Download Read the most recent presentation slides

Let’s Leverage the Work you did on
Healthy Hearts Northwest for MACRA
April 26, 2017
Jeff Hummel, MD, MPH
Qualis Health
1
This project is supported by grant number R18HS023908 from the Agency for Healthcare Research & Quality
Maximize Your Webinar Experience
1. If you have any trouble
connecting or hearing us, see
your invitation for troubleshooting
instructions. We are recording all
webinars, and you can find them
at: http://healthyheartsnw.org/events/
2. Aside from presenters, all
participants are muted, please
use the Chat feature to ask
questions. Direct your chat to “All
Participants”
3. We’ll be asking for your feedback
in a two question survey once the
webinar is finished. That’s also
another chance to ask us
questions if you would like.
2
Goals
• Is MACRA something I need to
pay attention to?
• How do the quality metrics from
H2N relate to MIPS Quality
Measures?
• How does the work we are doing
for H2N relate to the Clinical
Practice Improvement Activities
for MACRA?
• How can we use this first year of
MACRA to best prepare ourselves
for the future?
• So, what’s your plan?
3
Overview of the Quality Payment Program
Qualifying participants develop
incentives for better care, smarter
spending and healthier people
© Qualis Health, 2017
Consolidates PQRS/Value-Based
Payment Modifier/EHR
Incentive into a single program
4
Do I need to pay attention to MACRA?
Yes!
• > 100 Medicare Part B Patients (office visit) AND
billed Medicare > $30,000 for Part B
• Similar QPP programs for FQHCs, RHCs, IHS
are being developed that are aligned with
MACRA
• Alternative Payment Model programs require
managing the same quality metrics
© Qualis Health, 2017
5
Maybe I’m Exempt from all this
• Clinicians new to Medicare are exempt for
their first year
• Clinicians in Rural Health Clinics and
FQHCs are exempt for now, unless they
meet the visit and billing eligibility criteria
individually
• CMS is sending out letters to all Tax ID
Numbers informing practice manager
about the of exemption status of individual
clinicians
© Qualis Health, 2017
6
6 Quality Measures Required for MIPS
5 can be directly mapped from the H2N work
•
•
•
•
•
Statin therapy for preventing CVD
Tobacco screening & cessation
Controlling high blood pressure
Use of ASA for ischemic vascular disease
All or none ischemic vascular disease control
5 more can be readily adapted from H2N work
•
•
•
•
•
Tobacco Use: help quitting among adolescents
Screening for HTN and documented f/u
Improvement in blood pressure
Documentation of medications in EHR
Anti-platelet therapy for coronary artery disease
© Qualis Health, 2017
7
Improvement Activities
• 8 major categories of activities
•
•
•
•
•
•
•
•
Health equity
Patient engagement
Behavioral health
Care coordination
Increased access to care
Emergency response and preparedness
Patient safety
Population management
• Leverage anything you’re passionate about –
reporting is based on attestation
© Qualis Health, 2017
8
4 Improvement Activities Required (2 if
rural zip, < 15 providers, or HPSA)
16 to choose from that can be met directly with H2N work
•
•
•
•
•
•
•
•
•
•
•
•
•
Use evidence-based decision aids to support shared decision-making
Use of decision support and standardized treatment protocols
Tobacco use: Groups and integrated prevention & treatment interventions
Leadership engagement in regular guidance for practice improvement
Integration of patient coaching practices between visits
Improved practices that engage patients pre-visit
Improved practices that disseminate appropriate self-management materials
Implementation of formal QI methods for practice improvement
Implementation of chronic disease self-management support programs
Engagement with QIN-QIO to implement self-management training programs
RHC, HIS, FQHC QI activities
Regular review of practices in place on target population needs
The list goes on….
© Qualis Health, 2017
9
Advancing Care Information
•
Submit 4 or 5 base score measures
depending Certification (2014 or 2015)
•
•
•
•
•
•
Security Risk Analysis
ePrescribing
Patient Access
Send Summary of Care
Request/Accept Summary of Care
Bonus credit for
•
•
Reporting to Public Health
Using EHR for Improvement Activities
© Qualis Health, 2017
10
Options for MIPS Participation in 2017
• Put your head in the sand and regret it later
– not recommended
• Submit anything – 1 quality measure, 1
improvement activity, or Advancing Care
Information Measure – penalty avoided
• Submit 90 days of data in 2017 – may get a
positive adjustment and prepare for future
• Submit full year of data – may get a positive
adjustment and maximize preparation for
future
11
So, what do we do?
• Go to: https://qpp.cms.gov and see for yourself
• Talk to your H2N practice coach about
leveraging your H2N work in preparation for
MIPS
• Pick the “no brainer” H2N Quality measures you
already have
• Supplement those with quality measures easily
adapted from H2N
• Pick from Clinical Practice Improvement
Activities from the list that reflect things you’re
already doing or really care about
© Qualis Health, 2017
12
It might look something like this
5 can be directly mapped from H2N data
•
•
•
•
•
Statin therapy for preventing CVD
Tobacco screening & cessation P
Controlling high blood pressure P
Use of ASA for ischemic vascular disease P
All or none ischemic vascular disease control
5 more can be readily adapted from H2N work
•
•
•
•
•
Tobacco Use: help quitting among adolescents P
Screening for HTN and documented f/u P
Improvement in blood pressure
Documentation of medications in EHR
Anti-platelet therapy for coronary artery disease P
© Qualis Health, 2017
13
Pick things you’re already doing
16 to choose from that can be met directly with H2N work
•
•
•
•
•
•
•
•
•
•
•
•
Use evidence-based decision aids to support shared decision-making
Use of decision support and standardized treatment protocols
Tobacco use: Groups and integrated prevention & treatment interventions P
Leadership engagement in regular guidance for practice improvement
Integration of patient coaching practices between visits
Improved practices that engage patients pre-visit
Improved practices that disseminate appropriate self-management materials
Implementation of formal QI methods for practice improvement P
Implementation of chronic disease self-management support programs P
Engagement with QIN-QIO to implement self-management training programs
RHC, HIS, FQHC QI activities
Regular review of practices in place on target population needs P
The list goes on….
© Qualis Health, 2017
14
And Then…?
Develop a plan to submit full year data for
2017, so you get the most out of this year of
limited risk
• Quality metrics
• Clinical practice improvement activities
• Advancing care information
Ask your coach to connect you to the
regional source for technical assistance that
is right for your organization
© Qualis Health, 2017
15
The Big Picture: Quality Payment Programs
• It is a move away from reimbursement that
rewards only volume, and toward a system
that rewards for quality and value
• MACRA/MIPS is the first step for groups that
are not part of a A-AMP
• MIPS is a little like quicksand, i.e. you don’t
want to stand there for too long
• The long term strategy is to join an A-AMP,
but the skills needed be an asset to an AAMP are the skills needed to survive with
MIPS
16
Technical Assistance for QPP
© Qualis Health, 2017
17
Learn More
Resources available at:
https://qpp.cms.gov
Jeff Hummel, MD, MPH
e-mail: [email protected]
© Qualis Health, 2017
18