simple steps to mips success

webinar

Simple Steps to MIPS Success

Presented by Lea ChathamJanuary 18, 2017

@GoKareo

Agenda

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• Welcome & Introductions• Simple Steps to MIPS

Success• How Kareo Can Help• Your Questions

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How to Participate Today…

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Download today’s resources

View today’s presentation

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Speakers

Lea Chatham• Senior Content Marketing Manager,

Kareo• Nearly 20 years in healthcare and health

IT• Speaker and author• Published in leading journals including

Physicians Practice, Medical Practice Insider, PAHCOM Journal

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What Is MACRA?

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What is MACRA

MACRA is the rule that created the…QUALITY PAYMENT PROGRAM (QPP) which outlines the

Merit-Based Incentive Payment Program (MIPS) andAdvanced Alternative Payment Models (APMs)

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High Level Goals

Transition provider reimbursementFROM…

Fee-for-Service

TO…Quality Payment Program (QPP)

• Value-based reimbursement Quality of care Cost effectiveness Use of certified electronic

technology Practice improvement

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MIPS Overview

• Most providers will participate in MIPS• An eligible clinician is:

• Physician (Doctors of Medicine or Osteopathy, Doctors of Dental Surgery or Dental Medicine, Doctors of Podiatric Medicine, Doctors of Optometry, Chiropractors)

• Physician assistant• Nurse practitioner• Clinical nurse specialist• Certified Registered Nurse Anesthetist

• Eligible Clinicians are defined for years 1 & 2• Additional categories, PT, OT, etc. may be added in year 3.

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MIPS Overview

• You may be excluded if• First year in Medicare Part B• Low-Volume Threshold

• < $30,000 billed to Medicare Part B• < 100 Medicare Part B patients

• Advanced APM participant

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MIPS Timing

Timing

• Effective January 1, 2017• Two-year lag time from performance to payment in 2019• Requirements will be phased over next few years• Created a “Pick your pace” rule allowing a transition

period• PQRS and VBPM are gone at the end of 2016.• Medicaid providers participate in both MIPS and

Medicaid MU, if:• Providers meet the definition of a MIPS EC, and• Also meet the 30% Medicaid MU participation threshold

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Scoring for 2017

Percentage of Score 60% 15% 25% 0%

Status of Existing

ProgramsReplaces PQRS New Category Replaces MU Replaces Value-

Based Modifier

Targeted # of Activities for Individuals

6 measures, including one

outcome4 improvement

activities5 mandatory;9 maximum;bonus credits

No data submission;

based on claims

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Pick Your PaceAdded to the final rule to give options to smaller practices

Potential Adjustment

Reporting Period Quality Improvement

Activities Advancing Care

Bonus + Bonus (up to 12%) Full year

6 measures incl. 1

outcome> 4 activities 5 required, 1-4

additional + bonus

Full + Adj.Min 90 days to

a Full year

6 measures incl. 1

outcome4 activities 5 required, 1-4

additional

Partial Avoid –Possible + Min 90 days 1 1 5 required

measures

Test Neutral< 90 days (special

circumstance)1 OR 1 OR 5 required

measures

Don’t Participate Negative 0 0 0 0

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Pick Your Pace

• Recommend doing as much as possible• Look for things you may already be doing or can make simple

changes to do• If doing MU or PQRS, you may already be doing many of these

activities• Reminder: You must use a certified EHR


Quality

• 60% of Composite Score• 6 quality measures,

including an outcome measure

• Select measures individually or from specialty sets

• Certified EHR used for data

• All patients must be reported

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Quality

• For Test or Partial 1 quality measure you are probably doing now:- Documentation of Current Medications

• For full participation:- 6 measures

• 271 measures to choose from• You can sort by specialty and high

priority• Choose outcome measures or high

priority measures

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Advancing Care

• 25 % of Composite Score• 5 required measures (4 for

transitional in 2014) Security Risk Analysis e-Prescribing Provide Patient Access Send Summary of Care Request/Accept Summary of Care

(not for transitional)• Can submit up to 9 measures• Bonus points for Public Health

Reporting• Use of Certified EHR for

specific activities adds bonus points

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Advancing Care

• Other Measures for 2017 (2014 Edition)- Health Information Exchange- Immunization Registry Reporting- Medication Reconciliation- Patient-Specific Education- Secure Messaging- Specialized Registry Reporting- Syndromic Surveillance Reporting- View, Download, Transmit

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Clinical Improvements

• 15 % of Composite Score• Complete up to 4

improvement activities from a list of 93 potential activities

• APMs automatically receive points for participating in the requirements of the APM

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Improvement Activities

• For Test or Partial choose 1 Improvement such as- Depression screening- Diabetes screening- Implementation of antibiotic stewardship program- Tobacco use- Unhealthy alcohol use

• For full participation complete 4 or more• Other more common activities

- Collection and follow up on patient satisfaction data- Engagement of patients through implementation of improvements in

patient portal- Use of groups visit for common chronic conditions- Use of telehealth

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Reporting Options

Report by multiple mechanismsQuality Reporting

Claims (individual only)Qualified Registry Advancing Care

Attestation to CMS (MU website to be reconfigured)QCDR (individuals or groups may connect on their own)CMS Web Interface (group of 25 or more)EHR Improvement Activities

Qualified registryCMS attestation site

Reporting period January 2, 2018 through March 31, 2018

What Do You Do Next?

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Next Steps

• Verify using certified EHR• Confirm your EHR is working on 2015

Edition certification for 2018• Pick your pace• Visit qpp.cms.gov and select your

measures• Check to see if your vendor has any

added training or assistance for MIPS

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Awards and Rankings

Growth awards The speed at which

medical practices are moving to Kareo and referring it to other

providers.

Best places to work Happy, engaged

employees stay longer, have more experience and

offer better customer service

Analyst reviews 3rd party recognition,

driven by direct customer feedback,

equals trust and credibility

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Kareo Platform

Kareo Clinical

• Comprehensive dashboard

• Simple charting• Easy ePrescribing• Convenient eLabs• Specialty templates• Electronic Superbill• Integrated Patient

Portal • Secure messaging

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Kareo Platform

Kareo Marketing• Marketing and front

office automation• Online visibility and SEO • Online appt. scheduling • Email, text & voice

recording appt. reminders

• Post visit patient reviews• Practice analytics for ROI• Patient communications

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Discover Kareo’s Role

• PAHCOM has approved 1 CEU credit.• Each attendee will receive an email today

with a link to request certification. Certificates will be mailed within the next few days.

• Attendees must be logged into the webinar to receive credit.

• You’ll be asked at the end of the webinar if you want a CEU certificate.

“…Make Your Practice a Best Practice!”

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How to Participate Today…

Type your questions

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simple steps to mips success

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