CMS Transforming Clinical Practices Initiative and. The Southern New England Practice Transformation Network

Transcription

1 CMS Transforming Clinical Practices Initiative and The Southern New England Practice Transformation Network MIPS 2017 Overview 1/24/2017 and 1/27/2017 2

2 Agenda 2 Source: CMS. The Merit-based Incentive Program. November PowerPoint presentation

3 Quality Payment Program (QPP) Tracks Clinicians have two tracks to choose from: MIPS Advanced APMs The Merit-based Incentive Payment System (MIPS) If you decide to participate in traditional Medicare, you may earn a performance-based payment adjustment through MIPS. OR Advanced Alternative Payment Models (APMs) If you decide to take part in an Advanced APM, you may earn a Medicare incentive payment for participating in an innovative payment model. Adapted from: CMS. The Merit-based Incentive Program. November PowerPoint presentation 3

4 What Is MIPS? MIPS Performance Category Prior CMS Program Replaces the Physician Quality Reporting System (PQRS) Replaces the Value- Based Modifier (VBM) New Category Replaces the Medicare EHR Incentive Program (Meaningful Use) Transition Year Weight 60% 0% 15% 25% Adapted from: CMS. The Merit-based Incentive Program. November PowerPoint presentation 4

5 When does MIPS Start? Source: CMS. The Merit-based Incentive Program. November PowerPoint presentation 5

6 Who Is Eligible In 2017? Physicians Physician Assistants Nurse Practitioners Clinical Nurse Specialists Certified Registered Nurse Anesthetists Physicians include: Doctor of medicine Doctor of osteopathy Doctor of dental surgery Doctor of dental medicine Doctor of podiatric medicine Doctor of optometry Doctor of chiropractic Exceed low volume threshold: Medicare Part B clinicians who billed more than $30,000 AND provided care for more than 100 Medicare Part B patients (Sept 1, Aug 31, 2016) 6 Source: CMS. The Merit-based Incentive Program. November PowerPoint presentation

7 Who Is Excluded In 2017? 7 Source: CMS. The Merit-based Incentive Program. November PowerPoint presentation

8 MIPS Eligibility Decision Tree 8

9 What Pace Should You Pick In 2017? Don t Participate Test Pace Partial Year Full Year Do not report any data Report a minimum of 1 quality measure OR 1 improvement activity OR the required advancing care information measures for any time period Report more than 1 quality measure AND up to 4 improvement activities AND at least the required advancing care information measures for 90 days Report a minimum of 6 quality measures AND up to 4 improvement activities AND at least the required advancing care information measures for the full year Receive -4% payment adjustment Receive a neutral or small payment adjustment Receive a small positive payment adjustment Receive a modest payment adjustment Adapted from: CMS. The Merit-based Incentive Program. November PowerPoint presentation 9

10 How should I report In 2017? *If clinicians participate as a group, they are assessed as a group across all 4 MIPS performance categories Source: CMS. The Merit-based Incentive Program. November PowerPoint presentation 10

11 What are the data submission methods for 2017? 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 PowerPoint presentation 11

12 Preparing for MIPS How should 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 Review the Explore Measures section on the QPP website for all three performance categories Confirm your current EHR is certified under 2014 or 2015 standards Review the 2015 Quality and Resource Use Report (QRUR) to see your practice s cost performance Adapted from: CMS. The Merit-based Incentive Program. November PowerPoint presentation 12

13 Resources to prepare for MIPS CMS Quality Payment Program Website American Medical Association MACRA Assessment - SNE PTN Payment Reform Resource Page - Office of the National Coordinator for Health Information Technology - Quality and Resource Use Reports - Payment/PhysicianFeedbackProgram/Obtain-2013-QRUR.html 13

14 QUESTIONS? For additional questions please reach out to 14