QUALITY PAYMENT PROGRAM SMALL UNDERSERVED RURAL SUPPORT (QPP SURS) WEBINARJUNE 12, 3:30 PM ET AND JUNE 14, 11:00 AM ET

1

USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR TWO: ADVICE FOR SOLO AND SMALL GROUP PRACTICES

USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

HOUSEKEEPING ANNOUNCEMENTS

▸

▸

▸

If you are listening to this webinar through your phone, please remember to mute your computer speakers.

For assistance, enter your issue in the chat box.

To ask a question, enter your inquiry in the chat box.

2

USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

POLLING QUESTIONWhat is your role?▸

▸

▸

▸

▸

▸

▸

A clinician working in a practice with 15 or fewer clinicians

Non clinical staff from a practice with 15 or fewer clinicians

A clinician working in a practice with more than 15 clinicians

Non clinical staff in a practice with more than 15 clinicians

Quality Payment Program (QPP) contractor

Other person helping practices prepare for MIPS

Other

3

USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

POLLING QUESTIONHow would you describe your practice’s progress in participating in MIPS for Year 2?▸

▸

▸

▸

We’re already totally prepared

We’ve taken steps that will allow us to do full year reporting

We’ve taken steps that will allow us to do partial year reporting

We’re just going to accept the penalty

4

USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

POLLING QUESTIONIf you are struggling to participate in MIPS, what are the largest challenges you are encountering?

5

USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

CMS WELCOME

Brenda Gentles, RN, BS, MS

Division of ESRD, Population & Community Health

Centers for Medicare & Medicaid Services

QPP SURS Central Support Contractor COR

6

USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

Denise Green- Hudson, NR-CMA, Health Informatics

Specialist, HSAG

Bruce Spurlock, MDPresident & CEO,Cynosure Health

7

Dominic DiMartini, Clinical Practice Advisor, HCQIP, IPRO Terry Coleman, Practice

Administrator for Charleston Internal Medicine

USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

SETTING THE STAGE▸

▸

Focus: Understanding how to use available data and strategies for enhancing MIPS scores in each of the four performance areas.

Strategy: Discussion with panelists on how to understand available data sets, transition from partial reporting to full year reporting, and practical advice on how to avoid a penalty.

▸ Topic Overview: Basic requirements for MIPS for solo and small rural practices in Year 2 Review of the available data How to use this data to set priorities How MIPS activities benefit your patients Practical advice for small and solo practices

▸ Using the Chat Box

8

USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

RESOURCES FOR FREE SUPPORT9

Technical Assistance Organizations

Free technical assistance and advice available for small practices from CMS-funded organizations. Contact information for each organization at: https://qpp.cms.gov/docs/QPP_Support_for_Small_Practices.pdf

• General information about QPP for eligible clinicians participating in MIPS or Advanced APMs: https://qpp.cms.gov/

• Questions to CMS about Quality Payment Program:QPP@cms.hhs.gov

• Sources of support for larger practices and APM participants described in: https://qpp.cms.gov/docs/QPP_Technical_Assistance_Resource_Guide.pdf

QUESTION:

What are the basic requirements for MIPS for solo and small rural practices in Year two?

10USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

2018 ELIGIBILITY REQUIREMENTS

▸

▸

MIPS eligible clinicians billing more than $90,000 a year in Medicare Part B allowed charges ANDProviding care for more than 200 Medicare patients a year

11USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

MIPS PERFORMANCE CATEGORIES▸

▸

Quality: 12 months reporting▸

▸

Select 6 measures1 must be high outcome OR high-priority

Cost: 12 months reporting▸

▸

Medicare Spending per Beneficiary (MSPB)Total per Capita Cost

12USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

MIPS PERFORMANCE CATEGORIES▸

▸

Improvement Activities: 90 day reporting▸

▸

2 medium weighted activities OR1 high weighted activity

Promoting Interoperability (PI) (previously ACI): 90 day reporting▸

▸

Base performance and bonus scoreTwo measure sets available based on EHR edition

13USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

MIPS POINTS SYSTEM

▸

▸

▸

▸

Quality: 50% of final scoreCost: 10% of final scoreImprovement Activities: 15% of final scorePI: 25% of final score

14USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

MIPS FOR SOLO AND SMALL GROUP PRACTICES▸

▸

▸

▸

5 bonus points added to final score of any MIPS eligible clinician or group who is in a small practice (15 or fewer clinicians), so long as the MIPS eligible clinician or group submits data on at least 1 performance category in an applicable performance period.

Small practices will receive 3 points for Quality.

Complex Patient Bonus

MIPS eligible clinicians in small practices and practices in a rural areas will report on no more than 2 activities to achieve the highest score.

15USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

QUESTION:

How can practices like mine earn a good MIPS score?

16USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

ADVICE FROM A SMALL GROUP PRACTICE MANAGER

▸

▸

▸

Evolve from PQRS to MIPS

PCMH transformation programs

Start small

17USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

QUESTION:

What data is available now to help me know if I am on track?

18USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

AVAILABLE DATA SETS

▸

▸

QRUR: report that shows how clinicians performed on the quality and cost measures used to calculate the 2018 Value Modifier and payment adjustment.PQRS: 2016 was the last program year for this reporting system that encouraged practices to report information on the quality of care to Medicare.

19USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

2017 PRELIMINARY MIPS DATA20USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

2017 PRELIMINARY MIPS DATA21USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

2017 PRELIMINARY MIPS DATA22USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

QUESTION:

How can I use this data to set priorities?

23USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

DATA AND QUALITY MEASURES▸

▸

▸

▸

▸

Continue to use same measures as used in PQRSIf possible, obtain and review data from other payer sourcesQuality Benchmark documentsRegistriesClaims based information – are EOBs accurate

24USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

DATA AND QUALITY MEASURES▸ Formula for quality score

25USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

DATA AND PROMOTING INTEROPERABILITY (PI)▸

▸

EHR is set up and running reportsUpgrade your EHR when possible

26USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

DATA AND COST SCORING▸

▸

▸

▸

Reviewing the QRUR to see where costs are goingUsing ACO data to identify patients who are frequently admitted or re-admitted to the ERArranging for Care Coordinators when possibleProviding patient education on how patients can contribute to cost

27USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

DATA AND IMPROVEMENT SCORES▸

▸

MIPS Data Validation criteriaReview preliminary results in portal

28USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

QUESTION:

What advice do you have for small practices who are struggling to prepare for MIPS?

29USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

PRACTICAL ADVICE

▸

▸

▸

▸

▸

▸

Understand key deadlines for getting activities startedConsider group reporting to save time if you have an EHRSet a plan for how to ensure enough points to avoid a penaltyHard to do everything at once– focus on each performance area in stagesQuality is where your points will liveBonus points add up

30USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

PRACTICAL ADVICE

▸

▸

▸

▸

▸

Set up or modify EIDM account for yourself or your groupDon’t change your measures each yearDon’t focus on the big picture—yetPick measures that interest your clinicians Get buy-in from you staff as well as your clinicians

31USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

MIPS SUCCESS STORIES

▸Success is possible!

32USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

QUESTION:

If I need more help, where can I go?

33USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

FREE RESOURCES FOR ASSISTANCE FROM CMS▸

▸

▸

▸

QPP website: https://qpp.cms.gov/--includes information tailored for the needs of small practices https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Quality-Payment-Program-Events.html

Contact the Quality Payment Program at: QPP@cms.hhs.gov or call 1-866-288-8292

Support and Available resources for Small, Underserved, and Rural Practices: https://qualitypaymentprogram.cms.gov/about/small-underserved-rural-practices

Small Underserved Rural Support Technical Assistance Organizations (see list on slide 9)

Contact information is available at: https://qpp.cms.gov/docs/QPP_Support_for_Small_Practices.pdf

Available websites of each Technical Assistance Organization

Types of help: needs assessments, webinars, technical support, links to peers you can talk with, assistance getting signed up to report through an approved channel that meets your practice’s needs

▸ FREE Technical Assistance funded by CMS is also available for larger group practices and for clinicians interested in participating in an Alternative Payment Model. More information on those programs is available at: https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/Technical-Assistance-Resource-Guide.pdf

34USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

FREE RESOURCES FOR ASSISTANCE FROM CMS▸

▸

▸

▸

▸

▸

▸

Year 2 Overview Fact SheetImprovement Activities Fact SheetCost Performance Fact sheetPromoting Interoperability Fact SheetData Submission fact sheetOther national webinars focused on small practicesOther national events about Quality Payment Program

35USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

WRAP-UP ACTIVITIES▸

▸

Links to the recordings of the event are available here: https://qppsurs.wordpress.com/resources/

July: Understanding MIPS for Specialists: Advice for Solo and Small Group Practices

July 17, 2018 at 11:00am ET: Register

July 19, 2018 at 3:30 pm ET Register

▸ Please provide feedback on this event: Feedback Form

36USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

REFERENCESSome of the materials contained in these slides is drawn from:

https://www.cms.gov/Medicare/Quality.../QPP-Year-2-Final-Rule-NPC-Slides.pdf

http://www.healthcarefornewengland.org/event/qpp_year2_mha/ Slide decks created by event panelists also provided information reflected in this presentation. The input from project panelists is gratefully acknowledged.

Other documents on the https://qpp.cms.gov/ and https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/Resource-library.html website provide additional detail about the MIPS program.

Disclaimer: This presentation was current at the time it was published or uploaded onto the web. Medicare policy changes periodically so links to the source documents have been provided within the document for your reference. This presentation was prepared as a service to the public and is not intended to grant rights or impose obligations. This presentation may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of their contents.

37USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2

ACRONYMSAPM – Alternative Payment ModelACO – Accountable Care Organization ACI – Advancing Care InformationCMS – Centers for Medicare & Medicaid ServicesER— Emergency RoomEOB— Explanation of BenefitsEIDM— Enterprise Identity Data Management MIPS – Merit-based Incentives Payment SystemPCHM— Patient Centered Medical HomePI— Promoting Interoperability PQRS— Physician Quality Reporting

SystemIA – Improvement ActivitiesEHR – Electronic Health Records QPP – Quality Payment ProgramQRUR— Quality and Resource Use Reports

SURS - Small Underserved Rural Support TIN—Tax Identification Number

38USING DATA AND STRATEGY TO SUCCEED IN MIPS YEAR 2