MARCH 16, 2017 Creating a MIPS Success Roadmap
About Tom Lee, Ph.D. Founder & CEO of SA Ignite Tom is a serial entrepreneur and leading expert in healthcare valuebased programs such as MIPS, MACRA, Meaningful Use, and PQRS. He is the father of two small children and after a frightening personal healthcare experience, his concern for their future in the world inspired him to create a company that matched his personal passion: driving innovation in the public healthcare system. Leveraging its cloud-based physician performance analytics and reporting platform, SA Ignite has grown to serve 15,000+ providers in 80+ healthcare organizations. Tom is a member of the Young Presidents Organization and earned a B.S. with Distinction in Physics from Stanford, a Ph.D in Physics from U.C. Berkeley where he was a National Science Foundation Fellow, and an M.B.A. with Distinction from the Kellogg School of Management at Northwestern University. Contact him at: tom@saignite.com WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 2
Today s Agenda Key Takeaways from HIMSS17 Creating a MIPS Success Roadmap Examples of what s happening in the field Define success for 2017 Key activities and deadlines A sample roadmap WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 3
Key Takeaways from HIMSS17 1.Value-based care is here to stay. 2.MACRA APMs will be expanding beyond Medicare Part B. 3.Telemedicine and interoperability have deep bi-partisan support. 4.Greater state flexibility under ACA modifications. 5.The human element is the greatest cybersecurity vulnerability. For more: http://www.saignite.com/5-takeaways-himss-2017/ (Feb 27, 2017) WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 4
Examples of What s Happening in the Field A 100-Clinician Organization Educating docs, building out more MIPS EHR measures, starting to understand cost for 2018 MIPS A Practice Transformation Network (PTN) Deploying a MIPS monitoring system across hundreds of small practices and tens of EHRs A For-Profit Health System Documenting IA s to avoid 2017 penalties and get onto 2018 MIPS planning A Medicare Shared Savings Program Accountable Care Organization (MSSP ACO) Providing ACI support across TINs and EHRs An Academic Medical Center (AMC) Evaluating 2018 APM participation to avoid MIPS WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 5
Define Success for 2017 Is your org a penalty avoider or an incentive seeker? Notable 2017 MIPS thresholds: Performance Threshold = 3 Exceptional Performance Bonus Threshold = 70 To Penalty Avoiders: Avoid complacency! Rising thresholds Scores reported publicly Best Practice: Set score targets at clinician, TIN & ACO levels regardless of individual vs group reporting decision WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 6
Key Activities & Deadlines Educate your organization, particularly leadership WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 7
Educational Resources 10 FAQs About MIPS (Google mips ) www.saignite.com/mips-faqs 10 FAQs About APMs www.saignite.com/apm-faqs New v7.7! Free MIPS Financial Calculator (Google mips calculator ) www.saignite.com/resources Recorded MIPS monthly webinars and downloads: www.saignite.com/the-abcs-of-mips-webinars LinkedIn Group Merit-Based Incentive Payment System WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 8
Key Activities & Deadlines Baselining 1. Identify MIPS eligible clinicians (apply exclusions) 2. Calculate Medicare Part B $ subject to MIPS 3. For clinician/tin/aco, estimate baseline MIPS score using historical MU and PQRS measure values Note: if group reporting, must include data from clinicians individually excluded due to low-volume, first-year Medicare or AAPM participation exclusions) Estimate revenue impact of the baseline score WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 9
Key Activities & Deadlines SAI Free MIPS Financial Calculator v7.7 - Sensitivity Analysis www.saignite.com/resources WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 10
Key Activities & Deadlines Gap Analysis Identify required improvement on measures to reach target MIPS score Best Practice: Create multiple paths of measure improvement to achieve target Surface high-leverage improvement opportunities e.g. EHR re-configuration WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 11
Key Activities & Deadlines The Concept of Measure Leverage Current Performance = Baseline MIPS Score = 65 Improvement on #1 Measure due to N more tasks until EOY = Improved MIPS Score = 65 + 5 = 70 Improvement on #2 Measure due to N more tasks until EOY = Improved MIPS Score = 65 + 3 = 68 WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 12
Key Activities & Deadlines Select reporting methods and measures Best Practice: Compare individual to group reporting impacts on score Best Practice: Be cognizant that different methods have different measure benchmarks (see February 2017 ABCs of MIPS webinar) Best Practice: Factor clinician engagement and administrative burdens into selection decisions Budget, allocate, and organize resources for 2017 and 2018 Monitor measures and drive performance clinician peer comparison is a powerful motivator WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 13
Key Activities & Deadlines WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 14
Key Activities & Deadlines Understand how MIPS performance varies across your clinicians WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 15
Key Activities & Deadlines 2017 MIPS regulatory deadlines Q2 2018 QPP proposed rule published Q2 Deadlines to submit LOI(s) for 2018 APMs impacting MIPS participation June 30 Declare to CMS intention to use GPRO Web Interface or CAHPS Q3 Deadlines to submit applications for 2018 APMs Q1 2018 Data submission deadlines Aside from June 30 declarations, can select reporting methods up to point of submission WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 16
A Sample Roadmap Combine activities and deadlines into a high-level roadmap. Q2 2017 - The Busiest Quarter Education, baselining, and gap analysis Decide on GPRO Web Interface and CAHPS Review 2018 QPP proposed rule (includes 2018 MIPS) Submit LOI(s) to CMS for APMs impacting MIPS participation Q3 2017 Draft budget and targets for 2018 MIPS Monitor and drive performance Submit APM applications to CMS Q4 2017 Prepare for data submission Monitor and drive performance Review 2018 QPP final rule and identify 2018 roadmap impacts Finalize budget and targets for 2018 MIPS Q1 2018 Data submission ( The Second Busiest Quarter ) WEBINAR SERIES BROUGHT TO YOU BY: HITECHANSWERS.NET AND SAIGNITE.COM 17
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