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 and 2/3/2017 2
Review and Agenda Determine eligibility status Pick Your Pace for the 2017 Transition Year Choose to report as an individual or a group Review available data submission methods Review the Explore Measures section on the QPP website for all three performance categories 2
Performance Category: Quality Measures (60%) Requirements Choose up to 6 of 271 quality measures including: 1 outcome quality measure OR If an appropriate outcome measure is not available, at least 1 high priority quality measure May also select specialty-specific measure set 3
Performance Category: Quality Measures (60%) CMS Shopping Cart https://qpp.cms.gov/measures/quality Filter by: High Priority Measures Data Submission Method Specialty Specific Measure Sets Source: https://qpp.cms.gov/measures/quality 4
Considerations for Choosing Quality Measures All quality measures must be reported via one submission method Exception: CAHPS for MIPS survey Report on at least 50% of patient data Qualified Clinical Data Registry (QCDR), Electronic Health Record (EHR), or Qualified Registry: all payers Claims: only Medicare Part B patients Minimum case volume is 20 cases 5
Performance Category: Improvement Activities (15%) Requirements Small Practices (15 or fewer clinicians) 1 high weighted activity OR 2 medium weighted activities Large Practices (16 or more clinicians) 2 high weighted activities OR 1 high and 2 medium weighted activities OR 4 medium weighted activities Full credit for participants in certified patient centered medical homes, comparable specialty practices or an APM designed as a Medical Home Model 6 Adapted from: CMS. Quality Payment Program Overview Fact Sheet. October 14, 2016
Performance Category: Improvement Activities (15%) CMS Shopping Cart https://qpp.cms.gov/measures/ia Filter by: Note Subcategory Name Activity Weighting For small practices, participation in SNE PTN is a high weighted activity 7 Source: https://qpp.cms.gov/measures/ia
Performance Category: Advancing Care Information (25%) Requirements There are two measure set options for reporting the option you use is based on your EHR edition Option 1: Advancing Care Information Objectives and Measures (2015 Certified) Option 2: 2017 Advancing Care Information Transition Objectives and Measures (2014 Certified) Optional for Hospital-based MIPS clinicians, NP, PA, CNS, CRNAs This category can be reweighted under certain circumstances 8
Performance Category: Advancing Care Information (25%) Determine your EHR version by visiting Office of the National Coordinator for Health Information Technology - https://chpl.healthit.gov/#/search 9
Performance Category: Cost (0%) Requirements No reporting requirements Clinicians assessed on Medicare Part B claims data CMS will provide feedback on how you performed in this category in 2017 but it will not affect your 2019 payments Review 2015 QRUR report - https://portal.cms.gov 10
How do I submit my Performance Category Information? Individual QCDR (Qualified Clinical Data Registry) Qualified Registry EHR Claims Attestation QCDR Qualified Registry EHR Vendor Attestation QCDR Qualified Registry EHR Vendor Group QCDR Qualified Registry EHR Administrative Claims CMS Web Interface (group of 25 or more) CAHPS for MIPS Survey Attestation QCDR Qualified Registry EHR Vendor CMS Web Interface Attestation QCDR Qualified Registry EHR Vendor Source: CMS. The Merit-based Incentive Program. November 2016. PowerPoint presentation 11
Preparing for MIPS How do I start? Determine eligibility status Pick Your Pace for the 2017 Transition Year Choose to report as an individual or a group Review available data submission methods Visit the QPP website shopping cart and select measures for Quality and Improvement Activities Confirm your EHR s certification year and review associated Objectives and Measures 12
Example of 2017 Full Year Participation Primary Care Clinician Example Quality Measures (6 measures, including 1 outcome) Diabetes: Hemoglobin A1c Poor Control (>9%) (outcome measure) Falls: Risk Assessment Preventive Care and Screening: Influenza Immunization Breast Cancer Screening Advancing Care Information (Required Base Score and 1 performance measure) E-Prescribing Health Information Exchange Provide Patient Access Security Risk Analysis Improvement Activities (Up to 4 depending on practice size and activity weight) TCPI Participation (high-weighted) Colorectal Cancer Screening Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention Medication Reconciliation (performance score) 13
QUESTIONS? For additional questions please reach out to ptn@umassmed.edu 14