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Other Quality Reporting News – Looking forward at what is to come

Quality Reporting in 2017

Over the past few decades the healthcare industry has seen major advances in technology and quality-of-care initiatives and Physician Practices are no exception. Moving into 2017 and beyond, we turn our focus to the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA).  The MACRA Quality Payment Program serves to move providers and clinicians towards rewards for higher quality patient care as opposed to paying for the volume of care they provide.

  • The Quality Payment Program has two paths that providers can choose from:
    • Merit-Based Incentive Payment System (MIPS) – MIPS essentially gives clinicians the opportunity to be paid more for better care and investments that support patients. In 2017 it provides a flexible performance period, so those who are ready can dive in immediately, but those who need more time can prepare for participation later in the year. With MIPS, you will earn a performance-based payment adjustment (positive, neutral, or negative).
    • Advanced Alternative Payment Models (APMs) – Advanced APMs help clinicians go further by participating in organizations that get paid primarily for keeping people healthy. When these organizations get better heath results and reduce costs for the care of their patients, the clinicians receive a portion of the savings. With an Advanced APM, through Medicare Part B you may earn an an additional incentive payment up to 5%.

We believe most of our customers will participate in the MIPS path, so we will focus on those requirements here. However, more information about Advanced APMs or MIPS can be found on the CMS Quality Payment Program website at qpp.cms.gov.

MIPS

Within the MIPS path in 2017, there are 3 performance categories that Eligible Clinicians will be submitting data on to receive a composite score and determine payment adjustments:

  • Quality – This component will be based on Clinical Quality Measures (CQM), some of which will be carrying over from the PQRS program. CQR has the capability of reporting CQMs for this component.
  • Improvement Activities – This component has 90+ activities to choose from, each being weighted. These activities cross 6 subcategories and include activities such as same day appointments for urgent needs, timely communication of test results, use of surgical checklists, etc.
  • Advancing Care Information – This component will take on many attributes of the Meaningful Use objectives with measures such as e-Prescribing, Patient Access, Medication Reconciliation and HIE all be a part of this component. Again, like the Quality component CQR already has the capability of reporting measures that are numerator/denominator calculations.

2017 MIPS Reporting Period

For the 2017 Reporting Period, providers electing the MIPS route have 4 options (but only 3 good ones!).

  • Don’t Participate – If you don’t send in data in 2017, you will receive a negative 4% payment adjustment.
  • Test – If you submit a minimum amount of data in 2017, you may avoid a downward payment adjustment in 2019.
  • Partial – If you submit 90 days of data in 2017, you may earn a neutral or positive payment adjustment in 2019.
  • Full – If you submit a full year of data in 2017, you may earn a positive payment adjustment in 2019

As with all government programs, there are many details and specifics surrounding the Quality Payment Program. For more detailed information, please review our MACRA and MIPS: How Medicare Meaningful Use and PQRS are Changing webinar recording and slides available on our Podio site.

To receive MIPS specific emails, please sign up for our MIPS TIPS listserv HERE.

Quatris is committed to your Quality Reporting success as we transition to a new program with new requirements.