Academy Efforts to Enhance Patient Care & Clinical Practice: From Big Data to Public Policy. Cynthia Ann Bradford, MD President
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1 Academy Efforts to Enhance Patient Care & Clinical Practice: From Big Data to Public Policy Cynthia Ann Bradford, MD President
2 Financial Disclosure NONE 2
3 Big Data, Big Insights 3,000 ophthalmologists who participated in IRIS Registry in 2014 submitted their data to CMS Savings = $24.3 million through incentives earned and penalties avoided Having more data enables us to make evidence-based decisions, improve care & empower patients 3
4 Big Data, Enhancing Patient Care It s hard for us to look at our data objectively. The IRIS Registry has the potential to provide us with that objective feedback and with that feedback, frankly, we can do a better job of taking care of patients. George Williams, MD, Secretary for Federal Affairs 4
5 IRIS Registry: Current Stats (July 1, 2017) Contracted o 16,737 physicians from 5,097 practices Total for EHR Integration o 13,199 physicians from 3,176 practices Number of patient visits o million, representing million patients 5
6 Integrated with 47 EHR Systems Amazing Charts ChartMaker Medical Suite Compulink Crystal PM Cybax DoctorSoft Drchrono eclinicalworks emds Enable Doc EyeDoc EMR Eyefinity ExamWRITER EyeMD EMR GE Centricity EMR Greenway Intergy Greenway/Primesuite HCIT HER ifa systems EMR imedicware Integrity EMR for Eyes IO Practiceware KeyChart EMR Lytec ManagementPlus MaximEyes by First Insight Mastermind EHR MDIntelleSys MDoffice MDSuite Medent MedEvolve Medflow Medinformatix EHR My Vision Express NeoMed NexTech NextGen Origin Prime Clinical System PrognoCIS Soapware SRS StreamLane TriMed EHR VersaSuite Vitera EHR WebChart by MIE
7 Participation in IRIS Registry Practices Physicians Electronic
8 IRIS Registry Upcoming Publications Real World Vision in Age-Related Macular Degeneration Patients Treated with Bevacizumab, Ranibizumab or Aflibercept only Over One Year in a Cohort of the IRIS Registry, Prethy Rao, MD (submitted to Ophthalmology) o One year s monotherapy of anti-vegf drugs improves visual acuity for patients with AMD in the real world, and multivariate models were used to look at differences across the agents. The Real World Effect of Intravitreous Anti-VEGF Drugs on IOP: An Analysis Using the IRIS Registry, Mathew MacCumber, MD, PhD and Elizabeth Atchison, MD (submitted to Ophthalmology Retina) o Evaluation of the impact of repeated anti-vegf injections in patients with AMD on intraocular pressure over time 8
9 IRIS Registry Opportunities for Research 1. IRIS Registry Analytics Teams 2. Subspecialty Society Funded Projects (AGS) The IRIS Registry will compress the evolution and dissemination of science. William Rich, MD Academy Medical Director for Health Policy 9
10 Unprecedented Access to Address Increasing Regulatory Burdens 10
11 CMS Proposes Significant Relief from 2018 Penalties Academy launched regulatory relief effort late last year in response to the election outcome Got the AMA to weigh in that 2018 penalties must be revisited Built coalition with Dermatology, Rheumatology, Neurology, ENTs, Urology, Oncology, Retina & Glaucoma groups 11
12 Ophthalmology s 2018 Fee Schedule Issues Potential for Big Win PQRS, Value-based Modifier Changes Reimbursement All RUC Values approved Opportunities for practice expense increases Pitfalls in malpractice valuation Threat to watch CMS looking at revising E&M guidelines Another shot to ask for more regulatory relief 12
13 Regulatory Relief, IRIS Registry Empowerment Academy Asks include: o Amend legacy quality programs for 2018 payments o o o o Shield Part B drug payments from QPP penalties Expand MIPS recognition of IRIS Registry participation Revise the Quality Payment Program Simplify Medicare Advantage s Prior-Authorization 13
14 Regulatory Relief Next Steps CMS will consider the Academy s comments before it finalizes its fee schedule in November Academy also pursuing several legislative solutions to the issues we ve raised. 14
15 2018 Medicare Payments Look Better for Ophthalmology Overall No misvalued codes identified for ophthalmology and only a few remaining left to review from previous targeted codes. Overall rule shows there is zero impact to ophthalmology from policies contained in the proposed rule. 15
16
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