MACRA has been the hot topic since the proposed rule was announced in May. Feedback is still being collected, but we have seen the proposal and many responses from leading industry organizations. Find out what we know now and what we expect see in the coming months.
In this free webinar, renowned blogger John Lynn will look at:
1. Some of the components of MACRA, including MIPS
2. What they mean by Alternative Practice Models
3. The change from Meaningful Use to Advancing Care Information
4. How these changes may impact smaller practices
Don’t miss this chance to get the latest update on MACRA to understand how it may impact you starting in 2017.
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Speaker
John Lynn
Editor & Founder
HealthcareScene.com, a network of
10 EHR and HIT blogs
Co-founder of
InfluentialNetworks.com &
Physia.com
Blogs have published over 10,000
healthcare IT posts with more than
18 million views
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What is MACRA?
Medicare Access and CHIP Reauthorization Act of 2015
• Replaces Sustainable Growth Rate (SGR) and the annual "Doc Fix"
• Single Framework - Quality Payment Program
Streamlines Multiple Quality Reporting Programs Into
• APMs (Advanced Alternative Payment Models)
• MIPS (Merit-based Incentive Payment System)
Currently a Proposed Rule
• Public Comment Period Ended June 27th
• Final Rule – October 2016?
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Most Small Practices Will Do MIPS!
CMS Expects Most Will Move from
MIPS to APM Over Time
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Are You Part of an APM?
Who's Considered an Advanced APM in 2017?
• Shared Savings Program (Tracks 2 and 3)
• Next Generation ACO Model
• Comprehensive ESRD Care (CEC) (large dialysis
organization agreement)
• Comprehensive Primary Care Plus (CPC+)
• Oncology Care Model (OCM) (two-sided risk track
available in 2018)
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What’s the Benefit of Being an Advanced APM?
•Up to 5% Bonus Starting in 2019 through 2024
•Higher Fee Schedule Update in 2026
The MACRA APM Creates Extra Incentives,
It Doesn't Change Current APM Functions or
Rewards Value
11. @GoKareo 1111
Most Small Practices Won’t be Advanced APMs
Advice for Those Who Might Be in an APM:
• Consult Your ACO or other APM Organization
Ask:
• Are You a Qualified APM Participant (QP)?
Only Advanced APMs (QPs) Are Excluded from MIPS
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MIPS Details
Replaces 3 Programs:
• PQRS
• Medicare EHR Incentive Program (Meaningful Use)
• Value-Based Payment Modifier (VBM)
These Programs Go Through 2018
New Program:
• Clinical Practice Improvement Activities (CPIA)
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MIPS Details
Worth Noting:
• Medicaid EHR Incentive Program will Continue
• Medicare EHR Incentive Program for Hospitals Will Continue
Immediate Timeline:
• First Performance Period is 2017
• MIPS Adjustments Happening in 2019
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MIPS Composite Performance Score
• MIPS Performance Score Compared to Threshold - Determines
Adjustment You Receive
• CMS Intends to Publish the Benchmarks and Thresholds Prior to 2017
• Gives Credit for Partial Performance
• Scaling Factor to Keep Program Budget Neutral
• Exceptional Performance Incentive ($500 Million Available)
20. @GoKareo 2020
Quality Performance Category
PQRS Replacement
• Reduction from 9 to 6 measures
• No Domain Requirement
Changes
• Close to 300 Measures Available
• Specialty Specific Measure Sets
• Year 1 Weight - 50%
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Resource Use (Cost) Category
Value Modifier Replacement
No Data Submission Required
• Calculated Based on Claims
Changes:
• Added 40+ Episodic Specific Measures
• Year 1 Weight - 10%
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Clinical Practice Improvement Activities Category
New Category (CPIA)
• 90+ Activities to Choose From
• Minimum of One Activity
• Small practices (15 or fewer professionals)
- Two Activities = Full Credit
• Patient Centered Medical Home = Full Credit
• APM Participation = 50% Credit
• Year 1 Weight - 15%
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Advancing Care Information Category
EHR Incentive Program (Meaningful Use) Replacement
Changes:
• May Participate as Individual or Group
• Year 1 Weight - 25%
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Advancing Care Information Still Includes
Base Score (Reporting)
• Protecting PHI
• ePrescribing
• Patient Access
• Patient Engagement
• HIE
• Public Health and Clinical Data Registry Reporting
Performance Score
• Patient Electronic Access
• Coordination of Care through Patient Engagement
• HIE
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Advancing Care Information Changes
• Removed "All or Nothing" Approach from EHR (Meaningful Use)
Program
• Removed Redundant Measures
• Eliminated CPOE and CDS Objectives
• Reduced the Number of Required Public Health Registries
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Small Practice Support for MACRA
$20 million/year from 2016-2020 to Small Practices
• Provides Technical Assistance with MIPS or Transition to an APM
Concept of a "Virtual Group"
• Not Available Until 2nd Year of Program
Accommodations for Small Practice Reporting for:
• Quality Category
• Cost Category
• Clinical Practice Improvement Category
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MACRA Comment Period
134 Physician Events – 60,000 Participants
3,710 Formal Comments Received
General Feedback
• Delay the January 1, 2017 Start Date
• 90 Day Reporting Period for 1st Year of Advancing Care Information
• MU Stage 3 Requirements Should Be Delayed Until 2018
• More Simplification
• APMs Aren’t Accessible to Most (Which is Bad)
• Data Blocking Attestation Requirement is Controversial
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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 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
38. Connect with Kareo
Stop by and say hi!
Kareo @GoKareo GoKareo Kareo
3353 Michelson Drive, Suite 400
Irvine, CA 92612
(888) 775-2736
Editor's Notes
http://go.cms.gov/QualityPaymentProgram
CMS’ Technical Definition
APM Includes:
CMS Innovation Center model
MSSP (Medicare Shared Savings Program)
Demonstration under the Health Care Qaulity Demonstration Progrma
Demonstration Required By Federal Law
Advanced APMs (Criteria)
Use Certified EHR
Base Payment on Quality
Bears Financial Risk or Medical Home Model
See: https://engage.vevent.com/index.jsp?eid=3536&seid=380
Special circumstances of small practices, rural areas, and non-patient facing clinicians – Can exclude a category and decrease the scale
Shift to focus on Patient Access and Health Data Exchange
Kareo has received extensive industry recognition, including the Deloitte Technology Fast 500, Inc. 5000 and Black Book’s #1 Integrated EHR, Practice Management and Billing Vendor.