MACRA 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 this manual is protected by copyright. Participants who receive this book as part of a workshop presented by The Sage Associates have permission to reproduce any forms contain herein, solely for their own uses within their medical practices. Any other reproduction or use of material in this book without the permission of the author is strictly prohibited. The material in this manual was written by practice management consultants. Any advice or information contained in this manual should not be construed as legal advice. When a legal question arises, consult your attorney for appropriate advice. The information presented in this manual is extracted from official government and industry publications. We make every attempt to assure that information is accurate; however, no warranty or guarantee is given that this information is error-free and we accept no responsibility or liability should an error occur. CPT codes used in this manual are excerpts from the current edition of the CPT (Current Procedural Terminology) book, are not intended to be used to code from and are for instructional purposes only. It is strongly advised that all providers purchase and maintain up to date copies of CPT. CPT is copyrighted property of the American Medical Association. 2

MACRA AN OVERVIEW On April 15, 2015, Congress and President Obama approved one of the most significant bills in the history of U. S. healthcare reform, the Medicare Access and CHIP Reauthorization Act of 2015 ( MACRA ), which repeals the Medicare Part B Sustainable Growth Rate (SGR) reimbursement formula and replaces it with a new pay-for-performance program: the Merit-Based Incentive Payment system (MIPS). WHAT IT DOES: Repeals the Sustainable Growth Rate methodology for determining updates to the Medicare physician fee schedule. Establishes annual positive or flat fee updates for 10 years and institutes a two-tracked fee update afterwards Establishes a Merit-Based Incentive Payment System (MIPS) that consolidates existing Medicare fee-for-service physician incentive programs. Establishes a pathway for physicians to participate in alternative payment models, including the patient-centered medical home. Makes other changes to existing Medicare physician payment statutes. 3

MACRA AN OVERVIEW WHAT IT DOES Replacing the SGR and annual fee schedule is a very BIG deal! But the replacement is also a sea change in as much as the entire payment model is changing from fee for service to value based To some degree this is similar to the Medicare change for hospitals shifting to the DRG prospective payment system Except the new system will reward value moving the system of care to rewarding improved outcomes, reduction in waste and duplication and so forth It is a natural evolution from PQRS and meaningful use and implements many Stage 3 goals such as driving patient engagement and care coordination Unifies the disparate quality programs (PQRS, erx, Value Based Modifier Program, Meaningful Use, etc.) and perhaps simplifies reporting and practice level workload 4

The MACRA Timeline April 2015 MACRA legislation passes becomes LAW April 2016 Department of Health and Human Services issued a Notice of Proposed Rulemaking for MACRA October 2016 CMS released the Final Rule which was published in the Federal Register on November 4, 2016 5

The MACRA Timeline January 2017 First Quality Payment Program Performance year begins June 20, 2017 Department of Health and Human Services issued a Notice of Proposed Rulemaking for MACRA for 2018 November 2017 HHS should issue Final Rule for MACRA 2018 6

MACRA IS NOT GOING AWAY!!! MIPS is a result of MACRA MIPS begins in 2019 Based on what you do in 2017!!! 7

MACRA BASICS MACRA Established two Medicare payment paths for physicians MIPS APM 8

Payment Paths MACRA was designed to offer physicians a choice between two payment pathways: A modified fee-for-service model (MIPS) New payment models that reduce costs of care and/or support high-value services not typically covered under the Medicare fee schedule (APMs) In the beginning, most are expected to participate in MIPS CMS named the physician payment system created by MACRA the Quality Payment Program (QPP) https://qpp.cms.gov 9

MACRA is a Two - Track System: Merit-based Incentive Payment System (MIPS) Traditional Part B Medical Payment Methodology = Performance Based Payment Adjustment (up or down) Advanced Alternative Payment Models (AAPM): Shared Risk Based Payment Methodology = Incentive Payment for Participating in Innovative Payment Models Patient Centered Medical Home (PCMH) Accountable Care Organizations (ACO) and Medicare Shared Savings Programs (MSSP) Comprehensive Primary Care Plus Program (PCP+) Other Models 10

MIPS MERIT-BASED INCENTIVE PAYMENT SYSTEM 11

MIPS Aims Align 3 current independent programs PQRS (Physician Quality Reporting System) MU (Meaningful Use) VBM (Value-Based Modifier) Add 4 th component to promote improvement and innovation Clinical Practice Improvement Activities (IA) Provide more flexibility and choice of measures Retain a fee-for-service payment option 12

MIPS Components Quality Reporting (was PQRS) Cost (was Value- Based Modifier) MIPS Advancing Care Information (was MU) Clinical Practice Improvement Activities(IA) 13

MIPS Performance Category Weights (as originally defined) ( over time, the cost category will gradually become larger and the quality category will become smaller) 2017 2018 2019 Quality = 60% ACI = 25% CPIA = 15% Quality = 50% ACI = 25% CPIA = 15% Cost = 10% Quality = 30% ACI = 25% CPIA = 15% Cost = 30% 14

Component Scoring Quality 60 points groups < 15 70 points for larger groups Advancing Care Information 50 points base score 90 points performance score Improvement Activities 40 points (2-4 activities, 1-2 activities for practices < 15 clinicians, rural practices, and non-patient facing physicians) Cost 10 points per measure Score is average of attributable measures 15

2019 (1 st year) penalty risks compared Prior Law PQRS -2% MU -5% VBM Total penalty risk Bonus potential (VBM only) 2019 Adjustment -4% or more* -11% or more* Unknown (budget neutral)* MIPS factors Quality Measurement Advancing Care Info Resource Use Improvement Activities 2019 Scoring 60% of score 25% of score 0% of score 15% of score Total penalty risk Max of -4% * VBM was in effect for 3 years before MACRA passed, and penalty risk was increased in each of these year; therefore were no ceilings or floors on penalties and bonuses, only a budget neutrality requirement Bonus potential Max of 4%, plus potential 10% for high performers 16

Here s the Effect on Your Reimbursement: 2017 + 0.05% 2018 + 0.05% 2019 + 4% 2020 + 5% 2021 + 7% 2022 + 9% 2019 (12% for top performers) 2020 (15% for top performers) 2021 (21% for top performers 2022 and beyond (27% for top performers 17

Here s the Effect - One CPT Code: 99213 Year VBPM Fee Adj. MIPS Adj. Net Adj. 99213 MPFS QTY Subtotal Net Effect 2016 $ 73.40 1,000 $ 73,400 2017-2.00% 0.50% -1.50% $ 72.30 1,000 $ 72,299 $(1,101.00) 2018 0.00% 0.50% 0.50% $ 72.66 1,000 $ 72,660 $ 361.50 2019 0.50% - 4.00% -3.50% $ 70.12 1,000 $ 70,117 $(2,543.12) 2020-5.00% -5.00% $ 66.61 1,000 $ 66,612 $(3,505.87) 18

MIPS 2017: Who s In and Who s Out? Included About 45% of Clinicians Physicians, PAs, NPs, CNSs, CRNAs Groups that include the above clinicians Excluded About 55% of clinicians Clinicians, groups that fall under the low-volume threshold Providers billing Medicare for the first year Groups with significant participation in APMs 19

Low Volume Threshold < $30K in Medicare Part B allowed charges Or 100 or less unique Part B patients During one of the year-long determination periods Sept. 1, 2015 August 31, 2016 Sept. 1, 2016 Aug. 31, 2017 (includes 60-day claims run-out) 20

How Do I Know If I Am Exempt? Check Your Mail! CMS has mailed letters regarding participation (including exemption); check them carefully to assure they are accurate 1. Letter of Explanation regarding Quality Payment Program (QPP) 2. Attachment A includes a list of the clinician(s) associated with your TIN, their NPI, and whether they are subject to MIPS 3. Attachment B is important Q&A about the program 21

Check Your Eligibility Online at CMS 22

Eligibility Check CMS Website 23

Eligibility Check CMS Website 24

Check Eligibility thru AAPM 25

Your Options for 2017: Transitional Reporting Pick Your Pace 1. Do Nothing! 2. MIPS Testing 3. Partial MIPS Reporting 4. Full MIPS Reporting 26

1. Do Nothing - Report No Data The only clinicians who will experience negative payment adjustments (-4%) in 2019 are those who report no data in 2017! 2017 is not a stand-alone year! 27

2. MIPS Testing Report some data at any point in CY 2017 to demonstrate capability 1 quality measure, or 1 improvement activities, or 4/5 required ACI measures No minimum reporting period No negative adjustment in 2019 28

3. Partial MIPS Reporting Submit partial MIPS data for at least 90 consecutive days 1+ quality measure, or 1+ improvement activities, or 4/5 required ACI measures No negative adjustment in 2019 Potential for some positive adjustment (<4%) in 2019 29

4. Full MIPS Reporting Meet all reporting requirements for at least 90 consecutive days No negative adjustment in 2019 Maximum opportunity for positive 2019 adjustment (< 4%) Exceptional performers eligible for additional positive adjustment (up to 10%) 30

Before We Proceed: ADVANCED ALTERNATIVE PAYMENT MODELS 31

Advanced APM Participation Qualifying participants get: Exemption for MIPS 5% annual lump sum bonus payments through 2024 A 0.5% higher fee schedule update from 2028 onward Partially qualifying participants get: The option to forego participating in MIPS Favorable scoring in MIPS

Characteristics of an AAPM 1. Requires participants to use CEHRT Minimum of 50% of participating ECs in 2017 2. Provides payment based on quality measures comparable to those used in MIPS 3. Must satisfy financial risk requirements Be a CMMI expanded medical home model* OR Meet financial and nominal risk standards * To date, CMS has not issued any expanded medical home models that would meet this definition 33

AAPM Risk Standards Financial Risk Standard If actual aggregate expenditures exceed expected expenditures, the AAPM must: Withhold payments Reduce payment rates; OR Owe payments to CMS Nominal Risk Standard Under the terms of the APM, the total annual amount that the APM Entity would potentially owe or forego to CMS is at least: 8% of average estimated total Medicare Parts A and B revenues; OR 3% of expected expenditures for which the APM Entity is responsible for under the APM 34

Advanced APM Models 2017 and 2018 2017 MSSP ACO Tracks 2 & 3 Next Gen ACOs Comprehensive ESRD Care Models CPC+ Oncology Care Model (2-sided risk) CJR CEHRT Track CMS anticipates 10% of clinicians will be considered advanced APM qualified participants in 2017 35

AAPM 2018 Advancing Care Coordination through Episode Payment Models (Track 1) Cardiac Rehabilitation Incentive Payment Model MSSP ACO Track 1+ CMS anticipates 25% of clinicians will be considered advanced APM qualified participants in 2018 with the additional models. 36

?? Questions your practice should consider if it s thinking about joining an AAPM: Do we want to be evaluated collectively at the APM Entity level, or would my practice fare better at the TIN level under MIPS? What are the benefits of participating in a particular APM model outside of the lump sum bonus? What are he start-up and ongoing costs that go along with participating in an APM? Should we participate in MIPS in 2017 and wait for additional APMs in 2018 (or later)? 37

PREPARING FOR QPP 38

Ask These Questions: Will you likely be in MIPS or AAPM? Are you exempt from MIPS? Low volume provider? Qualified participant in an Advanced APM? Do you meet requirements for small, rural, non-patient-facing accommodations? Would you be reporting as a group or an individual?

To Group or Not to Group (Individual) Group = 2 or more clinicians billing under the same Tax Identification Number (TIN). If you elect to report as a group, every clinician billing under that TIN MUST report together Clinicians who participate as a group will be assessed at a group level across all 4 MIPS performance categories. The group will receive one payment adjustment for the group s performance. All members of the group report the SAME measures If you are a clinician that practices under more than one TIN, you will need to meet MIPS requirements under each TIN. Reporting as a group will only cover you for that particular TIN, and only services that are provided under that TIN will be included in your group s MIPS score. 40

Group vs Individual An individual clinician (NPI) can be excluded from the group: 1. If a clinician in a group is a qualified participant (QP) under the advanced alternative payment model (AAPM). In this scenario, this clinician s NPI will be removed from the group prior to calculating performance. In addition, any payment adjustments that are placed on the group with not affect this individual NPI. 2. If a clinician is in the first year of billing Medicare, he/she will be removed from the group prior to calculating performance. In addition, any payment adjustments that are placed on the group will not affect this individual NPI. Here s the kicker... If the clinician meets the low-volume threshold exemption under MIPS he/she WILL be included in the group. 41

As a Group: Group reporting is an all or nothing game. A group practice TIN is considered a super clinician under MIPS when reporting as a group. Every rule that applies to an individual eligible clinician will apply to the entire group as if it is a single eligible clinician. Thus, some ECs in a group cannot choose to report individually or qualify for exclusion while the rest of the group reports together. When one clinician reports or excludes individually, the rest of the group must do the same. This decision could greatly disadvantage other group members, as each would then be required to take on all of the responsibilities required to succeed in all of necessary MIPS categories rather than as a collective group entity. More favorable terms are available for reporting in the improvement activities (IA) category. When reporting as a group, only one individual clinician needs to participate in an improvement activity for the entire group to receive credit for that activity. This will greatly reduce the burden of participation in the IA category since it requires from one to four activities to maximize performance. Practices also have the ability to maximize participating in the quality category by selecting the best, most achievable measures to report across the entire group. This is especially helpful for groups with physicians who have fewer measures available. 42

As a Group: Financial benefit. When the group as a whole achieves a positive Medicare fee schedule adjustment, every member of the group who provides any level of Medicare Part B services will contribute to and receive that positive adjustment. If the ECs were reporting individually, exemption from MIPS would only allow for avoidance of a penalty while others in the practice would receive a positive payment adjustment. Reputational considerations: Medicare s Physician Compare website publishes the results of each physician s quality scores. By choosing to avoid MIPS participation, a physician will be missing from the listing, and this might raise questions in the minds of potential patients. Positive quality scores posted by Physician Compare can also be leveraged for marketing purposes and may ultimately appear on consumer ratings web sites such as Yelp and Healthgrades. Participation along with the group practice will give each physician the opportunity to have his or her positive quality scoring posted. 43

As a Group: Reduced administrative burden. When reporting as a group, everyone s interests and methods are aligned. If the practice administrator has to keep track of the measures and activities for each EC individually, the opportunity for error is greater, as is the amount of resources required to monitor and report each one separately. Planning for the future. Medicare s Quality Payment Program will be in place for the long term, but an exemption might be short-lived. As a physician s Medicare patient mix changes or as MIPS exemptions are phased out, he or she will most likely have to participate at some point in the future. Beginning participation early, with most likely less-stringent requirements, gives the physician the experience to succeed. Working on quality metrics within the group practice will allow success with less pressure than reporting as an individual when the time comes to participate. 44

Reporting EACH OF THE COMPONENTS 45

Quality Are you reporting quality metrics? Do you plan to report through claims, EHR, clinical registry, QCDR, or group practice reporting option (GPRO) Web-interface? Do you plan to report as a group or an individual? If a group, keep in mind all eligible clinicians (EC) in the group must report on the same measures across all 4 MIPS categories Claims reporting is only available if reporting as an individual web-interface is only available if reporting as a group and have 25 or more EC s Check our PQRS feedback reports! Check for topped out measures Check your cost docile 46

Advancing Care Information If you have an EHR, speak with your vendor about how their product supports the new payment models Is your EHR certified? If so, is it the 2014 or 2015 edition? Does it support Medicare quality reporting? Does your vendor offer patient tracking and clinical decision support tools? Can your EHR connect to public health or clinical data registries? What improvement activities can your EHR help with to earn bonus points? Conduct a careful security risk analysis early on! 47

Improvement Activities (CPIA) Review the more than 90+ approved improvement activities in the final rule Which Improvement Activities are you engaged in now? What are you interested in doing? Consider which 90 days in 2017 would work best for our practice s selected Improvement Activities? If you participate in a PCMH or comparable specialty practice, you will receive full credit! Review all your resources! 48

Cost Although the cost component of MIPS is weighted 0% for 2019, there are opportunities to prepare: Access and review our Medicare Quality and Resource Use Reports (QRURs) to see where improvements can be made Plan to review feedback CMS provides for informational purposes throughout the 2017 performance period that will affect your cost score in future years Review your most costly patient population conditions and diagnoses and seek improvement opportunities 49

Getting Started Merit-based Incentive Payment System (MIPS) 50

Choose a Reporting Option Claims* EHR Individual Reporting Clinical Data Registry Qualified Clinical Data Registry * Claims reporting option available only if reporting as an individual, and only certain measures Group Reporting (GPRO) A group is classified as two or more eligible clinicians (ECs) A physician in a group may choose to participate as an individual under MIPS Reporting Options: EHR Clinical Data Registry Qualified Clinical Data Registry, or Web-Interface** ** Web-Interface option open only to practices of 25 or more ECs due to CMS sampling methodology and restrictive nature of quality measures that are reported under this mechanism

Quality reporting in MIPS vs. PQRS PQRS 9 Measures Pass/fail approach 2% penalties, no bonuses Measures must fall across specific domains One cross-cutting measure required MIPS Quality 6 measures (or 1 specialty set) Partial credit allowed toward positive payment adjustment Flexibility in measure choice No domains, no cross cutting measures Bonuses available for reporting through EHR, qualified registry, QCDR, or web interface 52

Quality Category Reporting 1 Administrative Claims measure All-cause hospital readmission measure finalized for groups of 16 or more (vs. 10 in proposed rule) with 200 attributed measures Will be calculated by CMS from administrative claims data 6 measures must be reported, or a specialty measure set 1 must be an outcome measure If no applicable outcome measure available, must report 1 other high priority measure instead High priority areas include: appropriate use, patient safety, patient experience, care coordination For maximum points, measure must be reported on 50% of eligible patients in 2017 Threshold increases to 60% of eligible patients in 2018 53

Quality Category Bonus Point Scoring Additional points awarded for: Electronic reporting via clinical registry, EHR, qualified clinical data registry, or web-interface Reporting on CG-CAHPS survey measure Additional outcome of additional high priority measures outside the 1 required 54

ACI Reporting in MIPS vs. Meaningful Use MU 100% score required on all measures to avoid penalty Included redundant measures and problematic CPOE, CDS, and clinical quality measures Full-year reporting (although twice reduced in Q4) MIPS ACI Pass-fail program replaced with base and performance scoring 4/5 base measures required Partial credit allowed for performance measures Fewer measures: CPOE, CDS, and clinical quality measures eliminated Public Health registry reporting optional Performance score thresholds eliminated 90-day reporting periods for 2017 and 2018 Bonuses available for registry reporting and se of CEHRT in IA 55

ACI Performance Category Scoring: Required Measures (50% score) Objective ACI Measure Reporting Requirement Protect patient health information Security risk analysis Yes/No statement Electronic prescribing E-prescribing Numerator / denominator Patient electronic access Provide patient access Numerator / denominator Health information exchange Send summary of care Numerator / denominator Health information exchange (2015 CEHRT only) Request / accept summary of care Numerator / denominator 56

2017 ACI Performance Category Scoring: Optional measures (to reach full score) Objective ACI Measure Performance Score Reporting Requirement Patient electronic access Patient-specific education Up to 10% Numerator / denominator Coordination of care / patient engagement View, download or transmit Up to 10% Numerator / denominator Coordination of care / patient engagement Secure messaging Up to 10% Numerator / denominator Coordination of care / patient engagement Patient-generated health data Up to 10% Numerator / denominator Health information exchange Clinical information reconciliation Up to 10% Numerator / denominator Public health / data registry reporting Immunization registry reporting 0 to 10% Numerator / denominator 57

ACI Bonus Point Scoring 5% bonus potential for reporting (via Yes/No statement) to one or more additional public health and clinical data registries Syndromic surveillance Electronic case (in 2018) Public health registry Clinical data registry 10% bonus potential for reporting certain Improvement Activities (IAs) using CEHRT 58

Improvement Activities (formerly CPIA) New component, intended to provide credit for practice innovations that improve access and quality Over 90 activities that cross 8 categories No required categories 40 points required for medium and large practices (2-4 activities) Only 1-2 activities required for groups <15, rural and HPSA practices, non-patient facing specialists Most physicians fall into this category Participation in 2017 MIPS APMs and non-advanced medical homes worth 40 points PCMH definition expanded to include national, regional, state, private payer, and other certifications 59

Improvement Activities Categories Expanded Practice Access Population Management Care Coordination Beneficiary Engagement Patient Safety & Practice Assessment Achieving Health Equity Emergency Response and Preparedness Integrated Behavioral & Mental Health 60

Improvement Activities Expanded Practice Access: Expanded practice hours, telehealth services, participation in models designed to improve access to services Population Management: Participation in chronic care management programs, participation in rural and Indian Health Services programs, participation in community programs with other stakeholders to address population health, and use of a Qualified Clinical Data Registry (QCDR) to track population outcomes Care Coordination: Use of QCDR to share information, timely communication and follow up, participation in various CMS models designed to improve care coordination, implementation of care coordination training, implementation of plans to handle transitions of care, and active referral management Beneficiary Engagement: Use of EHR to document patient-reported outcomes, providing enhanced patient portals, participation in a QCDR that promotes the use of patient engagement tools, and use of QCDR patient experience data to inform efforts to improve beneficiary engagement 61

Improvement Activities Patient Safety and Practice Assessment: Use of QCDR data for ongoing practice assessments and patient safety improvements, and use of tools such as the Surgical Risk Calculator Achieving Health Equity: Seeing new and follow-up Medicaid patients in a timely manner, and use of QCDR for demonstrating performance of processes for screening for social determinants Emergency Response and Preparedness: Participation in disaster medical teams or participation in domestic or international humanitarian volunteer work Integrated Behavioral and Mental Health: Tobacco intervention and smoking cessation efforts, and integration with mental health services 62

Reporting Improvement Activities Reporting is via attestation - yes, I did it Keep supporting documentation to prove you did it Report via CMS Quality Website Registry QCDR 63

Cost in MIPS vs. VBM (No physician reporting required for this component; calculated by CMS based on claims submitted) Included both quality reporting and resource-use measures VBM PQRS failure counted twice in penalty calculations Poor risk adjustment produced penalties for treating sickest patients No statutory limits on penalty risk MIPS Cost Focuses solely on cost; no duplicative quality reporting, no duplicative penalties 10 episode groups finalized; others being tested and refined Plans to improve attribution methods in 2018 (for 2020 payments) Part D drug costs will not be included in calculations During 2017 transition, category weight will be zero Reports provided to physicians in transition for review; will include total costs per capita and Medicare spending per beneficiary 64

Cost Category Measures Cost based Medicare spending per beneficiary Total per capita cost Episode based Cataract/lens surgery Mastectomy Aortic/mitral valve surgery Coronary artery bypass graft Repair of hip/femur fracture or dislocation Cholecystectomy and common duct exploration Colonoscopy and biopsy Transurethral resection of the prostate for benign prostatic hyperplasia Hip replacement or repair Knee arthroplasty All 10 have been included in 2014 and 2015 Supplemental QRURs 65

GO The Five Steps of Implementation 66

What Physician Practices Can Do NOW Assess performance under current programs Consider which pathway is best suited for your practice Evaluate EHR and other vendor readiness and costs Protect yourself against a MIPS penalty Establish a game plan for participating/reporting Use Your MIPS Navigator from QVH Systems Engage in ongoing learning about MACRA Keep an open mind; your strategy could change in 2018+

Now is the Time to: 1. Decide how you will report - individual vs group 68

Now is the Time to: 2. Select your level of participation ( Pick Your Pace ) for 2017 Quality ACI IA 69

Now is the Time to: 3. Determine your reporting mechanism You may select a different mechanism for each component if you wish - determine what is most beneficial and efficient for you and your practice processes 70

Now is the Time to: 4. Adjust any practice operational processes needed to make sure you will capture appropriate data and assure complete reporting requirements 71

Now is the Time to: 5. BEGIN TO REPORT!!! 72

Proposed Rule Highlights 2018 73

Remember: This is a proposed rule; not a final rule! Use of 2015 certified EHR option in 2018 2015 certified EHR still required for certain APM participants Changes to low-volume threshold exclusion proposed Cost will remain 0% for overall MIPS score Multiple submission mechanisms allowed with the ACI, quality and IA categories Virtual groups allowed Significant hardship exception to opt of MIPS ACI for small practices Only minor tweaks to Advanced APM regulations Stay Tuned!!! 74

Use Your Resources 75

Resources (not an all inclusive list!) ASMA and MIEC https://asmadocs.org and www.miec.com Online Webinars and Videos Short Video Presentations Accessing Your QRUR Report Pick Your Pace Options Explained Using Practice Management Reports to Evaluate MIPS Participation Interactive Webinars (MIPS Components) Quality Measures Improvement Activities Advancing Care Information Cost Security Risk Analysis

Resources ASMA/MIEC (cont d) MIPS Navigator from QVH Systems create your plan for MIPS You will receive an access code for the QVH Systems MIPS Navigator This tool functions like a TurboTax for MIPS, allowing you to create an individualized plan for MIPS reporting If you have not received an access code, follow up with a staff member and they will make sure that you get an access code Remember - Use this as a planning tool; it is not a reporting tool Documents (available online) MACRA Acronyms and Terms Individual Quality Measures MIPS Specialty Measure Sets Improvement Activities Inventory ACI Objectives and Measures Cost Episode Based Measures CMS 2017 Qualified Registries List Step-by-Step Guide to Test Reporting Option 77

Resources CMS - www.qpp.cms.gov CMS measure selection tool Explore Measures Explore Quality Measures Advancing Care Information Improvement Activities Resource Library Measure Specifications Quality and ACI AMA - www.ama-assn.org State and Local Medical Association Your Specialty Association 78

Your Questions???? 1. 2. 3. 4. 5. 6. 7. 79

Mary Jean Sage The Sage Associates 791 Price Street, #135 Pismo Beach, CA 93449 Tel: (805) 904-6311 Fax: (805) 980-4026 www.thesageassociates.com mjsage@thesageassociates.com Thank You For Your Attention and Participation 80

Mary Jean Sage, CMA-AC Mary Jean Sage, founder and President of The Sage Associates has extensive experience in the healthcare field that spans more than 30 years. She received her degree in Business Administration from the University of Redlands and her degree in Allied Health from Ferris State University. She is a credentialed Certified Medical Assistant. Mary Jean is a nationally recognized speaker, consultant, and educator of healthcare issues. The excellent reputation of this consultant is built on her professional approach in helping healthcare providers succeed in a challenging healthcare economy and marketplace. She keeps abreast of the trends that shape the healthcare industry while assisting her client in managing costs, meeting regulatory compliance criteria, and managing patient relationships. Mary Jean is known for the practical seminars and workshops she presents to healthcare professionals, using a clear and concise style. It is that style that leaves those attending her presentations with a thorough understanding of the critical issues at hand and how to address them. She has currently been traveling throughout the Western U.S. educating physicians and their staff members on Medicare s newest payment system MIPS.