PQRS Reporting and Meaningful Use Attestation for 2016

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1 PQRS Reporting and Meaningful Use Attestation for 2016 August 25, :00 AM Mountain Time Welcome, we ll get started in moment Please mute your phones!

2 Agenda Overview PQRS for 2016 Requirements Reporting Options What to do NOW to be ready to report for 2016 Pick a Measure Group or 9 Individual Measures to Report on Measure Group Reporting review individual measures within the Measure Group. Make sure you are recording required data in the Progress Note. Individual Measure Reporting Pick 9 from 3 Domains; must have at least 1 Cross-Cutting Measure. Make certain you are recording required information in the Progress Note What else do I have to do? Run reports to validate patient population (PQRs, CQM or Query Builder) Select a Registry and sign-up before their deadline. Meaningful Use Update Waiver or Attest? I heard MU was no longer required in Will I need to report MU Measures in the future?

3 PQRS update for EP s to include NP s, PA s and Therapists If they have billed Medicare Part B 2. Added 3 new Group Measures Multi Chronic Conditions, CV Prevention (Million Hearts) and Diabetic Retinopathy Reporting to avoid 2% Payment Adjustment in This is the Last Year for separate PQRS Reporting here comes MACRA!

4 PQRS Reporting Options for 2016 No Change to Reporting Options: o Claims Based still need 9 measures; 3 domains with 1 cross-cutting measure o Registry Based o Individual Measures same as above o Measure Groups at least 20 patients with a majority being Medicare Part B insured o EHR Reporting Not supported by Caretracker yet (coming for 2017) o GPRO Large Groups not applicable to this audience

5 How Do I Prepare for PQRS? 1. Select the Measure Group or Individual Measures you will report on a) Guide to Measure Groups (sent Separately) b) Guide to Individual Measures 2. Review the data to be reported within each measure 3. Incorporate data collection into Progress Note; use discreet data if possible (not free text)

6 How do I pick a Measure Group? Consider the conditions you treat Consider the type of care you deliver (preventive, chronic or acute) Consider the setting in which you deliver care (office, ED, ASC, etc.) Review ALL of the measure responses to make sure you can collect the required data You must have at least one successful patient to report on for each individual measure within the measure group.

7 What else do I need to do? Run reports to identify patient population PQRS CQM or NQF Clinical Query Builder Review the progress notes to see what data gaps exist start recording data required for reporting

8 How do I report? Select a Registry to use and sign-up by their deadline Can t decide? Contact your specialty trade organization for their suggestion.

9 What is a cross cutting measure? If you have to report individual measures, be sure to include one cross cutting measure from the CMS list. A cross-cutting measure is defined as a measure that is broadly applicable across multiple providers and specialties

10 Meaningful Use update for Proposed Rule will change the reporting period from 365 days to 90 days. 2. This is the last year for attestation MACRA will introduce a score concept rather than the pass/fail system. 3. MU waivers have been filed for all Phasis clients. 4. First time attestation has a different set of requirements and time frame for reporting. 5. Don t fear the audit; keep documentation.

11 Will I still have to report MU Measures? In a word YES. However, there are many changes What would stay the same? The proposal applies only to clinicians who bill Medicare Part B. Medicaid EP s will continue to work within the existing MU program. CMS will keep their "two-year lookback" policy. Performance in 2017 would determine payment adjustments in Providers traditionally excluded from MU would not be scored on EHR use. This includes hospital-based providers, those facing an applicable hardship, and advanced practitioners at least for the first performance year.

12 What would change? MU will no longer be a standalone program. EHR use requirements now referred to as Advancing Care Information (ACI) would account for 25 percent of a provider's total MIPS composite performance score. That composite score, in turn, would be used to adjust a Medicare provider's payments upward or downward, or keep them flat. The total maximum downward adjustment for Year 1 would be negative 4 percent, and the maximum upward adjustment is 12 percent. The new rulel abandons MU's "all-or-nothing" approach. Currently, MU requires that providers meet all measure requirements, including specific performance thresholds. Under MACRA, CMS plans to reward providers for both participation and performance toward EHR use even if they don't meet performance goals. The participation component relates to a "base score" that awards providers 50 points of the total possible 100-point ACI category score. To receive the base score, providers would need to complete a security risk analysis, be in active engagement with an immunization registry (or qualify for an exclusion), and report a numerator (of at least one) and denominator for all remaining measures. EP s can still get zero points by not reporting. The performance score consists of additional points awarded for certain objectives. No minimum threshold would be required for each individual measure. Rather, providers would receive up to 10 points for certain measures; in theory these measures could sum up to greater than 50 points, but CMS caps this part of the category's score at 50. CMS focuses the performance score on the Stage 3 Patient Electronic Access, Coordination of Care through Patient Engagement, and Health Information Exchange objectives (or their associated Modified Stage 2 measures in 2017). Additionally, providers can add up to one public health bonus point if they achieve Active Engagement with a public health registry (e.g., Syndromic Surveillance, or Specialized Registry).

13 The impact of meaningful use will never go away. Regardless of when you first attest, you will have to continue to meet objectives in order to avoid penalties.

14 Useful links and files PQRS Information: Meaningful Use Information: MACRA Information: APMs/MACRA-MIPS-and-APMs.html We will send (and make available on our website) the following reference documents: 2016 Physician Quality Reporting System (PQRS) Measures Groups Specifications Manual 2016 Qualified Registries 2016 Cross-Cutting Measure Set Let us know if you need additional reference material.

15 Questions?