The document discusses the Medicare Access and CHIP Reauthorization Act (MACRA) and its Quality Payment Program. Some key points:
- MACRA rolled several existing programs (PQRS, Meaningful Use, Value Modifier) into a single program with two tracks: MIPS and Advanced APMs. MIPS assesses clinicians on quality, cost, improvement activities, and advancing care information.
- Most clinicians will be subject to MIPS based on Medicare billing amounts and patient volumes. MIPS scoring is based on a composite of these categories, with financial incentives or penalties applied after a two-year delay.
- The categories have different measures and reporting methods. Quality makes up 30% of
The document provides an overview of the services offered by Integrated Services (ICS) including call center services, early intervention case management, medical bill review, utilization review, independent medical evaluations, pharmacy benefit management, fraud investigation, and proprietary technology solutions. ICS offers a comprehensive suite of integrated medical cost containment and claims management services to reduce costs and improve outcomes for workers' compensation and liability claims.
Maximising Technology and Information Solutions Through "Interoperability"Louise Sinclair
The document discusses digital priorities for improving health and social care, including creating electronic health records, analyzing population data, clinical decision support, remote care, and optimizing resources. It emphasizes standards for information sharing across systems, focusing initially on using the NHS number and improving transfers of care. Local areas will assess progress using a digital maturity index and create annual roadmaps. The priorities are aimed at joining up information to provide better, safer, and more efficient care.
The document provides an overview of Anthony Faneli's experience and qualifications for leadership in healthcare. It discusses his commitment to quality, integrity, innovation, accountability, collaboration, and leadership. It outlines his experience with integrated delivery networks, managed care organizations, health information technology, and perspectives on trends in healthcare reform and personalized medicine. The document promotes Faneli's expertise across multiple areas of the healthcare industry.
This document discusses Elder Medical, a division of IPC Healthcare that provides elder care services across the continuum of care. It outlines Elder Medical's focus on personalized medicine through risk assessment, prevention, early detection, accurate diagnosis, targeted treatment, disease management, and seamless information sharing. The document discusses the growing elder population and increasing prevalence of chronic diseases as attractive markets. It also discusses integrated delivery networks and partnerships that can improve coordination of care, reduce costs, and increase quality. The role of Elder Medical in providing medical management and care coordination for post-acute care facilities is highlighted.
This document provides an overview of interactive health communication systems and telehealth technologies. It discusses physician perspectives on adoption barriers like workflow integration and reimbursement issues. It also profiles two AHRQ grants that utilize telehealth to improve cancer care in rural areas and provide remote monitoring for heart failure patients.
The document discusses the medical home model of patient-centered primary care. It outlines the challenges currently facing primary care and describes the design principles of the medical home model, which aims to improve care coordination, access, and patient engagement. Pilot outcomes data from Group Health showed improved quality measures, patient/staff satisfaction, and reduced costs with the medical home model over 2 years.
It’s 2020 and healthcare is at a crossroads. Will this be the tipping point in the transformation of care or are we in for yet-another decade of radical change and resistance? Here's six key trends that I think are likely to tip the scales and shape the healthcare business model of the new era.
This document summarizes InstaHEAL, a telepsychiatry solution that uses video conferencing to connect patients with psychiatrists. It aims to address shortages in psychiatric care by expanding access to remote and rural areas. Key features include its Digital Clinician assessment tool, integrated office management software, and secure video conferencing capabilities. InstaHEAL is designed for use in emergency rooms, hospitals, clinics, correctional facilities, and other clinical settings to improve efficiency and expand the reach of specialty psychiatric care.
The document provides an overview of the services offered by Integrated Services (ICS) including call center services, early intervention case management, medical bill review, utilization review, independent medical evaluations, pharmacy benefit management, fraud investigation, and proprietary technology solutions. ICS offers a comprehensive suite of integrated medical cost containment and claims management services to reduce costs and improve outcomes for workers' compensation and liability claims.
Maximising Technology and Information Solutions Through "Interoperability"Louise Sinclair
The document discusses digital priorities for improving health and social care, including creating electronic health records, analyzing population data, clinical decision support, remote care, and optimizing resources. It emphasizes standards for information sharing across systems, focusing initially on using the NHS number and improving transfers of care. Local areas will assess progress using a digital maturity index and create annual roadmaps. The priorities are aimed at joining up information to provide better, safer, and more efficient care.
The document provides an overview of Anthony Faneli's experience and qualifications for leadership in healthcare. It discusses his commitment to quality, integrity, innovation, accountability, collaboration, and leadership. It outlines his experience with integrated delivery networks, managed care organizations, health information technology, and perspectives on trends in healthcare reform and personalized medicine. The document promotes Faneli's expertise across multiple areas of the healthcare industry.
This document discusses Elder Medical, a division of IPC Healthcare that provides elder care services across the continuum of care. It outlines Elder Medical's focus on personalized medicine through risk assessment, prevention, early detection, accurate diagnosis, targeted treatment, disease management, and seamless information sharing. The document discusses the growing elder population and increasing prevalence of chronic diseases as attractive markets. It also discusses integrated delivery networks and partnerships that can improve coordination of care, reduce costs, and increase quality. The role of Elder Medical in providing medical management and care coordination for post-acute care facilities is highlighted.
This document provides an overview of interactive health communication systems and telehealth technologies. It discusses physician perspectives on adoption barriers like workflow integration and reimbursement issues. It also profiles two AHRQ grants that utilize telehealth to improve cancer care in rural areas and provide remote monitoring for heart failure patients.
The document discusses the medical home model of patient-centered primary care. It outlines the challenges currently facing primary care and describes the design principles of the medical home model, which aims to improve care coordination, access, and patient engagement. Pilot outcomes data from Group Health showed improved quality measures, patient/staff satisfaction, and reduced costs with the medical home model over 2 years.
It’s 2020 and healthcare is at a crossroads. Will this be the tipping point in the transformation of care or are we in for yet-another decade of radical change and resistance? Here's six key trends that I think are likely to tip the scales and shape the healthcare business model of the new era.
This document summarizes InstaHEAL, a telepsychiatry solution that uses video conferencing to connect patients with psychiatrists. It aims to address shortages in psychiatric care by expanding access to remote and rural areas. Key features include its Digital Clinician assessment tool, integrated office management software, and secure video conferencing capabilities. InstaHEAL is designed for use in emergency rooms, hospitals, clinics, correctional facilities, and other clinical settings to improve efficiency and expand the reach of specialty psychiatric care.
Executive summary india healthcare inspiring possibilities and challenges mck...brandsynapse
Over the past decade, while India has made some progress in healthcare access and quality through government reforms and private sector growth, major challenges still persist. Health outcomes continue to lag behind peers. Healthcare spending has not kept pace with GDP growth, remaining at 4% of GDP. High out-of-pocket costs remain a burden, and infrastructure gaps are still substantial despite underutilization of existing resources. For India to achieve its vision of universal healthcare coverage, bolder reforms and greater public-private collaboration will be needed going forward.
It is that time of year again – time to look at healthcare trends, predictions and technology innovations for 2018.
Identifying trends is fairly simple, since it relies on looking back to see what the most popular topics have been and continue to be. Many trends tend to stay for more than a year as their momentum builds. Predictions are a little more difficult to identify and assure accuracy, since they are a look into the future. This year we will also be looking at the top 10 technology-related clinical innovations.
The healthcare industry in India is growing rapidly. Healthcare spending in India is projected to increase at an annual rate of over 12% from $96.3 billion in 2013 to $195.7 billion in 2018. There is also a large bed deficit in India of approximately 30 lakhs beds. The private sector accounts for around 80% of hospital capacity growth in India. Globally, healthcare spending increased 2.8% in 2013 and is projected to increase 5.2% annually through 2018 to $9.3 trillion, driven by aging populations and the rise of chronic diseases. Cost containment remains a major issue for healthcare systems worldwide.
During this webinar, we'll review CMS regulations and what’s required from providers for both Price Transparency and the No Surprises Act. We'll review strategies for implementation of both and talk about how CMS is currently responding to providers that haven't complied with Price Transparency requirements yet.
Current healthcare expenditure in the GCC is projected to reach US$ 104.6 billion in 2022. Find out about the key drivers for the long-term healthcare development in the GCC.
The healthcare industry in India is growing rapidly and is expected to reach $280 billion by 2020. Key factors driving this growth include a strong economy, increasing healthcare financing options, a large demand from India's growing and aging population, and increased opportunities in healthcare delivery. Emerging trends include a rise in chronic diseases due to an aging population, empowered and informed consumers demanding more options, and the use of mobile health technologies to improve access. There are also excellent career opportunities in healthcare given the continued high demand for healthcare professionals.
In this latest edition of our regular newsletter, The Gen, we take a look at some of the current trends and emerging technologies particularly in the healthcare and personal care sectors. Our first article examines how algorithms are enabling low cost 3D visualisation in surgery.
The second feature looks at how information systems are reshaping healthcare delivery; other topics covered in the newsletter include our perspective on how wireless communication systems are improving the way medical devices work, and the use of chemistry in personal care devices.
We finish with an article by the Prof Phil Gray, MD of Quadro Design, a member of the Sagentia Group, on the subject of the industrial design revolution.
http://www.sagentia.com/The-Gen-Summer-2013
PATHS provides revenue cycle management services to healthcare providers. It offers services including A/R billing, A/R system conversions, auto/workers compensation claims management, behavioral health billing, cash acceleration programs, claims management software, consulting, credit balance adjudication, denial management, Medicaid entitlement, and physician practice management. PATHS has over 30 years of experience in healthcare revenue cycle management and manages over $3 billion in accounts receivable annually. It is committed to using technology, employee training, and best practices to provide cost-effective solutions and exceptional customer service.
Vision Zero is an approach to road safety that aims to eliminate traffic fatalities and severe injuries. It emphasizes a Safe Systems approach that acknowledges human mistakes and focuses on influencing system-wide practices, policies, and designs to lessen the severity of crashes. This document outlines 10 core elements for Vision Zero communities, including leadership commitment to Vision Zero goals, strategic planning through an action plan, implementing projects to improve road safety, adopting context-appropriate speeds, conducting equity-focused analysis, and being transparent and accountable in efforts. The core elements are meant to help communities prioritize impactful actions and benchmark progress according to best practices.
Kareo Billing Product Overview and Training: Success SummitKareo
This document provides an overview and training on Kareo's billing product. The agenda includes introductions, reviewing insurance enrollment enhancements, sending clean claims, improving patient collections, and a Q&A session. Key highlights include new insurance enrollment dashboards for tracking progress, tools for fixing rejected claims, collecting patient payments through email statements and credit card processing, and categories for managing patient collections.
Private Practice Model Perspectives 2015 SurveyKareo
Kareo believes in the independent practice and the physician entrepreneur. Small practices are vital to their communities for the personalized care they can offer; however, to keep the doors of a small practice open, healthcare providers need to learn to think like an entrepreneur to ensure financial stability and improved patient satisfaction. And there’s never been a better time to be a physician entrepreneur in healthcare.
The demand for individualized care and convenience has become exceedingly important to patients as they are coming to expect the same level of service from their provider as they receive in other aspects of their lives. With the average deductible exceeding $1,200 and roughly 80 percent of employers offering high deductible plans in 2015, patients are beginning to think more like consumers. This new demand is a crucial piece for healthcare providers who own a private practice, as they are better positioned to handle this demand than larger healthcare systems. In short, the trend towards the consumerization of healthcare favors the small practice over large healthcare organizations.
To empower the small practice physician, Kareo is shining a light on the path to success—an agile medical practice model—combining traditional fee for service options with the flexibility of concierge services. This includes offering flexible payment plans and increasing the focus on practice marketing and patient engagement.
The document discusses disruptive technologies and their impact on consumers and enterprises. It finds that cloud and data & analytics continue to drive innovation for enterprises by improving efficiencies and enabling faster innovation cycles. However, security remains the top challenge for adopting cloud services. For consumers, mobile saw a decline as a disruptor while emerging technologies like 3D printing, biotech, and the Internet of Things are gaining prominence. The competition is fierce across the mobile ecosystem to gain market share.
Telenor Workshop on Welfare Tech: EDB InputNino Lo Cascio
From EDB's strategy on Health-IT towards 2020 and short term focus on self service and Health 2.0.
Input to Telenor workshop on welfare technologies, august 2010.
Presentation: Leading the Change In Healthcare Education and Delivery: how to surmount the barriers.
Presented by: Dalal Haldeman, Senior Vice President, Marketing and Communications, John Hopkins Medicine
What does the triple aim really mean and how do we get there? How can strong brands in healthcare influence outcomes, research and patient wellbeing for a healthier future in America and in the world.
The business of medicine is changing quickly. Government and commercial payers know that we're paying more for healthcare and we're getting worse results. Patients know it too. The role of independent practices, their reimbursement models, and how they care for patients are all changing as a result.
Medicare Access and Chip Reauthorization Act (MACRA) is the law that changes how Providers are to be reimbursed. One of the key characteristics is that it rewards Providers based on value and not volume.
This document provides an overview and agenda for a presentation on succeeding under MACRA and MIPS. It discusses what MACRA is and why providers should care about it. MACRA replaces previous payment systems with two new tracks: MIPS and Advanced APMs. MIPS has four performance categories that will determine reimbursements starting in 2017. It also provides a checklist for MIPS participation eligibility and requirements. The presentation reviews the specific criteria and measures under each MIPS performance category. It outlines the MIPS reporting timeline for 2017 and options to pick the best pace. The document concludes by explaining how the Elation software can support practices in meeting MIPS requirements through built-in quality tracking, clinical decision support, and other tools.
Executive summary india healthcare inspiring possibilities and challenges mck...brandsynapse
Over the past decade, while India has made some progress in healthcare access and quality through government reforms and private sector growth, major challenges still persist. Health outcomes continue to lag behind peers. Healthcare spending has not kept pace with GDP growth, remaining at 4% of GDP. High out-of-pocket costs remain a burden, and infrastructure gaps are still substantial despite underutilization of existing resources. For India to achieve its vision of universal healthcare coverage, bolder reforms and greater public-private collaboration will be needed going forward.
It is that time of year again – time to look at healthcare trends, predictions and technology innovations for 2018.
Identifying trends is fairly simple, since it relies on looking back to see what the most popular topics have been and continue to be. Many trends tend to stay for more than a year as their momentum builds. Predictions are a little more difficult to identify and assure accuracy, since they are a look into the future. This year we will also be looking at the top 10 technology-related clinical innovations.
The healthcare industry in India is growing rapidly. Healthcare spending in India is projected to increase at an annual rate of over 12% from $96.3 billion in 2013 to $195.7 billion in 2018. There is also a large bed deficit in India of approximately 30 lakhs beds. The private sector accounts for around 80% of hospital capacity growth in India. Globally, healthcare spending increased 2.8% in 2013 and is projected to increase 5.2% annually through 2018 to $9.3 trillion, driven by aging populations and the rise of chronic diseases. Cost containment remains a major issue for healthcare systems worldwide.
During this webinar, we'll review CMS regulations and what’s required from providers for both Price Transparency and the No Surprises Act. We'll review strategies for implementation of both and talk about how CMS is currently responding to providers that haven't complied with Price Transparency requirements yet.
Current healthcare expenditure in the GCC is projected to reach US$ 104.6 billion in 2022. Find out about the key drivers for the long-term healthcare development in the GCC.
The healthcare industry in India is growing rapidly and is expected to reach $280 billion by 2020. Key factors driving this growth include a strong economy, increasing healthcare financing options, a large demand from India's growing and aging population, and increased opportunities in healthcare delivery. Emerging trends include a rise in chronic diseases due to an aging population, empowered and informed consumers demanding more options, and the use of mobile health technologies to improve access. There are also excellent career opportunities in healthcare given the continued high demand for healthcare professionals.
In this latest edition of our regular newsletter, The Gen, we take a look at some of the current trends and emerging technologies particularly in the healthcare and personal care sectors. Our first article examines how algorithms are enabling low cost 3D visualisation in surgery.
The second feature looks at how information systems are reshaping healthcare delivery; other topics covered in the newsletter include our perspective on how wireless communication systems are improving the way medical devices work, and the use of chemistry in personal care devices.
We finish with an article by the Prof Phil Gray, MD of Quadro Design, a member of the Sagentia Group, on the subject of the industrial design revolution.
http://www.sagentia.com/The-Gen-Summer-2013
PATHS provides revenue cycle management services to healthcare providers. It offers services including A/R billing, A/R system conversions, auto/workers compensation claims management, behavioral health billing, cash acceleration programs, claims management software, consulting, credit balance adjudication, denial management, Medicaid entitlement, and physician practice management. PATHS has over 30 years of experience in healthcare revenue cycle management and manages over $3 billion in accounts receivable annually. It is committed to using technology, employee training, and best practices to provide cost-effective solutions and exceptional customer service.
Vision Zero is an approach to road safety that aims to eliminate traffic fatalities and severe injuries. It emphasizes a Safe Systems approach that acknowledges human mistakes and focuses on influencing system-wide practices, policies, and designs to lessen the severity of crashes. This document outlines 10 core elements for Vision Zero communities, including leadership commitment to Vision Zero goals, strategic planning through an action plan, implementing projects to improve road safety, adopting context-appropriate speeds, conducting equity-focused analysis, and being transparent and accountable in efforts. The core elements are meant to help communities prioritize impactful actions and benchmark progress according to best practices.
Kareo Billing Product Overview and Training: Success SummitKareo
This document provides an overview and training on Kareo's billing product. The agenda includes introductions, reviewing insurance enrollment enhancements, sending clean claims, improving patient collections, and a Q&A session. Key highlights include new insurance enrollment dashboards for tracking progress, tools for fixing rejected claims, collecting patient payments through email statements and credit card processing, and categories for managing patient collections.
Private Practice Model Perspectives 2015 SurveyKareo
Kareo believes in the independent practice and the physician entrepreneur. Small practices are vital to their communities for the personalized care they can offer; however, to keep the doors of a small practice open, healthcare providers need to learn to think like an entrepreneur to ensure financial stability and improved patient satisfaction. And there’s never been a better time to be a physician entrepreneur in healthcare.
The demand for individualized care and convenience has become exceedingly important to patients as they are coming to expect the same level of service from their provider as they receive in other aspects of their lives. With the average deductible exceeding $1,200 and roughly 80 percent of employers offering high deductible plans in 2015, patients are beginning to think more like consumers. This new demand is a crucial piece for healthcare providers who own a private practice, as they are better positioned to handle this demand than larger healthcare systems. In short, the trend towards the consumerization of healthcare favors the small practice over large healthcare organizations.
To empower the small practice physician, Kareo is shining a light on the path to success—an agile medical practice model—combining traditional fee for service options with the flexibility of concierge services. This includes offering flexible payment plans and increasing the focus on practice marketing and patient engagement.
The document discusses disruptive technologies and their impact on consumers and enterprises. It finds that cloud and data & analytics continue to drive innovation for enterprises by improving efficiencies and enabling faster innovation cycles. However, security remains the top challenge for adopting cloud services. For consumers, mobile saw a decline as a disruptor while emerging technologies like 3D printing, biotech, and the Internet of Things are gaining prominence. The competition is fierce across the mobile ecosystem to gain market share.
Telenor Workshop on Welfare Tech: EDB InputNino Lo Cascio
From EDB's strategy on Health-IT towards 2020 and short term focus on self service and Health 2.0.
Input to Telenor workshop on welfare technologies, august 2010.
Presentation: Leading the Change In Healthcare Education and Delivery: how to surmount the barriers.
Presented by: Dalal Haldeman, Senior Vice President, Marketing and Communications, John Hopkins Medicine
What does the triple aim really mean and how do we get there? How can strong brands in healthcare influence outcomes, research and patient wellbeing for a healthier future in America and in the world.
The business of medicine is changing quickly. Government and commercial payers know that we're paying more for healthcare and we're getting worse results. Patients know it too. The role of independent practices, their reimbursement models, and how they care for patients are all changing as a result.
Medicare Access and Chip Reauthorization Act (MACRA) is the law that changes how Providers are to be reimbursed. One of the key characteristics is that it rewards Providers based on value and not volume.
This document provides an overview and agenda for a presentation on succeeding under MACRA and MIPS. It discusses what MACRA is and why providers should care about it. MACRA replaces previous payment systems with two new tracks: MIPS and Advanced APMs. MIPS has four performance categories that will determine reimbursements starting in 2017. It also provides a checklist for MIPS participation eligibility and requirements. The presentation reviews the specific criteria and measures under each MIPS performance category. It outlines the MIPS reporting timeline for 2017 and options to pick the best pace. The document concludes by explaining how the Elation software can support practices in meeting MIPS requirements through built-in quality tracking, clinical decision support, and other tools.
The document discusses how physicians can prepare for the Medicare Access and CHIP Reauthorization Act (MACRA) Quality Payment Program, which incorporates quality measurements into Medicare payments. It provides a 5-step guide to transition successfully to the Merit-based Incentive Payment System (MIPS) in 2017. The steps include: determining eligibility and reporting status; reviewing current performance under programs like PQRS; selecting a pace of participation in MIPS; choosing quality measures; and identifying gaps to address in order to improve performance scores.
MACRA and the Merit-Based Incentive Payment System (MIPS)PYA, P.C.
This document provides an overview of the Merit-based Incentive Payment System (MIPS) under the Medicare Access and CHIP Reauthorization Act (MACRA). MIPS replaces previous quality reporting programs and includes four components that determine a Composite Performance Score: Quality, Resource Use, Clinical Practice Improvement Activities, and Advancing Care Information. Scores will determine payment adjustments beginning in 2019, with the potential for bonuses or penalties up to 9% by 2022 based on performance compared to benchmarks and thresholds. The document reviews the scoring methodology and reporting requirements for each MIPS component.
Melinda Hancock is Partner at Dixon Hughes Goodman and Chair Elect of HFMA for 2014-2015. She is responsible for developing new financial modeling products and services related to alternative payment models. Edward Stall has over 20 years of healthcare consulting experience providing strategic planning for healthcare clients. The presentation discusses the transition to alternative payment models like accountable care organizations and bundled payments requiring new forms of enterprise intelligence and analytics. It provides an overview of upcoming risk models and payment reforms, and the intelligence needs of organizations to succeed under new models.
Hfma 2016 10 (3) block chain technology by steve omansSteve Omans
The document provides an overview and breakdown of the requirements of the Medicare Access and CHIP Reauthorization Act (MACRA) and its Merit-based Incentive Payment System (MIPS). MACRA replaces several Medicare reporting systems and creates two paths for medical groups: MIPS or Advanced Payment Models. MIPS incorporates aspects of previous programs and measures performance on quality, clinical practice improvement activities, advancing care information, and resource use. It explains each component in detail and provides actions medical groups can take to understand requirements and prepare for MACRA, such as evaluating current performance, selecting quality measures, and documenting improvement activities.
The document discusses the transition to value-based care models and accountable care organizations (ACOs). It outlines five core competencies needed for early success in an ACO program like the Medicare Shared Savings Program (MSSP): 1) physician-centered governance, 2) collection and reporting of quality metrics, 3) data analysis and spend identification, 4) developing a post-acute quality provider network, and 5) population management strategies. It provides examples from Methodist Health System's experience in an MSSP ACO.
Performance and Reimbursement under MIPS for OrthopedicsWellbe
The 2015 MACRA legislation fundamentally changed the way in which providers are paid for their services. It also provides some relief from the “all or nothing” approach used by Meaningful Use.
This session, a review of the Final Rule published on Oct 14, 2016, conveys a practical approach to maximizing reimbursement under MIPS while reducing burden on clinical staff.
After this session, attendees will have a firm grasp of:
– the major components of the Quality Payment Program
– operational strategies for measure selection
– orthopedic-specific quality measures
About the Speaker:
karenclarkKaren R. Clark is chief information officer for OrthoTennessee, where she has worked since 1998. In that role, she serves on national committees for the Healthcare Information Management Systems Society (HIMSS.) A HIMSS Fellow and Certified Professional in Healthcare Information and Management Systems, her current HIMSS committee is the HIT User Experience, which focuses on clinician experience with health information technology.
She has spoken at the AAOE, AAOS and OrthoForum conferences on both information security and the 2015 MACRA legislation, specifically on the Merit Based Incentive Payment System (MIPS.). She is a member of the College of Healthcare Information Management Executives (CHIME) as well as the CIO/CMIO Council with the American Medical Group Association.
After graduating from American University with a degree in marketing in 1979, she joined Brooks Brothers in New York, where she was a buyer. She earned her MBA in finance from Fordham University in 1984. She moved to Knoxville in 1988 and joined Watson’s as director of planning and distribution when her husband, Brooks, was recruited from Sports Illustrated to Whittle Communications. They have two adult daughters, Isabel, and Olivia.
PYA Principal Martie Ross joined University of Kansas Medical Center’s Robert Moser, MD, and CIO Chris Hansen for the keynote presentation at the joint symposium by Heart of America Healthcare Information and Management Systems Society and Missouri Health Information Management Association, September 14, 2016, at Johnson County Community College in Overland Park, Kansas. They discussed insights related to the role of advanced analytics and technology in transforming and transitioning to new payment models.
2016 MIPS Final Rule: What you need to know NOWBen Quirk
Find out why you need to pay attention to this Final Rule and what adjustments you need to make to ensure you end up on the winning side of MIPS. It's a complicated program, and results from the Final Rule don't make it any easier.
The document discusses 4 dangerous trends facing medical groups: 1) Regulatory and compliance burdens continue to increase with many new regulations and compliance dates in 2015. 2) Operating costs continue to rise significantly each year, especially for staffing which accounts for over half of practice costs. 3) Provider reimbursement is declining from both government and commercial payers, with Medicare payments being cut and penalties increasing. 4) Patient collections have become critical with declining reimbursement. The presentation provides strategies for practices to address these challenges through improving productivity, evaluating costs, and protecting staff.
The Next Revolution in Healthcare: Why the New MSSP Revisions Matter Now More...Health Catalyst
Now more than ever, we are entering a period of rapid change catalyzed by the power of data. On December 21, 2018, the Centers for Medicare and Medicaid Services (CMS) issued a final rule for the Medicare Shared Savings Program (MSSP), strengthening the financial incentives for ACOs to drive improved outcomes. The health systems that embrace data to achieve financial success will grow while the rest will struggle to compete. View this webinar for a discussion on how to prepare.
The US healthcare system didn’t develop overnight, rather, it is the culmination of a series of revolutions within wealthy parts of the world. In this webinar, we explore the high points of history that have led us to our current challenges. While care has steadily improved over time, the cost of that care has risen at a much more dramatic rate. CMS created the MSSP to help mitigate the growth of these costs while providing better care for individuals and populations. On a larger scale, the program serves to shift the healthcare industry towards fee-for-value.
Despite general frustration related to legislative involvement, history has proven that regulatory changes precede attitudinal changes and the MSSP (combined with accurate, timely data) may be just the piece of legislation to help make value-based care a reality. By viewing this webinar you will learn:
- How the US healthcare industry reached its current state.
- Why financial imperatives drive cultural change in our economic model.
- Ways that the MSSP can help your organization achieve financial success.
- Ideas for how to utilize data to develop better healthcare delivery systems.
Dr. Will Caldwell is a strong proponent of the use of data analytics to promote good health and save lives. His area of expertise rests in technology-enabled health care delivery models and value-based care platforms. We hope that you will view this webinar and learn from his 17-years of work as a data-informed clinician.
MACRA consolidates existing Medicare quality programs and establishes two pathways for physicians: MIPS and APMs. MIPS assesses performance in four categories (quality, cost, improvement activities, advancing care information) and adjusts payments up or down based on a composite score. It allows physicians to ease into reporting over multiple years. APMs provide an alternative for physicians meeting thresholds in qualifying models, exempting them from MIPS and providing bonus payments through 2024. MACRA aims to shift Medicare payments from volume to value over time through 2026.
Macra, qpp, mips and ap ms rules of the gameSuperCoder LLC
Does the alphabet soup of MACRA have your head spinning? Join TCI for this one-hour webinar that will help you understand the ins and outs of MACRA and what it means for your practice.
You’ll learn:
The latest on MACRA and QPP trends
The payment changes you’ll face over the next four years
What a MIPS Composite Performance Score is and how you can improve yours
The differences between MIPS Advancing Care Information and Meaningful Use
How to create an improvement activities team
The winning strategy for tackling MIPS performance measures
And more!
The Medicare Access and CHIP Reauthorization Act (MACRA) overhauls the payment system for Medicare providers. It’s a complex program that requires careful study so physicians can make the best choice for how they want to report. This choice ultimately impacts reimbursement and the potential bonuses or penalties associated with each reporting option.
This FAQ covers both tracks of the new rule, the Merit-based Incentive Payment System (MIPS), and the Advanced Alternative Payment Model (APM), with a background review and a comprehensive list of questions and answers.
It’s a practical guide complete with next steps for strategic and tactical planning.
Riding the Rapids of Payment Reform: Downstream Effects of Quality Reporting ...Bill Presley
In this presentation, we highlighted how quality measurement programs impact reimbursement affecting your revenue. The revenue at risk in your organization. We focused on quality programs like Value-Based Purchasing (VBP), Merit-Based Incentive Program (MIPS) and Alternative Payment Models (APM) and their impact on Part A and Part B reimbursements.
It’s no surprise that reimbursement tied to quality performance is quickly becoming a reality for hospitals and physicians. CMS’ aggressive goals aimed at increasing the percentage of Medicare payments associated with quality versus quantity can be achieved through such programs as Value-based Purchasing and MACRA. This session will cover scoring methodologies, reporting requirements, reimbursement impact, infrastructure (and other resource needs), EMR tools and tactics, and workflow modifications.
The healthcare transformation from fee for service to fee for outcomes just got an adrenaline shot in the arm April 27th when the Department of Health and Human Services surprised many in the market by announcing a Quality Payment Program, a proposed set of new rules to take effect in 2019 based on key provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
C4 provides data integrity services to optimize client infrastructure through initial assessments, ongoing monitoring, and regular reporting. They will conduct an initial assessment of requested SQL servers and databases to identify any issues and create an optimization roadmap. C4 will then provide monthly and weekly reports on server and database health, activities, and jobs to track improvements and identify any new problems. The goal is to maintain optimized systems through ongoing assessments and transparency around progress.
This document is an order from Classic Exhibits Inc. for a client named Heartland Dental. It includes specifications for a 10x20 graphic with dimensions of 66"x30"x40" to be applied as a first surface vinyl graphic to a laminated panel face. It also includes a fabric back wall graphic and greeting counter front graphic with dimensions and attachment instructions using velcro.
Amicus Medical Group is a growing medical organization composed of 12 primary care offices that has implemented Greenway Health's EHR and Greenway Revenue Services Essentials in 8 of its locations so far. This has helped relieve the billing team of repetitive tasks, allowing them to focus on higher value work, and improved billing accuracy. The integrated systems and support from Greenway provide efficiencies and expertise that help Amicus effectively manage its continued growth and acquisitions of new practices.
Greenway Health Dr. Randolph Lamberson Case StudyIdeba
Dr. Randolph Lamberson left a large practice group to open his own small practice. This required new systems for health records, practice management, and billing. He chose Greenway's Intergy EHR software which could be customized for a small practice. Greenway also provided billing services and comprehensive training for Dr. Lamberson and his practice manager Tammy Bentley. The personalized, hands-on training helped them learn to use the new systems efficiently. Both found that the Greenway software and services made their practice more efficient and easier to manage.
Cow Creek Health and Wellness Center serves both Native American and non-native populations through two clinic locations. They implemented Greenway's EHR/practice management solution and Greenway Revenue Services for revenue cycle management to gain better visibility and control over their financial performance. This created a learning partnership where Greenway gained knowledge of tribal health practices and Cow Creek learned revenue cycle processes. Since implementing these solutions, Cow Creek has seen major improvements like increased clean claim rates, faster payments, and reduced days in accounts receivable. The clinic director feels Greenway Revenue Services is now part of their team rather than just a vendor.
A combination of case study and infographic, this piece uses the experience of a specific practice to flesh out both the challenges of the healthcare landscape, and Greenway’s ability to help meet those challenges.
Ideba is very excited to continue our work in Uganda, with a big focus on Summer 2020. In total 40 people, half from the Ideba family, will be cycling through the project over four weeks. While the team has completed many projects at the school over the years, our biggest project yet will be to build out dormitories for 120 students. Our design team created these logo options for this final trip. After a team vote, the final decision is design “I”!
This document lists 13 marketing assets for various medical companies including RS Medical, Ideba, Greenway Health, Fiserv, and Microsoft Medical. The assets include videos, websites, ebooks, infographics, training web pages, LinkedIn graphics, PowerPoint presentations, and event materials promoting topics such as white glove training, rebranding, deposit growth, and HIMSS events.
Unlocking the Secrets to Safe Patient Handling.pdfLift Ability
Furthermore, the time constraints and workload in healthcare settings can make it challenging for caregivers to prioritise safe patient handling Australia practices, leading to shortcuts and increased risks.
Letter to MREC - application to conduct studyAzreen Aj
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
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This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
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TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
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Explore the groundbreaking work of Dr. David Greene, a pioneer in regenerative medicine, who is revolutionizing the field of cardiology through stem cell therapy in Arizona. This ppt delves into how Dr. Greene's innovative approach is providing non-surgical, effective treatments for heart disease, using the body's own cells to repair heart damage and improve patient outcomes. Learn about the science behind stem cell therapy, its benefits over traditional cardiac surgeries, and the promising future it holds for modern medicine. Join us as we uncover how Dr. Greene's commitment to stem cell research and therapy is setting new standards in healthcare and offering new hope to cardiac patients.
INFECTION OF THE BRAIN -ENCEPHALITIS ( PPT)blessyjannu21
Neurological system includes brain and spinal cord. It plays an important role in functioning of our body. Encephalitis is the inflammation of the brain. Causes include viral infections, infections from insect bites or an autoimmune reaction that affects the brain. It can be life-threatening or cause long-term complications. Treatment varies, but most people require hospitalization so they can receive intensive treatment, including life support.
2. The Daunting Landscape
32% of those expenditures are
being spent in the hospital market,
where prices are significantly
higher than services in the
ambulatory market, which only
receives 20% of the spend2
Public payers such as Medicare,
Medicaid, and the VA pay for over
40% of all healthcare services2
Healthcare expenditures will
represent over 19% of GDP
by 20231
1
Kaiser Family Foundation calculations using NHE data from Centers for Medicare and Medicaid Services, Office of the Actuary,
National Health Statistics Group at http://www.cms.hhs.gov/NationalHealthExpendData/
2
Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group
Preparing your practice for MACRA 2
3. What is the Medicare and CHIP
Reauthorization Act of 2015?
MACRA was enacted to replace the Sustainable Growth
Rate (SGR), which was designed to ensure that growth in
per beneficiary Medicare expenditures did not exceed
GDP Growth.
• MACRA reauthorizes appropriations for Medicare Part B
(physician services) and CHIP. It only applies to Medicare Part B
• MACRA creates the Quality Payment Program, which is broken into
two tracks:
• Merit-based Incentive Program (MIPS)
• Advanced Alternative Payment Models
Preparing your practice for MACRA 3
4. What Does MACRA Do?
MACRA was passed in 2015 to roll the following programs
into a single Quality Payment Program (QPP) that focuses
on quality, cost, and administrative simplification by
removing different reporting requirements.
• PQRS
• Meaningful Use
• Value-based Modifier
PQRS
Meaningful
Use
Value-based
Modifier
MACRA Quality
Payment Program
Preparing your practice for MACRA 4
5. MIPS
MIPS is the default of the two programs. It
measures Eligible Clinicians on Quality, Cost,
Clinical Practice Improvement Activities, and
Advancing Care Information.
You are subject to MIPS if:
• You take enough Medicare revenue and/or see
enough Medicare patients; and,
• You are an “Eligible Clinician” (EC), meaning:
• Physicians (MD/DO and DMD/DDS), PAs,
NPs, clinical nurse specialists, certified
registered nurse anesthetists for years
one and two
• CMS may expand this to physical or
occupational therapists, speech-language
pathologists, audiologists, nurse midwives,
clinical social workers, clinical psychologists,
dietitians/nutritional professionals
• Even if you are an EC, you are not subject to
MIPS if it’s your first year accepting Medicare
or participating in an APM
Preparing your practice for MACRA 5
6. Who is Eligible to Participate in MIPS?
YEARS 1 AND 2
Physicians (MD/DO and DMD/DDS), PAs,
NPs, clinical nurse specialists, certified
registered nurse anesthetists
YEARS 3+
Physical or occupational therapists,
speech-language pathologists,
audiologists, nurse midwives, clinical
social workers, clinical psychologists,
dietitians/nutritional professionals
Preparing your practice for MACRA 6
7. Eligible Clinician Reporting
Eligible clinicians can participate in MIPS as an individual or group.
GROUP
A group, as defined by taxpayer
identification number (TIN),
would be assessed as a group
practice across all four MIPS
performance categories
VIRTUAL GROUP REPORTING
To be implemented in 2019
performance period where
multiple TINs with 10 ECs
or fewer may report as a
single entity
INDIVIDUAL
Preparing your practice for MACRA 7Preparing your practice for MACRA 7
8. Who Is Not Eligible to Participate
in MIPS?
MIPS does not apply to hospitals or facilities.
First year of Medicare
Part B participation
Below low patient
volume threshold
Certain participants
in Advanced APMs
Medicare billing charges
≤$90,000 OR providers
care for ≤200 patients in
one year
Preparing your practice for MACRA 8
9. Most Clinicians Will Be Subject to MIPS
MIPS does not apply to hospitals or facilities.
Subject to MIPS
Not in APM In non-Advanced APM QP in Advanced APM
In Advanced APM,
but not a QP
Some people may be
in Advanced APMs
but not have enough
payments or patients
Preparing your practice for MACRA 9
10. MIPS and Your Bottom Line
Two years after each performance period, you’ll
get a payment adjustment on your FFS claims.
• For the 2017 performance period, you’ll get
up to a positive or negative 4% adjustment
depending on your performance in 2019
• For the 2018 performance period, you’ll get
up to a positive or negative 5% adjustment
depending on your performance in 2020
• For the 2019 performance period, you’ll get
up to a positive or negative 7% adjustment
depending on your performance in 2021
• For the 2020 performance period and future
ones, you’ll get up to a positive or negative 9%
adjustment depending on your performance in
2022 onwards
Preparing your practice for MACRA 10
11. Initial Years’ Exceptional
Performers Bonus
For the first six years of the program,
Congress has appropriated $500 million per
year for “exceptional performers.”
• These exceptional performers can earn up to
an additional 10% positive adjustment on their
claims (for example, for the 2017 performance
period, up to 14%)
• For the first two years of the program, to be
an exceptional performer you have to earn a
composite score of 70 or higher
• These funds are exempt from budget neutrality
Preparing your practice for MACRA 11
12. MIPS at Maturity
Once the program is fully implemented, CMS will set a “performance threshold” each
year, comprised of the mean or median of all prior year MIPS scores.
This principal is called budget neutrality. The program is designed to not increase or decrease the
impacts on the federal budget.
CMS performance threshold
Exceed threshold – make money
Meet threshold – no impact
Fall below threshold – lose money
Preparing your practice for MACRA 12
13. MIPS Scoring
MIPS measures in four categories, which collectively create a composite score of 100:
QUALITY
replaces the Physician Quality
Reporting System (PQRS) and will
represent 30% of your total score
after full implementation (2019)
ADVANCING CARE
replaces Meaningful Use, measures
how providers use technology
and represents 25% of your
composite score
COST
replaces the Value-based Modifier
and measures healthcare
expenditures per patient, will
represent 30% of your score after full
implementation (2019)
IMPROVEMENT ACTIVITIES
measures clinical process
improvements, representing 15%
of your MIPS composite score
Preparing your practice for MACRA 13
14. Quality Quality
Quality
Cost
Cost
60% 50%
30%
10%
30%
15%
15%
15%
25% 25%
25%
Advancing Care
Information
Advancing Care
Information
Advancing Care
Information
Clinical Practice
Improvement Activities
Clinical Practice
Improvement Activities
Clinical Practice
Improvement Activities
2017
CATEGORY
WEIGHTS
2018
CATEGORY
WEIGHTS
2019
CATEGORY
WEIGHTS
Preparing your practice for MACRA 14
15. MIPS Categories: Quality
• While Quality represents 30% of the
composite score, you earn up to 60
points within Quality (10 per measure)
• If you are in the top decile on a measure,
you’ll get 10 points, the next decile will
get nine points, and so on
• The floor is three points for most
measures (so even if you’re in the
bottom decile you’ll get three points
instead of one)
• Reporting is accomplished by claims,
QCDR, qualified registry, or through an
EHR depending on the measure
Quality
Cost
30%
30%
15%
25%
Advancing Care
Information
Clinical Practice
Improvement Activities
2019
CATEGORY
WEIGHTS
Preparing your practice for MACRA 15
16. MIPS Categories: Cost
• It will include the Medicare Spending
Per Beneficiary (MSPB), which is a per
capita measure of overall spending
• Going forward, CMS will introduce new
episode-based measures that assess
cost for certain events, like a heart
attack
• Reporting is done by CMS on the back-
end through claims
Quality
Cost
30%
30%
15%
25%
Advancing Care
Information
Clinical Practice
Improvement Activities
2019
CATEGORY
WEIGHTS
Preparing your practice for MACRA 16
17. MIPS Categories: Advancing
Care Information
• Within Advancing Care Information
(ACI), you can earn up to 100 points
• 50 points comes from your base
score. There are 4-5 base measures
that require you to complete an activity
at least one time for one patient
• If you do not meet your base measures
you will fail the entire category
• Base measures include:
• Electronic Prescribing
• Health Information Exchange
(sending and receiving summaries
of care)
• Providing patients with electronic
access to their health record
• Security Risk Analysis
Quality
Cost
30%
30%
15%
25%
Advancing Care
Information
Clinical Practice
Improvement Activities
2019
CATEGORY
WEIGHTS
Preparing your practice for MACRA 17
18. Advancing Care Information (Cont’d)
• The remaining 50 points comes from
your performance score and bonus score
• Essentially, the more you do, the more
you earn. For example, one performance
measure is “View, Download, Transmit.” If
1/10 patients view their electronic health
record, you will get one point to your ACI
score. If 2/10 do, you’ll get two points, all
the way up to 10
• You can also get a bonus score. You
get more points for connecting to
public health registries, immunization
registries, and for using CEHRT to report
improvement activities
Quality
Cost
30%
30%
15%
25%
Advancing Care
Information
Clinical Practice
Improvement Activities
2019
CATEGORY
WEIGHTS
Preparing your practice for MACRA 18
19. ACI Measures – 2017
Preparing your practice for MACRA 19
Objective Measure Required Performance
Protect Patient Health Information Security Risk Analysis Y 0
Electronic Prescribing e-Prescribing Y 0
Patient Electronic Access
Provide Patient Access Y Up to 20%
View, Download or Transmit (VDT) N Up to 10%
Patient-Specific Education Patient-Specific Education N Up to 10%
Secure Messaging Secure Messaging N Up to 10%
Health Information Exchange Health Information Exchange Y Up to 20%
Medication Reconciliation Medication Reconciliation N Up to 10%
Public Health and Clinical Data
Registry Reporting
Immunization Registry Reporting N 0 or 10%
Syndromic Surveillance Reporting N
Up to 5% bonus per measure,
15% maximum bonus allowed
Specialized Registry Reporting N
Preparing your practice for MACRA 19
20. ACI Measures – 2018 onward
Preparing your practice for MACRA 20
Objective Measure Required Performance
Protect Patient Health Information Security Risk Analysis Y 0
Electronic Prescribing e-Prescribing Y 0
Patient Electronic Access
Provide Patient Access Y Up to 10%
Patient-Specific Education N Up to 10%
Coordination of Care Through
Patient Engagement
View, Download or Transmit (VDT) N Up to 10%
Secure Messaging N Up to 10%
Patient-generated health data N Up to 10%
Health Information Exchange
Send a Summary of Care Y Up to 10%
Request/Accept Summary of Care Y Up to 10%
Clinical Information Reconciliation N Up to 10%
Public Health and Clinical Data
Registry Reporting
Immunization Registry Reporting N 0 or 10%
Syndromic Surveillance Reporting N
Up to 5% bonus per measure, 15%
maximum bonus allowed
Electronic Case Reporting N
Public Health Registry Reporting N
Clinical Data Registry Reporting N
Preparing your practice for MACRA 20
21. Preparing your practice for MACRA 21
Essentially, the more you do, the more you
earn. For example, one performance measure
is “View, Download, Transmit.” If 1/10 patients
view their electronic health record, you will get
one point to your ACI score. If 2/10 do, you’ll get
two points, all the way up to 10.
Don’t forget that you can also get a bonus
score. You get more points for connecting to
public health registries, immunization
registries, and for using CEHRT to report
improvement activities.
Maximizing ACI
Preparing your practice for MACRA 21
22. MIPS Categories – Clinical Process
Improvement Activities
Preparing your practice for MACRA 22
Within this category, you can earn up to 40 points. If you are a small practice, defined as having 15
ECs or fewer, you only need 20 points.
Some activities are high-weighted, others are medium-weighted. High-weighted activities are
worth 20 points. Medium-weighted activities are worth 10 points.
Some examples of activities:
Providing patients with 24/7 access to their care team
Chronic care and preventative care management for empaneled patients
Engagement of patients through implementation of improvements in patient portal
Collection and follow-up on patient experience and satisfaction data on beneficiary engagement
Engagement of patients, family and caregivers in developing a plan of care
Becoming a recognized Patient-centered Medical Home (automatic 100%)
Preparing your practice for MACRA 22
23. Preparing your practice for MACRA 23
Compare
Learn
Design
LEARN ABOUT THE PROGRAM
Learn what it means for your bottom line,
and what’s coming in the future. Visit qpp.
cms.gov and Greenway Health webinars for
more information.
COMPARE YOUR DATA
Look at your historical data and measures,
and focus on what you’re good at, what’s
relevant to your patient population, and where
you can make the easiest improvements.
DESIGN A PLAN
Design a plan based on your data that
accounts for 2017 and 2018. Use the
transition year to test your plan. Don’t slack
this year or 2018 might catch you off-guard.
Don’t take the transition year off, instead prepare for success
How to Succeed with MACRA
Preparing your practice for MACRA 23
24. Preparing your practice for MACRA 23
Compare
Learn
Design
COMPARE YOUR DATA
Look at your historical data and measures,
and focus on what you’re good at, what’s
relevant to your patient population, and where
you can make the easiest improvements.
Don’t take the transition year off, instead prepare for success
How to Succeed with MACRA
LEARN ABOUT THE PROGRAM
Learn what it means for your bottom line,
and what’s coming in the future. Visit qpp.
cms.gov and Greenway Health webinars for
more information.
DESIGN A PLAN
Design a plan based on your data that
accounts for 2017 and 2018. Use the
transition year to test your plan. Don’t slack
this year or 2018 might catch you off-guard.
Preparing your practice for MACRA 24
26. Preparing your practice for MACRA 25
If you are eligible, start learning about the program.
Read the executive summary
Talks with your doctors to establish financial, clinical,
and performance goals
Do you want to simply comply and avoid penalties?
Do you want to test your systems and gradually improve over time?
Do you want to be a high performer?
Determine what workflow and process changes might be required
to meet your performance goals
Getting Started
Preparing your practice for MACRA 26
27. Preparing your practice for MACRA 26
2017 Compliance/Penalty Avoidance
Failure to participate results in a 4% negative adjustment rate.
To simply avoid a penalty (reach three points):
Read the executive summary
Start collecting data on–
1. One CQM;
2. One improvement activity; or,
3. The required ACI measures
Preparing your practice for MACRA 27
28. 2017 High Performance
(scores exceeding 70)
Preparing your practice for MACRA 27
It is strongly recommended that you upgrade to 2015 CEHRT
to add a bonus to your composite score.
Choose and start collecting data on:
Six quality measures
• Analyze prior years’ CQM performance to determine
what your practice is good at
• One outcomes measure or another high priority
measure if outcomes is unavailable
• Attempt to come in at least in the 4th decile across
all your quality measures
• Visit this page to download measure specifications
and what scores place you in what deciles
Preparing your practice for MACRA 28
29. 2017 Test Your Systems
(scores from 3–70)
Preparing your practice for MACRA 28
It is strongly recommended that you upgrade to a 2015 Certified EHR Technology (CEHRT) to add
a bonus to your composite score.
Choose and start collecting data on:
Six quality measures
• Analyze prior years’ CQM performance to determine what your practice is good at
• One outcomes measure or another high priority measure if outcomes is unavailable
• Attempt to come in at least in the 4th decile across all your quality measures
• Visit this page to download measure specifications and what scores place you
in what deciles
Collect data on the required ACI measures
• Pick several to excel at and implement process changes at the clinician level so
technology is consistently used to ensure you reach the maximum ACI score
Choose 1-4 improvement activities depending on practice size and priority weights
(get to 40 points)
Conduct workflow analyses across the organization on all measures to ensure data is being
captured on a quarterly basis.
Really look at full year reporting to make sure your organization is prepared and has staff
capacity to do this year after year.
Preparing your practice for MACRA 29
30. Preparing your practice for MACRA 29
2018 Compliance/
Penalty Avoidance
Determine a pathway to 15 composite points.
Sample reporting options:
Start collecting data on–
• Six CQMs
• Full improvement activity participation; or,
• The required ACI measures and one CQM
Preparing your practice for MACRA 30
31. Preparing your practice for MACRA 30
2018 Test Your Systems
(scores from 15-70)
It is strongly recommended that you upgrade to a 2015 Certified
EHR Technology (CEHRT) to add a bonus to your composite score.
Choose and start collecting data on:
Six quality measures
• One outcomes measure or another high priority measure
if outcomes is unavailable
• Attempt to come in at least in the 4th decile across
all your quality measures. Visit this page to download
measure specifications and what scores place you in
what deciles
.
Collect data on the required ACI measures, and pick a couple
you really want to hone in on and excel at (workflow dependent); and,
Choose 1-4 improvement activities (get to 40 points)
Conduct workflow analyses across the organization on all
measures to ensure data is being captured on a quarterly basis.
Preparing your practice for MACRA 31
32. Preparing your practice for MACRA 31
2018 High Performance
(scores exceeding 70)
It is strongly recommended that you upgrade to a 2015 Certified EHR
Technology (CEHRT) to add a bonus to your composite score.
Choose and start collecting data on:
Six quality measures
• Analyze prior years’ CQM performance to determine what
your practice is good at
• One outcomes measure or another high priority measure if
outcomes is unavailable
• Attempt to come in at least in the 4th decile across all
your quality measures
• Visit this page to download measure specifications
and what scores place youin what deciles
• Consider trying to improve on a prior year’s CQM to
take advantage of improvement scoring under MIPS
Preparing your practice for MACRA 32
33. 2018 High Performance (cont’d)
Preparing your practice for MACRA 32
Collect data on the required ACI measures
• Pick several at which to excel; implement process changes at the clinician level and use
technology consistently to ensure you reach the maximum ACI score
Choose 1-4 improvement activities depending on practice size and priority weights
(get to 40 points)
Conduct workflow analyses across the organization on all measures to ensure data is being
captured on a quarterly basis
Participate in full year reporting to prepare for the eventual transition to an Advanced APM.
Begin evaluating what Advanced APMs are available to you in 2019 and beyond, whether through
Medicare, Medicaid, or the All-Payer Option; determine on whether it makes sense to participate
based on:
• Process readiness
• Clinician culture
• Financial performance under MIPS
• Alignment with other programs/initiatives in your payer mix
Preparing your practice for MACRA 33
34. 2019?
Preparing your practice for MACRA 33
Cost and resource use will be measured at 30% of your MIPS score
• 2019 episode-based measures have not been determined, so subscribe for updates at
qpp.cms.gov
• The Medicare spending per beneficiary measure will likely be included
• Review prior Quality and Resource Use Reports (QRUR) to assess current levels
of performance
The MIPS performance threshold will be set at the mean or median of prior years’ MIPS
composite scores
This means each year the performance threshold will increase
As the program becomes more aggressive, consider Advanced APMs; Determine whether it
makes sense to participate based on:
• Process readiness
• Clinician culture
• Financial performance under MIPS
• Alignment with other programs/initiatives in your payer mix
Preparing your practice for MACRA 34
35. Greenway Health: A Record of Success
in Value-based Care
Preparing your practice for MACRA 34
Exclusive to the ambulatory market, Greenway Health has specialized in
serving independent practices for over 40 years.
We have over 17,000 meaningful use attestations, and over 80% of our
participating clients have made money or avoided negative adjustment in
MU 1, MU 2, and MU 3.
Over 90% of our participating clients made money or avoided a negative
adjustment in ACO or PCMH.
Preparing your practice for MACRA 35
36. Simplifying MACRA Participation
Minimize confusion and disruption as you tackle
MACRA and MIPS challenges. [CTA HERE]
Preparing your practice for MACRA 35
Greenway Health’s systems can help simplify meeting and exceeding minimum MIPS requirements.
Install Greenway Health’s 2015 CEHRT edition and add 2.5 points to your composite score
Report the base ACI measures, which requires only a one in the numerator, for 12.5 points
Use Greenway Health’s EHR to report on 6 quality measures, meet the data submission criteria,
and you get 15 points (the minimum is 2.5 points per measure)
Greenway supports all 53 EHR-based measures through Intergy and Intergy Practice Analytics.
Because that qualifies as electronic reporting, it brings you to 20 points
Just meeting the reporting requirements with our systems gets you 35 points when the threshold
for next year is 15.
Preparing your practice for MACRA 36