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Page 1: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Medicare Payments in 2017: Moving Beyond Meaningful Use

Page 2: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ Understand MACRA/MIPS better+ Learn how it affects you and your practice

§ How is the Quality Payment Program different from MU/PQRS?§ What if I’m a new provider and this is my first time reporting?§ Who is eligible for these programs?§ What are the penalties and exemptions?§ How will this impact my CMS reimbursements?§ How can I get started?

Why Are YOU Here?

2

Page 3: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

What Practice Fusion provides:+ Comprehensive MACRA resource center+ Ongoing live webinars+ Intuitive dashboard to track progress+ Knowledge Base articles+ Fully trained EHR support team

Practice Fusion is here to help

3

Page 4: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ Paper-based practices can still partially participate MIPS, but it’s much more difficult§ Requires manual data collection§ Increased record-keeping burden during CMS audit§ Adherence to complex CMS measure calculations

+ Practice Fusion offers intuitive tools and dashboard to simplify participation in Quality Payment Programs

+ Get started today 100% free

Don’t have an EHR?

4

Page 5: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

1) MACRA2) Structure and Timeline3) Eligibility4) 2017 Reporting Options5) MIPS and CPC+ Program Details

a. MIPS Performance Categoriesb. CPC+ Requirements

6) Product Functionality7) Resources8) Recap and Q&A

Agenda

5

Aliza Brinton Emma Johnson

Veeral Chudasama Richard Loomis, MD

Page 6: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ Medicare Access & CHIP Reauthorization Act of 2015 (MACRA)

+ Changes how Medicare pays those who care for Medicare beneficiaries (Americans 65 and older)§ Ends Sustainable Growth Rate (SGR) formula for Medicare

payments § Ends existing quality reporting programs (MU, PQRS, VBM)§ Creates new Quality Payment Program with 2 paths

What is MACRA?

6

Page 7: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Physician Quality Programs

*MIPS

Medicare Shared Savings

**Comprehensive Primary Care Plus (CPC+)

Advancing Care Information

Quality

CostClinical Practice

Improvement Activities

Next Generation ACO Model

MACRAAlternative Payment Models (APMs)

Comprehensive End Stage Renal

Disease Care Model

* Practice Fusion will be available for participation in MIPS** Practice Fusion will be available for participation in CPC+ Track 1

Page 8: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Changing Payment Landscape

2015 2016 2017 2018 2019 2020 2021 2022

2022MACRA: MIPS and APMs Reporting

CURRENT PROGRAMS

2015 to 2019

+/- 4% +/- 5% +/- 7% +/- 9%MIPS Payment Adjustments*

NOTE: Practice Fusion already supports MU and PQRS reporting *Maximum MIPS Payment Adjustment (+/-)

QUALITY PAYMENT PROGRAM

PQRS, Value Based Modifier, MU Reporting

MU/PQRS Payment Adjustments

Page 9: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ Medicare Part B Clinicians*

*Medicaid providers continue reporting for Meaningful Use. More here

+ Exemptions§ Newly enrolled in Medicare§ Have less than or equal to $30,000 in Medicare charges OR less than or

equal to 100 Medicare patients§ Are significantly participating in an APM

MIPS Eligibility & Exemptions

NOTE:PracticeFusionsupportsallMedicarePartBClinicianseligibleforMIPS1.“QualityPaymentProgram.” QualityPaymentProgram,https://qpp.cms.gov/.

Page 10: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Reporting Options for MIPS in 2017

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NOTE:PracticeFusionwillsupportallreportingoptions1.“QualityPaymentProgram.” QualityPaymentProgram,https://qpp.cms.gov/.

Page 11: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

MIPS: Submit Something (Test Group)

111.“Merit-basedIncentivePaymentSystem(MIPS).” CentersforMedicare&MedicaidServices,https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Quality-Payment-Program-Events.html.

Page 12: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ Practice Fusion will support reporting of the minimal data set required from the Test Group

+ You will easily be able to track your progress on the measures you select to report on

How will Practice Fusion Support the Test Group?

12

MinimalDataset

Easily select your reporting

option

Track your progress

1/1 is all that is needed!

MIPS

*Sample Dashboard

Page 13: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

MIPS: Partial Participation

13

1.“Merit-basedIncentivePaymentSystem(MIPS).” CentersforMedicare&MedicaidServices,https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Quality-Payment-Program-Events.html.

Page 14: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ Practice Fusion already supports reporting on a Custom 90-Day reporting option

+ You will easily be able to track your progress on the measures you select to report on

How will Practice Fusion Support Partial Participation?

14

*Sample Dashboard

Select your Custom 90 Day reporting option

Just select beginning date

Easily track your progress on the

measures you choose to report on

MIPS

Page 15: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

MIPS: Full Participation

15

1.“Merit-basedIncentivePaymentSystem(MIPS).” CentersforMedicare&MedicaidServices,https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Quality-Payment-Program-Events.html.

Page 16: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ Practice Fusion already supports reporting Full Year reporting option

+ You will easily be able to track your progress on the measures you select to report on

How will Practice Fusion Support Full Participation?

16

*Sample Dashboard

Select “1 Year” reporting option

Dates will auto adjust

Easily track your progress on measures

MIPS

Page 17: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Here are the MIPS Performance Categories…

Page 18: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Merit-based Incentive Payment System (MIPS)

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Advancing Care Information (replaces

Meaningful Use)25%

Quality (Replaces

PQRS)60%

Improvement Activities

15%

Percentage of MIPS score in 2017

Page 19: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Replaces PQRS

Quality

Page 20: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Advancing Care Information (replaces

Meaningful Use)25%

Quality (Replaces

PQRS)60%

Improvement Activities

15%

+ Report up to 6 quality measures, including an outcome measure, for 90 days or a full year§ *1 quality measure for the Test group

Quality Reporting Requirements

20

+ Practice Fusion currently supports 24 different eCQMsfor the 2017 reporting period:

http://www.practicefusion.com/qpp/mips-quality-measures/

Page 21: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Select Measures to Attest to

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Page 22: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Base ScoreAdditional ACI Measures

Advancing Care Information (Replaces Meaningful Use)

Page 23: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ Fulfill the required measures for a minimum of 90 days for base score (50% of total ACI score):§ Security Risk Analysis (outside of EHR)ü e-Prescribing (1 e-prescription – already supported in Practice Fusion )ü Provide Patient Access (1 patient invited to PHR - www.PatientFusion.com )ü Health Information Exchange (1 Summary of Care record sent to a verified recipient –

already supported in Practice Fusion)+ *Just Base Score for Test group

Advancing Care Information Base Score

23

Page 24: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Advancing Care Information (replaces

Meaningful Use)25%

Quality (Replaces

PQRS)60%

Improvement Activities

15%

+ Additional measures account for another 90% of ACI score, include:ü Provide Patient Access ü View, Download, or Transmit ü Health Information Exchange ü Secure Messaging ü Medication Reconciliation ü Patient-Specific Education ü Immunization Registry Reporting

+ For bonus credit (up to 15%), you can:§ Report to one or more additional public health and clinical data registries

beyond the Immunization Registry Reporting measure§ Use certified EHR technology to complete certain improvement activities

in the improvement activities performance category

Advancing Care Information Additional Measures

24

Page 25: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Track Progress on Dashboard

25

Page 26: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

ACI Additional Measure Scoring Methodology

26

1.“Merit-basedIncentivePaymentSystem(MIPS).” CentersforMedicare&MedicaidServices,https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Quality-Payment-Program-Events.html.

Page 27: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

ACI Additional Measure Scoring Methodology (continued)

27

1.“Merit-basedIncentivePaymentSystem(MIPS).” CentersforMedicare&MedicaidServices,https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Quality-Payment-Program-Events.html.

Page 28: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Brand New Category

Improvement Activities

Page 29: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ 4 improvement activities for a minimum of 90 days§ Groups with fewer than 15 eligible providers or if you are in a rural or

health professional shortage area: Attest that you completed up to 2 activities for 90 days to full year (92 Improvement Activities to choose from)

§ *1 improvement activity for the Test group

Improvement Activities Reporting Requirements

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+ To learn more about Improvement Activitiesyour practice can participate in, visit:

http://www.practicefusion.com/qpp/mips-improvement-activities/

Page 30: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ The majority of Improvement Activities are completed and tracked outside of the EHR.

+ It’s important to review the list of 90+ improvement activities to identify which 1-4 are most relevant and attainable for your practice.

+ CMS has not specified documentation requirements yet

For a full list of possible Improvement Activities, visit:http://www.practicefusion.com/qpp/mips-improvement-activities/

Improvement Activities

30

Page 31: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

APMs

Advanced Alternative Payment Models

Page 32: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ More advanced value based care than MIPS+ Participation in one of the following:

§ Comprehensive Primary Care Plus (CPC+)§ Comprehensive ESRD Care (CEC) - Two-Sided Risk§ Next Generation ACO Model§ Shared Savings Program - Track 2§ Shared Savings Program - Track 3§ Oncology Care Model (OCM) - Two-Sided Risk

Advanced Alternative Payment Models (APMs)

32

Page 33: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

CPC+

Comprehensive Primary Care Plus

Page 34: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ There are no specialty restrictions+ Practice Fusion is available providers participating in Track 1

of CPC+, starting in January 2017+ Applications will reopen in 2017 for 2018 performance year+ Only available in certain states and regions+ Determine your eligibility

§ http://www.practicefusion.com/blog/comprehensive-primary-care-cpc-plus-right-for-your-practice/

Comprehensive Primary Care Plus (CPC+)

34

Page 35: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

How Does Practice Fusion Support YOU?

Page 36: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Measures can be easily tracked on Intuitive Dashboard

36

Page 37: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Practice Fusion QPP Center

37

http://www.practicefusion.com/qpp/

Page 38: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Practice Fusion Knowledge Base

38

http://knowledgebase.practicefusion.com/

Page 39: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Practice Fusion Tutorials

39

https://learn.practicefusion.com/

Page 40: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ Our Phenomenal Support team is here to help:§ Phone – 415-346-7700§ Live chat§ Support cases

+ Download a copy of this presentation at:§ www.practicefusion.com/qpp-

handout

Additional resources

40

+ Practice Resource Center§ www.practicefusion.com/practice-

resource-center/

Page 41: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

Recap

Page 42: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ Is Practice Fusion certified for the Quality Payment Program?

+ Yes. Practice Fusion is 100% certified § http://www.practicefusion.com/ehr-policy-support/

Recap

42

Page 43: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ What are my reporting options for MIPS in 2017? § Report nothing and get penalized 4%§ Report as ‘test group’ and get no penalty§ Report MIPS requirements for a 90-day or full year reporting period and

get an incremental positive adjustment

+ When do I start reporting for MIPS in 2017?§ Test Group and Partial Participation: you have flexibility to begin reporting

anytime in 2017, as late as Oct. 2nd 2017§ Full Participation: Jan 1st, 2017

Recap

43

Page 44: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ What are the performance categories for MIPS (in the 2017 reporting year)?

+ Quality – You must report 1 or 6 Quality Measures. Practice Fusion currently supports 24 Quality Measures

+ ACI – You must report the Base Score measures and you can report on additional and bonus measures

+ Improvement Activities – You must complete 1 or 2 if your practice has less than 15 providers, 4 if your practice has 15 providers or more

Recap

44

Page 45: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ What Advanced Alternative Payment Models should I consider?

+ Any that you’re qualified for, but CPC+ is a great option given that Practice Fusion supports Track 1.

+ Visit CMS’s CPC+ webpage or Practice Fusion’s blog for more information.§ http://www.practicefusion.com/blog/comprehensive-primary-care-cpc-plus-

right-for-your-practice/§ https://innovation.cms.gov/initiatives/comprehensive-primary-care-plus

Recap

45

Page 46: Medicare Payments in 2017: Moving Beyond Meaningful Use*Medicaid providers continue reporting for Meaningful Use. More here + Exemptions §Newly enrolled in Medicare §Have less than

+ What do I need to do next for MIPS?

+ Determine eligibility+ Pick your pace+ Review program timeline+ Report! Practice Fusion makes participation easy

NOTE: you do not need to register to CMS for MIPS participation

Recap

46


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