Meaningful Use is not dead!
MIPS may be just around the corner, but MU is still very much in the picture. There is enough time, however, for your practice to optimize 2016 reporting and increase 2018 payments and avoid penalties.
This presentation takes you through the steps needed to successfully attest for 2016 and be prepared for upcoming changes.
3. We will be covering the following
information today …
2016 Programs and how they will impact 2018 payments
• Medicare EHR Incentive Program: Meaningful Use
• PQRS (Physician Quality Reporting System)
• VBM (Physician Value-based Payment Modifier)
Key Points for 2016 MU Reporting
• Reporting Periods – Returning Participants / New Participants
• 2016 MU Objective Measures
• 2016 Clinical Quality Measures
• Attestation Timeframe to Avoid 2018 Penalty
What you should be doing now to prepare for a successful attestation
What’s next?
4. Penalties
• 2016 Reporting affects your 2018 Medicare FFS payments.
• The last year to begin participation and receive an incentive
payment for MU was 2014. For the Medicaid program, 2016
is the last year to begin and receive incentive payments.
• Negative payment adjustments for those who do not
demonstrate MU of EHR began in 2015, unless a
hardship exemption was filed and accepted.
5. Potential 2018 Penalties
Meaningful Use:
- The 1st negative payment adjustment began in 2015
by 1% and has increased each year by 1%.
• If you never participated in MU you are looking
at a -4% payment adjustment in 2018.
Physician Quality Reporting System: 2%
Value-based Program Modifier Program:
Depending on practice size, 2% - 4%
Potential Total Penalty: 10%
6. Reporting Periods
• The EHR reporting period for all providers is based on
a calendar year.
• In 2016, the reporting period is as follows:
- Returning participants: full calendar year
- First-time participants: minimum of 90 continuous
days
While CMS has proposed offering additional flexibility for all EP, not just those
reporting for first time, this ruling has not yet been approved. It is
recommended that EPs not in their first reporting year be prepared to provide
the full year of reporting.
7. MU 2016 – 10 Objectives
1. Protect Patient Health Information – Yes / No
2. Clinical Decision Support – Yes / No / Exclusion
• Measure 1: Implement 5 CDSR related to 4 or more CQM.
• Measure 2: Enable and implement functionality for drug-drug and drug-
allergy interaction checks.
3. Computerized Provider Order Entry (CPOE) – Numerator / Denominator
• Measure 1: More than 60% of medication orders created by the EP
during the reporting period are recorded using computerized provider
entry.
• Measure 2: More than 30% of laboratory orders created
by the EP during the reporting period are recorded using
computerized provider entry.
• Measure 3: More that 30% of radiology orders created
by the EP during the reporting period are recorded using
computerized provider entry.
8. 4. Electronic Prescribing (eRX) – Numerator / Denominator / Exclusion
More than 50% of all permissible prescriptions written by the EP are
queried for a drug formulary and transmitted electronically.
5. Health Information Exchange - Numerator / Denominator / Exclusion
The EP that transitions or refers their patient to another setting of care
or provider o care must create a SOC record and transmit the summary
to a receiving provider electronically for more than 10% of transitions of
care and referrals.
6. Patient Specific Education – Numerator/Denominator/Exclusion
Patient Specific education is provided to more than 10% of
all patients seen during the reporting period.
MU 2016 – 10 Objectives (cont.)
9. 7. Medication Reconciliation - Numerator / Denominator
• Medication reconciliation for more than 50% of transitions of care in
which the patient is transitioned into the care of the EP
8. Patient Electronic Access (VDT) - Numerator / Denominator / Exclusion
• Measure 1: More than 50% of all unique patients seen during the
reporting period are provided timely access to view online, download,
and transmit to third party their health information.
• Measure 2: At least 1 patient views, downloads or transmits
their health information.
9. Secure Messaging – Yes / No / Exclusion
• At least 1 patient sends or responds to a secure
message electronically via a patient portal.
10. Public Health Reporting – Yes / No / Exclusion
• Measure 1: Immunization Registry Reporting
• Measure 2: Syndromic Surveillance Reporting
• Measure 3: Specialized Registry Reporting
MU 2016 – 10 Objectives (cont.)
10. MU 2016 – Clinical Quality Measures
You must select 9 measures that cover at least 3 of the 6 domains
Patient and Family Engagement
Patient Safety
Population / Public Health
Efficient Use of Healthcare Resources
Clinical Process / Effectiveness
Care Coordination
There are no thresholds for CQMs, so you can
report “0” on these measures
11. Attestation Deadline
Returning and New Participants who successfully
demonstrate Meaningful Use for this CY 2016 and
satisfy all other program requirements will avoid
the payment adjustment in CY 2018 if the EP
successfully attests by February 28, 2017.
12. Don’t wait until the last minute to prepare
What you do now can prepare you for a successful attestation.
1. Confirm your provider’s stage: Returning participant or First time participant
2. Check your provider’s registration status
• NPPES login information
• Verify email address
• Verify payment information is correct
• Identity and Access management
• Does each provider have a surrogate user and is the login information up
to date?
3. Verify your EHR vendor is certified and your software meets the certification
requirements for 2016.
4. Verify Reporting tools are in place and working properly.
• If you have not already done so, get benchmark reporting as soon as
possible.
5. Complete your Meaningful use audit binder to ensure your data and
screenshots reflect your reporting period.
13. What’s Next???
Meaningful Use is NOT dead!
MIPS: Merit-Based Incentive Payment System
MACRA: Medicare Access and CHIP Reauthorization Act
Beginning in 2017 providers will be annually measured in 4
performance categories:
• Meaningful Use (proposed rename: “Advancing Care
Information”)
• Value Based Modifier for Cost
• PQRS and Value Base Modifier for Quality
• Clinical Practice Improvement
These programs make up 85% of the MIPS score.
14. Improve on these programs NOW
IS YOUR PRACTICE
HEADING IN THE
RIGHT DIRECTION?????
In order to potentially increase your net revenue now and help prepare yourself
and your practice to become “MIPS/MACRA ready”, you should:
• Report data on quality measures through the Physician Quality Reporting
System.
• Know your Quality and Resource Use Report
• Use your electronic health record (EHR) and attest to Meaningful use
• If your practice doesn’t provide chronic care management (CCM) services,
consider starting now.
15. The Future of MU
• Meaningful Use IS expected to change again under
MACRA/MIPS, but it is not going away.
• The pending changes will affect the Medicare MU
program but not necessarily the Medicaid MU program
currently scheduled to end in 2021.
16. State of the Practice Review
• Complimentary
• 30 Minutes to Run
• Available for any EHR/PM System
17. State of the Practice Report
• Top 20 Payers
• Denial Rate
• A/R Aging
• Bill Lag Time
• Charge Entry Lag Time
• Unapplied Credits
• Active Contracts
• BBP Jobs List
• Average Appointment per Day
by Provider
The State of the Practice Report captures information in these areas
• First Third Appointment by Resource
• Meaningful Use Attestation
• CQM/PQRS by Provider
• CCM Coding
• Users with Old/Unresolved Tasks
• All Templates by Usage
• All KBM Templates in Use During the
Last 2 Months
• Open Referrals
• MIPS Bonus/Penalty
• Unspecified ICD-10 Codes in Use