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AMA Introduces MACRA Tools – MACRA Monday

Posted on October 10, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

The American Medical Association has released a package of online tools designed to help physicians cope with major changes to Medicare rolling out next year under MACRA. While it’s likely that practices will still have plenty of challenges to address on their own, these tools seem like they may offer a leg up on the subject, particularly for smaller practices with less resources to throw at MACRA issues.

One of the tools being introduced is the AMA Payment Model Evaluator (Sadly an account is required, but there’s an option to create a new account), designed to help doctors determine how their practices will be impacted by MACRA. The Evaluator, which was developed in partnership with physicians and AMA partners, asks physicians and medical practice administrators to fill out an online questionnaire on their practice. The Evaluator then offers an assessment of their specific situation, along with educational material and other resources. This includes recommendations on which MACRA payment model is best for them, which can help your practice know the best direction for your specific needs.

The AMA has also added new MACRA-specific tools to its AMA Steps Forward collection of practice improvement strategies. The STEPS modules help physicians determine how to report on quality metrics central to MACRA as well as the Physician Quality Reporting System. The STEPS modules each focus on a specific issue and offer solutions, steps for implementation, case studies, CME opportunities and downloadable additional tools.

In addition, the physician group has launched a podcast series, Inside Medicare’s New Payment System, featuring acting CMS administrator Andy Slavitt, AMA staff experts and other healthcare leaders. The series, which will include five episodes, should help get physicians up to speed on MACRA-related changes. I for one am eager to hear what Slavitt has to say about MACRA, as he is about the best source on the subject you could have.

At first glance, it doesn’t seem that the AMA plans to spend a lot of time on the Advancing Care Information subset of MIPS, better known as the replacement for the Meaningful Use program. I guess that’s not a huge surprise, given that physicians are still grappling with broad implications of MACRA which go well beyond HIT issues. However, given how important Meaningful Use has been to physicians over the past few years, one might expect it to get a little bit of special attention. Maybe they’re waiting for the MACRA final rule to come out.

With CMS casting a wider net and looking for more from medical practices than just adequate levels of EMR adoption, the AMA is probably following CMS’ path in talking about more than just the meaningful use (Advancing Care Information) portion of MACRA.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

Overview of the Advancing Care Information Category in MIPS – MACRA Monday

Posted on October 3, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

In our last edition of MACRA Monday we covered 3 of the 4 categories that are part of MIPS: Quality Performance, Resource Use (Cost), and the new Clinical Practice Improvement Activities Category. This week we’ll be covering the details of the 4th category known as Advancing Care Information.

The Advancing Care Information category is probably one you’ve heard about since it’s the replacement for the well known meaningful use program. One change that will be available in the Advancing Care Information category that wasn’t available in meaningful use is that you may participate as an individual or as a group. It’s also worth noting that the Advancing Care Information category makes up 25% of the total MIPS composite score.

One thing that can be a little confusing about MIPS is that the Advancing Care Information category has a score within a score. Advancing Care Information makes up 25% of the MACRA score, but in order to calculate how much of the 25% you’ll receive you have to figure out how many points you receive in the Advancing Care Information category. This chart illustrates how the points will be calculated:
advancing-care-information-scoring-for-macra
As you can see from this chart, your base score, performance score, and any bonus points will be used to calculate whether you receive the full 25% for your MIPS composite score or not.

The base score requires that you report your participation in the following items:

  • Protecting PHI
  • ePrescribing
  • Patient Access
  • Patient Engagement
  • HIE
  • Public Health and Clinical Data Registry Reporting

The good thing about the base score is that you’ll receive full credit for each item if you submit the reports for each item. There’s no threshhold required.

The performance score focuses on the following areas:

  • Patient Electronic Access
  • Coordination of Care through Patient Engagement
  • HIE

Unlike the base score, the performance score will need to achieve certain performance in order to receive points. You’ll also notice that these three areas indicate CMS’ efforts to focus on patient access and health data exchange.

A few other high level things to note for the Advancing Care Information category. First, they’ve removed the “All or Nothing” approach that existed in the EHR (Meaningful Use) program. Second, they’ve removed redundant measures to try and streamline the program. Third, they’ve eliminated CPOE and CDS objectives. Finally, they’ve reduced the number of required public health registries.

As you can see from the list above, this will not be that different than meaningful use. So, if you’ve been participating in meaningful use, then advancing care information won’t be a huge obstacle. If you haven’t been participating in meaningful use, well then you have some work to do.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

Details for 3 MIPS Performance Categories – MACRA Monday

Posted on September 19, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Last week we got a bit side tracked on MACRA Monday as we covered the news about modifications to the MACRA timeline. That seems to be a welcome change. As we mentioned at the end of our post on the MIPS performance categories and MIPS composite score, now we’re going to start diving into the details of those performance categories starting with: Quality Performance, Resource Use (Cost), and the new Clinical Practice Improvement Activities Category.

Quality Performance Category
This category is a replacement for PQRS, but is a reduction from 9 to only 6 measures. Plus, there is no longer a domain requirement. MIPS also expands the program to include close to 300 measures. To combat this explosion of options, they’ll also be offering specialty specific measure sets so that each specialty can more easily identify the measures that might be best for their specialty.

The Quality Performance category makes up 50% of the MIPS composite score.

Resource Use (Cost) Category
The resource use category is also often called the cost category and is a replacement of the value based modifier. The great part of the resource use category is that there is no data submission required to report your work in this category. Instead, this MIPS category will be calculated based on your Medicare claims. MACRA will add 40+ episodic specific measures so providers have more options to participate in this category.

The Resource Use (Cost) category makes up 10% of the MIPS composite score.

Clinical Practice Improvement Activities Category
The CPIA (Clinical Practice Improvement Activies) category that is the new category created as part of MACRA. It will include 90+ activities to choose from and you must participate in a minimum of one activity. Small practices (ie. 15 or fewer professionals) can participate in 2 activities and receive full credit for CPIA. Practices participating as a Patient Centered Medical Home (PCMH) also receive full credit for this category. Participation in an APM gives you 50% credit.

The Clinical Practice Improvement Activities category makes up 15% of the MIPS Composite Score.

That’s the general overview for these three MIPS performance categories. We’ll cover the Advancing Care Information category next week since it’s a bit more complicated.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.