macra: developing a success plan
TRANSCRIPT
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Speakers
Jas GrewalCEO and Co-Founder
Aditya MangalVP of Customer Success
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• MACRA impacts both physicians and hospitals
• Most providers will fall under the MIPS category
• Performance in 2017 will determine payment in
2019
MACRA Recap
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1. Have you prepared a MACRA plan for 2016 through
2018?
Poll
• I have a plan in place (67%)• I somewhat have details of a plan
(17%)• I have yet to begin preparing a plan
(16%)
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Action Plan for 2016 through 2018 to
Prepare for MACRA
Agenda
Risks and Milestones to Consider Through
This Journey
Tools and Resources Required for a
Successful Plan
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2016: Know Yourself
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• Understand your PQRS reports
• Benchmark your performance
Action Plan
• Get certified EHR• Evaluate solutions for
patient engagement
• Plan and schedule your 90-day reporting period for 2017
• Review CPIA list
• Analyze population by cost/patient
• Identify workflow changes for plans
Quality (50%) Advancing Care Information (25%)
Clinical Practice Improvement
(15%)
Resource Use andCost (10%)
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2016 (August) 2017
Certified EHR a Must Have
Evaluate cost analyticstools
Enable quality team to review PQRS & CPIA
Milestone: MACRA ruling in November
Milestones, Resources, and Tools
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2017: CMS Performance
Benchmark Year
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• Report 6 domains; 1 cross-cut, 1 outcome
• Watch for NPRM (July) to address changes
Action Plan
• Ensure efficacy of EHR• Complete security risk
assessment
• Execute 90-day reporting period. Decide on CPIA
• Enable patient reach out for health status checks
• Monitor high-risk patients for specialized care
Quality (50%) Advancing Care Information (25%)
Clinical Practice Improvement
(15%)
Resource Use andCost (10%)
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2017 2018Complete SRA inEarly 2017
Complete the 90 day reporting for the period you decided
Quality teams review & adjust measures based on feedback
Milestone: First Feedback report in July
Milestone: CMS collects data starting January
Get a clear picture of yourPopulation; Enable structured outreach programs.
Milestones, Resources, and Tools
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2018: Continue to Optimize
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You will get penalized in 2019 based on 2018 performance.
Review your quality performance based on CMS feedback reports and put in place improvement action plans; focus on high risk patients
Focus on payment maximizing initiatives. Think of achieving high patient engagement through automation
Optimize Your Performance
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2018 2019Improve quality based on your first feedback report
Enable tools & processes to focus on high risk and high utilization patients
Quality teams review & adjust measures based on feedback
Milestone: Second Feedback report in July
Get a clear picture of yourPopulation; Enable structured outreach programs.
Milestones, Resources, and Tools
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