Don’t Let MACRA MIPS You in the

HealthWRS

PART 1

SURVIVALIST GUIDE TO UNDERSTANDING MERIT-BASED INCENTIVE PAYMENT SYSTEM (MIPS)

This two-part guide is designed to give smaller practices clarity and a road map to adapt to the coming changes that MACRA and MIPS will bring.

DemystifyingMACRA & MIPS

HealthWRS

MACRA (MEDICARE ACCESS AND CHIP REAUTHORIZATION ACT OF 2015)

MACRA represents the largest change in how Medicare clinicians are paid. The first performance year begins January 1, 2017.

MIPS (THE MERIT-BASED INCENTIVE PAYMENT SYSTEM)

MIPS is the workhorse for the MACRA program. MIPS is the “how we get it done.”

1997

2015

2017

HealthWRS

WHERE DID MIPS COME FROM? MIPS has evolved from a series of efforts to control healthcare spending and improve quality.

Sustainable Growth Rate (SGR) CreatedPURPOSE: Restrict growth in Medicare Part B spending.

MACRA Replaced SGRPURPOSE: Prioritize quality over quantity. Instituted Meaningful Use (MU), Physician Quality Reporting System (PQRS) and Value-Based Modifier (VBM).

MIPS LaunchesPURPOSE: Combines MU, PQRS and VBM.

As many doctors and patients will tell you and have told us, we remain a long way from fully realizing the potential of these important tools, whether measured in patient care or physician satisfaction. At the same time we have been invested in technology, the healthcare system as a whole has been changing. As a nation, we have made significant advances in transitioning the healthcare system to one that pays for quality, encourages coordinated care and smarter spending, and focuses on healthier outcomes for people.

– CMS official blog HealthWRS

WHAT CHANGES WITH MIPS?MIPS changes how Medicare links performance to payment. MIPS links fee-for-service payments with quality and value.

• Expect to see a new emphasis that supports better patient care and more connected technology.

• MIPS is intended to improve the relevance and depth of Medicare’s value and quality-based payments

• MIPS will allow clinicians to choose measures and activities appropriate to the type of care they provide.

Most Medicare clinicians will participate in a Quality Payment Program through MIPS.

MIPS DOESN’T APPLY TO: • First-year Medicare participation. • Those who are in eligible alternative payment models who qualify for the

bonus payment.• Those who are below low-volume threshold.

HealthWRS

That’s right, the Centers for Medicare & Medicaid Services will release each clinician’s annual Composite Performance Score (CPS) to the public.

We have not seen this level of transparency before. It goes beyond existing programs such as VBM (Value-Based Modifier) which calculates quality and resource use scores – but does not publicly show the results.

MIPS Scores Go Public

see how their providers

COMPARE to peers nationally

0 to

100

For the1st TIME consumerswill be able to see their providers rated on a scale of

How should medical practices start preparing for the change?

HealthWRS

TAKE A PROACTIVE APPROACH.• Create a strategy for implementing MIPS by Q4 of 2016. • Get familiar with details of clinical quality measures. Identify the potentially highest performing clinical

quality measures appropriate to your scope of practice.• Check measures against other quality program initiatives to maximize efficiency and performance.• Ensure your certified EHR system can collect quality data appropriate for your practice, so you can report on

those measures.

MONITOR. ASSESS. IMPROVE. • Continue to track and improve your MU, PQRS and VBM, as 75% of MIPS scores relies on the performance

of these programs. • Check your progress via MU reports.• Research and select the best PQRS reporting vehicle to match the measures identified. • Monitor quality report card dashboards early and often to identify deficiencies, remediate and advance to

the next performance level.

EDUCATE. COMMUNICATE. PARTICIPATE. • Educate and create conversations about the new regulations.• Expand your network for optimal patient care and reimbursement.• Participate in the Alternative Payment Models concept (ACO, Medicare Shared Savings Program, PCMH, etc.)

The highest achievers will be rewarded.

CHECK YOUR PROGRESSCheck the Physician Compare clinical quality statistics. These are publically reported and available online. By reaching highest quality scores now, you shine in the eyes of prospective patients.

START PREPARING NOWForward-thinking EHR platforms such as WRS Health already have the technology and management expertise in place to adapt to the coming changes. Their systems and software provide practices reporting and revenue cycle management tools as well as the support they need to handle the administrative burden of MIPS.

To speak to one of our practice management consultants to discuss your particular RCM and reporting needs,

PLEASE CALL 866-977-4367

WATCH FOR MIPS UPDATESAt this printing, MIPS is scheduled to take effect on January 1, 2017. Industry leaders are still hammering out the details of launch date and other key points. What you’ve just read is what we know thus far.

In the meantime, schedule time to learn and take action in preparing for the coming changes. Success is possible for every practice.

HealthWRS

HealthWRS

DON’T LET MACRA MIPS YOU IN THE BUTT is brought to you by WRS Health

WRS Health is a cloud-based certified EHR and Practice Management System and Solutions provider.

Offering more than just specialty specific workflows and note types, WRS Health can help manage your:

• Online Professionalism, Presence and Reputation• Achievement of Clinical Compliance for Meaningful Use• Billing Processes and Reporting

Find out why your colleagues are switching to WRS Health for their EHR, practice marketing and management needs.

More information can be found atwww.WRSHealth.com

CALL (866) 977-4367Lets get the conversation started.