Member Orientation 2017-2018 SVS QPMC Quality and Performance Measures Committee Policy and Advocacy Council (Chair Sean Roddy) Chair: Brad Johnson,
More informationMIPS Checkpoint. Beth Hickerson Quality Improvement Advisor. PHA Lunch and Learn May 19, Value Driven. Health Care. Solutions.
MIPS Checkpoint Beth Hickerson Quality Improvement Advisor PHA Lunch and Learn May 19, 2017 Check Your MIPS Eligibility QPP.CMS.GOV 2 MIPS Category Weights Over Time : Quality Advancing Care Information
More informationMIPS Program: 2017 Advancing Care Information Category (formerly known as Meaningful Use) Proposed Rule Guide
MIPS Program: 2017 Advancing Care Information Category (formerly known as Meaningful Use) Proposed Rule Guide On April 27, 2016, CMS released a proposed rule on the Quality Payment Program, which includes
More informationThe MIPS Survival Guide
The MIPS Survival Guide The Definitive Guide for Surviving the Merit-Based Incentive Payment System TABLE OF CONTENTS 1 An Introduction to the Merit-Based Incentive Payment System (MIPS) 2 Survival Tip
More informationUnderstanding PQRS and the Value-Based Modifier: CMS Plan to Achieve High Value Care through Transforming Payment Systems
Understanding PQRS and the Value-Based Modifier: CMS Plan to Achieve High Value Care through Transforming Payment Systems Dr. Ashby Wolfe, Chief Medical Officer Centers for Medicare and Medicaid Services,
More informationQUALITY PAYMENT PROGRAM YEAR 2 CY 2018 PROPOSED RULE Improvement Activities Component Reporting Requirements. No change.
QUALITY PAYMENT PROGRAM YEAR 2 CY 2018 PROPOSED RULE Improvement Activities Component Reporting Requirements Brief Synopsis: The Improvement Activities (IA) performance category will continue to comprise
More informationAgenda. Surviving the New Program Requirements and the Financial Penalties Under MIPS 9/9/2016. Steps to take to prepare for MIPS
Surviving the New Program Requirements and the Financial Penalties Under MIPS September 2016 Selena Hood Agenda Steps to take to prepare for MIPS Introduction and Evaluation of the Merit-Based Incentive
More informationQuality Payment Program MIPS. Advanced APMs. Quality Payment Program
Proposed Rule: Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models The Department
More informationMACRA Fall into Place. By Stephanie Cecchini, CPC, CEMC, CHISP, AAPC Fellow, AAPC MACRA Prof
MACRA Fall into Place By Stephanie Cecchini, CPC, CEMC, CHISP, AAPC Fellow, AAPC MACRA Prof About the Presenter https://www.linkedin.com/in/stephaniececchini 2 Introduction Love it Hate it Don t know a
More informationThe Merit-Based Incentive Payment System (MIPS) Survival Guide. August 11, 2016
The Merit-Based Incentive Payment System (MIPS) Survival Guide August 11, 2016 Speakers Nina Marshall, MSW, Senior Director, Policy and Practice Improvement, National Council for Behavioral Health Elizabeth
More informationQuality Payment Program October 14, 2016
Executive Summary Department of Health and Human Services Centers for Medicare & Medicaid Services 42 CFR Parts 414 and 495 [CMS-5517-FC] RIN 0938-AS69 Medicare Program; Merit-based Incentive Payment System
More informationQuality Payment Program: The future of reimbursement
Quality Payment Program: The future of reimbursement Presented by Evan M. Gwilliam, DC MBA BS CPC CCPC NCICS CCCPC CPC-I MCS-P CPMA CMQP Executive Vice President 1 Dr. Evan Gwilliam Education Bachelor
More informationDecoding the QPP Year 2 Quality Measure Benchmarks and Deciles to Maximize Performance
Decoding the QPP Year 2 Quality Measure Benchmarks and s to Maximize Performance Leila Volinsky, MHA, MSN, RN, PCMH CCE, CPHQ Senior Program Administrator New England Regional Lead Quality Payment Program
More informationMeaningful Use 2016 and beyond
Meaningful Use 2016 and beyond Main Street Medical Consulting May 12, 2016 Meaningful use, MACRA, MIPS? Whaaaaat? 1 Reporting Period and Timeline In 2016 all providers are required to use CEHRT versions
More informationSteps toward Sustainability with the second year of the Quality Payment Program
Steps toward Sustainability with the second year of the Quality Payment Program Deanna Graham, QI Consultant, Qualis Health March 27, 2018 Speaker Deanna Graham QI Principal Qualis Health 2 Qualis Health
More informationCMS Priorities, MACRA and The Quality Payment Program
CMS Priorities, MACRA and The Quality Payment Program Ashby Wolfe, MD, MPP, MPH Chief Medical Officer, Region IX Centers for Medicare and Medicaid Services Presentation on behalf of HSAG November 16, 2016
More informationQuality Payment Program
Quality Payment Program MIPS: Quality Category for 2017 Wednesday, April 19, 2017 Lisa Sagwitz, Rabecca Dase, Joe Pinto and Lisa Sherman with Quality Insights Learning Objectives/Agenda Quick review of
More informationVirtual Group Participation Overview Fact Sheet
Virtual Group Participation Overview Fact Sheet Starting on January 1, 2017, eligible clinicians began participation in the Quality Payment Program in one of two ways: Merit-based Incentive Payment System
More informationThe Healthcare Roundtable
The Healthcare Roundtable MACRA Update Jayme R. Matchinski Greensfelder, Hemker & Gale, P.C. April 7, 2017 New Orleans, Louisiana This presentation and outline are limited to a discussion of general principles
More informationQuality Payment Program Year 2: 2018 MIPS Participation. An Introductory Guide for CRNAs in 2018
Quality Payment Program Year 2: 2018 MIPS Participation An Introductory Guide for CRNAs in 2018 Quality Payment Program (QPP) The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established
More informationMIPS Deep Dive: 9 steps to Reporting. Sharon Phelps QPP Webinar Series Webinar 4 June 20, 2017
MIPS Deep Dive: 9 steps to Reporting Sharon Phelps QPP Webinar Series Webinar 4 June 20, 2017 HealthInsight Our business is redesigning health care systems for the better HealthInsight is a private, non-profit,
More informationAlternative Payment Models and Health IT
Alternative Payment Models and Health IT Health DataPalooza Preconference May 8, 2016 Kelly Cronin, MS, MPH, Director, Office of Care Transformation, ONC/HHS HHS Goals for Medicare Payment Reform In January
More informationThe Evolving Landscape of Healthcare Payment: Incentive Programs and ACO Model Optimization. Quality Forum August 19, 2015
The Evolving Landscape of Healthcare Payment: Incentive Programs and ACO Model Optimization Quality Forum August 19, 2015 Ross Manson rmanson@eidebailly.com 701.239.8634 Barb Pritchard bpritchard@eidebailly.com
More informationMarch Data Jam: Using Data to Prepare for the MACRA Quality Payment Program
March Data Jam: Using Data to Prepare for the MACRA Quality Payment Program Elizabeth Arend, MPH Quality Improvement Advisor National Council for Behavioral Health CMS Change Package: Primary and Secondary
More informationMACRA for Critical Access Hospitals. Tuesday, July 26, 2016 Webinar
MACRA for Critical Access Hospitals Tuesday, July 26, 2016 Webinar MACRA presenters Harold D. Miller, President & CEO CHQPR Claudia Sanders, Sr. Vice President, Policy Development Andrew Busz, Policy Director,
More informationMACRA The shift to Value Based Care and Payment. Michael Munger, M.D., FAAFP
MACRA The shift to Value Based Care and Payment Michael Munger, M.D., FAAFP Current State Silos of Care Over Utilization Volume over Value Push Towards Value and Quality 85% Medicare Payments tied to quality
More informationMedicare Physician Payment Reform
Medicare Physician Payment Reform What practices need to know about MIPS and APMs in 2018 MGMA Government Affairs 2018 MGMA. All rights reserved. - 1 - MIPS Timeline for 2017 Performance Period Mar. 31,
More informationAre physicians ready for macra/qpp?
Are physicians ready for macra/qpp? Results from a KPMG-AMA Survey kpmg.com ama-assn.org Contents Summary Executive Summary 2 Background and Survey Objectives 5 What is MACRA? 5 AMA and KPMG collaboration
More informationPQRS and Alignment Opportunity: Concept to Operationalization March 1, 2016
PQRS and Alignment Opportunity: Concept to Operationalization March 1, 2016 Debe Gash/ VP & Chief Information Officer/ Saint Luke s Health System Anantachai (Tony) Panjamapirom/ Senior Consultant/ The
More informationMIPS eligibility lookup tool (available in Spring 2018): https://qpp.cms.gov/participation-lookup
2018 MIPS Roadmap Under the Quality Payment Program launched in 2017, the Centers for Medicare and Medicaid Services (CMS) evaluates all eligible clinicians based on one of two tracks. The Academy expects
More informationThank You to Our Sponsor!
AMCP Webinar Emerging Physician Payment Models: What Does it Mean for AMCP Members and Medication Management? April 19, 2017 Thank You to Our Sponsor! 1 Disclaimer Organizations may not re use material
More informationMACRA FLEXIBILITY & THE MACRA FINAL RULE. Compliance & Opportunity for Your Practice
MACRA FLEXIBILITY & THE MACRA FINAL RULE Compliance & Opportunity for Your Practice CONTENTS Overview... 5 What s new... 5 Advancing Care Information... 8 Major changes... 9 Proposed rule vs. final rule
More informationUsing Updox to Succeed with MIPS
Using Updox to Succeed with MIPS Who is Updox? A Communications Platform built by physicians, for physicians 56,000+ providers and more than 300,000 users--and growing 100+ EMR integrations 72 million
More informationBeyond Meaningful Use: Driving Improved Quality. CHCANYS Webinar #1: December 14, 2016
Beyond Meaningful Use: Driving Improved Quality CHCANYS Webinar #1: December 14, 2016 Agenda The Current State Measuring Monitoring & Reporting Quality. Meaningful Use 2018 and Beyond The New Quality Payment
More informationMedicare Physician Payment Reform:
Medicare Physician Payment Reform: Implications and Options for Physicians and Hospitals Background The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law on April 14, 2015.
More informationHow CME is Changing: The Influence of Population Health, MACRA, and MIPS
How CME is Changing: The Influence of Population Health, MACRA, and MIPS Table of Contents Population Health: Definition and Use Case The Future of Population Health and Performance Improvement MACRA and
More informationDecember 19, Dear Acting Administrator Slavitt:
December 19, 2016 Andy Slavitt Acting Administrator Centers for Medicare and Medicaid Services U.S. Department of Health and Human Services Attn: CMS-5517-FC Room 445 G, Hubert H. Humphrey Building 200
More informationMACRA & Implications for Telemedicine. June 20, 2016
MACRA & Implications for Telemedicine June 20, 2016 Presentation Overview Introductions Deep Dive Into MACRA Implications for Telemedicine Questions Growth in Value-Based Care Over Next Two Years Growth
More informationAdvancing Care Information Performance Category Fact Sheet
Fact Sheet The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) replaced three quality programs (the Medicare Electronic Health Record (EHR) Incentive program, the Physician Quality Reporting
More informationThe Influence of Health Policy on Clinical Practice. Dr. Kim Kuebler, DNP, APRN, ANP-BC Multiple Chronic Conditions Resource Center
The Influence of Health Policy on Clinical Practice Dr. Kim Kuebler, DNP, APRN, ANP-BC Multiple Chronic Conditions Resource Center Disclaimer Director: Multiple Chronic Conditions Resource Center www.multiplechronicconditions.org
More informationACCOUNTABLE CARE ORGANIZATION & ALTERNATIVE PAYMENT MODEL SUMMIT
ACCOUNTABLE CARE ORGANIZATION & ALTERNATIVE PAYMENT MODEL SUMMIT The Centers for Medicare and Medicaid Services Kate Goodrich, MD MHS Director, Clinical Standards & Quality Chief Medical Officer 1 DISCLAIMERS
More informationGetting Ready for the Post-SGR World. Presented by: Sybil R. Green, JD, RPh, MHA. West Virginia Oncology Society Spring Meeting May 5, 2016
Getting Ready for the Post-SGR World Presented by: Sybil R. Green, JD, RPh, MHA West Virginia Oncology Society Spring Meeting May 5, 2016 CME/CE Information For Physicians: This activity has been planned
More informationThe Society of Thoracic Surgeons
The Society of Thoracic Surgeons STS Headquarters 633 N Saint Clair St, Floor 23 Chicago, IL 60611-3658 (312) 202-5800 sts@sts.org STS Washington Office 20 F St NW, Ste 310 C Washington, DC 20001-6702
More informationLegislative Update Wipfli CAH/RHC Conference
Legislative Update Wipfli CAH/RHC Conference Nathan Baugh Director, Government Relations (202) 543-0348 Baughn@capitolassociates.org www.narhc.org Overview NARHC Washington Update MACRA Overview and Update
More informationMACRA is Coming: Reimbursement for Quality and the Shift to Population-Based Care
MACRA is Coming: Reimbursement for Quality and the Shift to Population-Based Care AMERICAN NEUROLOGICAL ASSOCIATION October 17, 2017 Marc R. Nuwer, MD PhD Professor and Vice Chair UCLA Lyell K. Jones,
More informationUnder the MACRAscope:
Under the MACRAscope: G08: Under the MACRAscope: MIPS and EHRs Robert Tennant, MA Director, HIT Policy, MGMA Government Affairs rtennant@mgma.org Learning Objectives This session will provide you with
More informationSubmitted electronically:
Mr. Andy Slavitt Acting Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Attention: CMS-5517-FC P.O. Box 8013 7500 Security Boulevard Baltimore, MD 21244-8013
More informationMIPS, MACRA, & CJR: Medicare Payment Transformation. Presenter: Thomas Barber, M.D. May 31, 2016
MIPS, MACRA, & CJR: Medicare Payment Transformation Presenter: Thomas Barber, M.D. May 31, 2016 Michael Porter- Value Based Care Delivery, Annals of Surgery 2008 Principals: Define Value as a Goal Care
More informationDescribe the process for implementing an OP CDI program
1 Outpatient CDI: The Marriage of MACRA and HCCs Marion Kruse, RN, MBA Founding Partner LYM Consulting Columbus, OH Learning Objectives At the completion of this educational activity, the learner will
More informationFinal Meaningful Use Rules Add Short-Term Flexibility
Final Meaningful Use Rules Add Short-Term Flexibility Allison W. Shuren, Vernessa T. Pollard, Jennifer B. Madsen MPH, and Alexander R. Cohen November 2015 INTRODUCTION On October 16, the Centers for Medicare
More informationMichelle Brunsen & Sandy Swallow May 25, , Telligen, Inc.
MIPS Survive and Thrive: Advancing Care Information Michelle Brunsen & Sandy Swallow May 25, 2017 2016, Telligen, Inc. Objectives Quality Payment Program Updates Advancing Care Information (ACI) Category
More informationMACRA: Disrupting the health care system at every level
Health Policy Brief MACRA: Disrupting the health care system at every level Produced by the Deloitte Center for Health Solutions and the Deloitte Center for Regulatory Strategies Executive summary The
More informationPromoting Interoperability Measures
Promoting Interoperability Measures Previously known as Advancing Care Information for 2017 and Meaningful Use from 2011-2016 Participants: In 2018, promoting interoperability measure reporting (PI) is
More informationTable 1: MIPS Exemptions. Exemption Individual Determination Group Determination Treatment under MIPS Already Finalized EXEMPTIONS Low-Volume
Exemptions and Special Status Determinations under the Merit-Based Incentive Payment System (MIPS): A Resource Guide for Existing and Proposed Policies The following tables provide information on exemptions
More informationHow to Align Quality Reporting Across PQRS, MU, and VBPM
Health Care IT Advisor How to Align Quality Reporting Across PQRS, MU, and VBPM Anantachai (Tony) Panjamapirom Senior Consultant, Health Care IT Advisor Debe Gash CIO, St. Luke s Health System March 10,
More informationMerit-Based Incentive Payment System: 2018 Performance Year
Knowledge Brief Merit-Based Incentive Payment System: Performance Year The Merit-based Incentive Payment System (MIPS) impacts the 2020 Medicare Part B payment for billed visits in calendar year. MIPS
More informationAdvancing Care Information Measures
Participants: Advancing Care Information Measures In 2017, Advancing Care Information (ACI) measure reporting is optional for Nurse Practitioners, Physician Assistants, Clinical Nurse Specialists, CRNAs,
More informationQuality Payment Program and Alternative Payment Models. Brian R. Bourbeau, MBA COA Administrators Network April 11, 2018
Quality Payment Program and Alternative Payment Models Brian R. Bourbeau, MBA COA Administrators Network April 11, 2018 Speaker Background Associate Director, Business Metrics & Analysis Clinical Affairs
More informationMACRA WHAT DOES IT MEAN FOR YOUR PRACTICE?
MACRA WHAT DOES IT MEAN FOR YOUR PRACTICE? A Presentation for ASMA and MIEC Members & Guests Copyrighted 2017, The Sage Associates, Pismo Beach, California All rights reserved. All material contained in
More informationCenters for Medicare and Medicaid CMS Updates. Christol Green, Anthem Inc.
Centers for Medicare and Medicaid CMS 2016-2017 Updates Christol Green, Anthem Inc. Agenda Topic Page Payment Models - BPCI 3 Sequestration 5 CPC+ Initiative 7 What is MACRA? 12 CMS Social Security Number
More informationRE: CMS-1677-P; Medicare Program; Request for Information on CMS Flexibilities and Efficiencies
June 13, 2017 Ms. Seema Verma Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Attention: CMS-1677-P P.O. Box 8011 Baltimore, MD 21244-1850 RE: CMS-1677-P;
More informationVALUE BASED ORTHOPEDIC CARE
VALUE BASED ORTHOPEDIC CARE Becker's 14th Annual Spine, Orthopedic and Pain Management- Driven ASC Conference + The Future of Spine June 9-11, 2016 Swissotel, Chicago, IL LES JEBSON Administrator, Adjunct
More informationCMS Transforming Clinical Practices Initiative and. The Southern New England Practice Transformation Network (SNE PTN)
CMS Transforming Clinical Practices Initiative and The Southern New England Practice Transformation Network (SNE PTN) MIPS 2017- Selecting Performance Category Measures and Reporting Requirements 1/31/2017
More informationVALUE PAYMENT: A NEW REIMBURSEMENT SYSTEM USING QUALITY AS CURRENCY
VALUE PAYMENT: A NEW REIMBURSEMENT SYSTEM USING QUALITY AS CURRENCY Danielle Hansen, DO, MS (Med Ed), MHSA Healthcare Quality/ Value Challenge 1 Value-Based Programs Supports the IHI Triple Aim: 1. Better
More informationMACRA MACRA MACRA 9/30/2015. From the Congress: A New Medicare Payment System. The Future of Medicare: A Move Toward Value Driven Healthcare W20.
W20.8XXA The Future of Medicare: A Move Toward Value Driven Healthcare Emily L. Graham, RHIA, CCS-P VP, Regulatory Affairs, Hart Health Strategies Consultant, Coalition of State Rheumatology Organizations
More informationMACRA, MIPS, QPP, and APMs.
MACRA, MIPS, QPP, and APMs. The acronym soup of moving from volume to value. Dale W. Bratzler, DO, MPH, MACOI, FIDSA Edith Kinney Gaylord Presidential Professor Professor, Colleges of Medicine and Public
More informationESSENTIAL STRATEGIES IN MEDI-CAL PAYMENT REFORM. Richard Popper, Director, Medicaid & Duals Strategy August 3, 2017
ESSENTIAL STRATEGIES IN MEDI-CAL PAYMENT REFORM Richard Popper, Director, Medicaid & Duals Strategy August 3, 2017 1 DISCLAIMER The enclosed materials are highly sensitive, proprietary and confidential.
More informationThe Quality Payment Program: Your Questions Answered
APRIL 20, 2017 The Quality Payment Program: Your Questions Answered Quality Payment Program Panel BETH HOUCK, MBA Vice President, Client Services SA Ignite MATTHEW BARRON, MBA Director, Advisory Services
More informationMIPS Advancing Care Information: Tips, Tools and Support Q&A from Live Webinar March 29, 2017
MIPS Advancing Care Information: Tips, Tools and Support Q&A from Live Webinar March 29, 2017 Below are questions that were submitted during the Quality Insights Advancing Care Information webinar on March
More informationPhysician Quality Reporting System & VBPM, 2015
Physician Quality Reporting System & VBPM, 2015 Andrew Bienstock Transformation Support Services Manager 1 Agenda 1. PQRS Penalty 2. PQRS Eligibility 3. PQRS Reporting Options 4. Value Based Payment Modifier
More informationTips in Selecting Quality Measures
Learning Forum Fridays Countdown to Merit-based Incentive Payment System (MIPS) Data Submission Webinar Series Tips in Selecting Quality Measures Ohio Physician Office Team Health Services Advisory Group
More informationGlossary of Acronyms for the Quality Payment Program
The Physicians Advocacy Institute s Medicare Quality Payment Program (QPP) Physician Education Initiative Glossary of Acronyms for the Quality Payment Program 1 P a g e MEDICARE QPP PHYSICIAN EDUCATION
More informationMedicare Quality Payment Program: Deep Dive FAQs for 2017 Performance Year Hospital-Employed Physicians
Medicare Quality Payment Program: Deep Dive FAQs for 2017 Performance Year Hospital-Employed Physicians This document supplements the AMA s MIPS Action Plan 10 Key Steps for 2017 and provides additional
More informationWashington Update. Agenda
Washington Update Agenda Trending topics Quality Payment Program: Mid-Year Status Report Proposed 2018 Medicare regulations Healthcare Reform Update Q&A 1 Non Discrimination Standards Where did it come
More information