an up-to-the-minute update on macra
TRANSCRIPT
webinar
An Up-to-the-Minute Update on MACRAPresented by John Lynn November 16, 2016
@GoKareo
Agenda
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Agenda
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• Welcome & Introductions• MACRA Final Rule Update• How Kareo Can Help• Your Questions
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How to Participate Today…
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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
@GoKareo
Agenda
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Agenda
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• Welcome & Introductions• MACRA Final Rule Update• How Kareo Can Help• Your Questions
@GoKareo 77
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 ProgramStreamlines Multiple Quality Reporting Programs Into
• APMs (Advanced Alternative Payment Models)• MIPS (Merit-based Incentive Payment System)
Final Rule Published on October 14th
• Includes Comment PeriodImpact of New President?
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MACRA Comment Period
• 4000 Comments• 100,000 Physicians and Stakeholders in Outreach Sessions• 2,398 page Final Rule• Result
• 2017 - Transition Year• Iterative Learning• Development Period
Overarching Goal: Move to Quality
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Most Small Practices Will Do MIPS!
CMS Expects Most Will Move from MIPS to APM Over Time
Final Rule Included More APM Options
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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 End Stage Renal Disease
Care Model (Two-Sided Risk Arrangements)• Comprehensive Primary Care Plus (CPC+)• Oncology Care Model (OCM) (two-sided risk
track)
Advanced APMs List Will Be Updated at: QPP.CMS.GOV
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Are You Part of an APM?
Future Advanced APMs in 2018:
• Comprehensive Care for Joint Replacement (CJR) Payment Model (CEHRT)
• Advancing Care Coordination through Episode Payment Models Track 1 (CEHRT)
• ACO Track 1+• New Voluntary Bundled Payment Model• Vermont Meidcare ACO Initiative (as part
of the Vermony All-Payer ACO Model)New Proposals Reviewed by PTAC (Physician-Focused Payment Model Technical Advisory Committee)
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Are You Part of an APM?
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Are You Part of an APM?
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What’s the Benefit of Being an Advanced APM?
The MACRA APM Creates Extra Incentives, It Doesn't Change Current APM Functions or
Rewards Value
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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• MIPS is Not an Exclusion
Immediate Timeline:
• First Performance Period is 2017• MIPS Adjustments Happening in 2019
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MIPS Timeline
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Who's Eligible for MIPS?
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Who's Not Eligible for MIPS?
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What's the MIPS Incentive or Penalty?
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MACRA “Pick Your Pace” Options
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Pick Your Pace – “Test”
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MIPS Performance Category Weighting
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Quality Performance Category
PQRS Replacement
• 1 Measure must be Outcome or High-Priority Measure• Specialty Specific Measure Sets• Year 1 Weight - 60% (Up from 50%)
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Quality Performance Category
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Quality Performance Category
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Resource Use (Cost) Category
Value-Based Modifier ReplacementNo Data Submission Required
• Calculated Based on Medicare ClaimsDetails:
• Feedback Only in 2017 – Does Not Affect 2019 Payments
• Year 1 Weight - 0% (Down from 10%)
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Clinical Practice Improvement Activities Category
New Category (CPIA)
• 90+ Activities to Choose From 9 Subcategories
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Clinical Practice Improvement Activities Category
New Category (CPIA)
• Year 1 Weight - 15% (Same)
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Clinical Practice Improvement Activities Category
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Advancing Care Information Category
EHR Incentive Program (Meaningful Use) ReplacementDetails:
• Year 1 Weight - 25% (Same)• Significant Hardship Exemption – Weighted to 0%• 25% Weight Goes to Other Categories
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Advancing Care Information Category
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Advancing Care Information Scoring
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Advancing Care Information Changes
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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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MIPS APM Benefits
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Transition Year 2017 Payment Adjustments
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Small Practice Support for MACRA
• Pick Your Pace• More Access to Advanced APMs• Increased Exemptions• Transforming Clinical Practice Initiative (“RECs”)
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Next Steps
• Evaluate if You’re in An Advanced APM or MIPS• MIPS
• What’s Your Medicare Part B Reimbursement?• Shoot for Full Participation – Prepare for 2018
• Best Case: Full Participation (with Bonuses)• Middle Case: Partial Participation• Worst Case: Test
• MACRA Isn’t Going Away
• Commercial Payers Might Follow• Help Desk: [email protected]
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Agenda
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Agenda
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• Welcome & Introductions• MACRA Final Rule Update• How Kareo Can Help• Your Questions
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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’s MACRA Resource Center
www.kareo.com/MACRA
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Kareo Platform
Kareo Clinical
• Comprehensive dashboard
• Simple charting• Easy ePrescribing• Convenient eLabs• Specialty templates• Electronic Superbill• Integrated Patient
Portal • Secure messaging
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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
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Discover Kareo’s Role
• PAHCOM has approved 1 CEU credit.• Each attendee will receive an email today
with a link to request certification. Certificates will be mailed within the next few days.
• Attendees must be logged into the webinar to receive credit.
• You’ll be asked at the end of the webinar if you want a CEU certificate.
“…Make Your Practice a Best Practice!”
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Agenda
46
Agenda
46
• Welcome & Introductions• MACRA Final Rule Update• How Kareo Can Help• Your Questions
@GoKareo 4747
How to Participate Today…
Type your questions
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