MIPS Made Easy with TheraOffice. Nick Austin, Director of Product Management
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1 MIPS Made Easy with TheraOffice Nick Austin, Director of Product Management
2 A Tale of Two Webinars Today s Webinar What is MIPS? Do I need to participate? What are the incentives to participating? What options do I have? How do I get started? The Next Webinar Which measures do I need to report on? What improvement activities should I use? How are these measures scored? 1:00 PM CST
3 What is MIPS? In 2015, the Medicare Access and CHIP Reauthorization Act, or MACRA, was passed. Permanently repealed the SGR cut. Started us down a path where all healthcare providers would have two options: Participate in an Advanced Payment Model Participate in the MIPS Program, a consolidation of PQRS, Meaningful Use, and Value Based Modifier. Program started in PTs, OTs, and SLPs are starting the program in 2019.
4 Who has to participate? Exempt Participation Optional Participation Required Participation Speech Language Pathologists. Providers that submit Institutional claims to Medicare. New providers that are enrolling into Medicare for the first time in Providers who participate in an Advanced Payment Model. PTs and OTs that do not meet any of the Determination Period thresholds. PTs and OTs that meet one or two of the Determination Period thresholds. PTs and OTs that meet all three of the Determination Period thresholds.
5 Determination Period For the 2019 Reporting Year, there are two determination periods. 10/1/2017 9/30/ /1/2018 9/30/2019 The thresholds are as follows: Greater than 200 Professional Services (Units) Greater than 200 Distinct Patients Greater than $90, in Allowable Amounts
6 What are the MIPS Incentives? Similar to PQRS Performance Year (Reporting Year) 2 Year Gap Payment Year For participating in the 2019 Performance Year, you will not see any payment until Providers are scored based on their actual performance with each measure Payments are budget neutral How much successful reporters receive is directly related to how many providers unsuccessfully report. except for an Exceptional Performance Bonus that is allotted each year to be paid out despite what is done on the lower end.
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8 The Impact of Budget Neutrality For the 2017 Reporting / 2019 Payment Year, the maximum payment adjustment fell short by about 53%. For the 2019 Reporting / 2021 Payment Year, the maximum incentive / penalty is 7%. Advisory.com: How Much Incentive Do You Get For The Max MIPS Score of 100?
9 Advisory.com: How Much Incentive Do You Get For The Max MIPS Score of 100?
10 Cost The MIPS Categories Promoting Interoperability Quality Improvement Activities
11 Cost Previously known as Value Based Modifier Cost is a program that requires no additional work to be involved in. Based on the CPT codes you submit to Medicare, they will determine how costeffective your treatments are. PTs, OTs, and SLPs will not be participating in the Cost category in The impact of this category will be weighted to zero in your final MIPS score.
12 Promoting Interoperability Previously known as Advancing Care Information or Meaningful Use. Requires the use of a certified EHR for objectives like e-prescribing and patients having access to documentation. When you hear that you need to use a CEHRT (Certified EHR Technology), it is for this category. PTs, OTs, and SLPs will not be participating in the Promoting Interoperability category in The impact of this category will be weighted to zero in your final MIPS score.
13 Quality Previously known as PQRS or PQRI. The Quality category is required and will make up the bulk of your MIPS participation. List of various measures you can participate in to improve the quality of your patient care. These measures are very similar to what you did in PQRS.
14 PT/OT Specialty Set Quality # Measure Title Measure Type 128 Preventative Care and Screening: BMI Screening and Follow-Up Plan Process 130 Documentation of Current Medications in the Medical Record Process 131 Pain Assessment and Follow-Up Process 182 Functional Outcome Assessment Process 217 Functional Status Change for Patients with Knee Impairments Outcome 218 Functional Status Change for Patients with Hip Impairments Outcome 219 Functional Status Change for Patients with Lower Leg, Foot or Ankle Impairments Outcome 220 Functional Status Change for Patients with Low Back Impairments Outcome 221 Functional Status Change for Patients with Shoulder Impairments Outcome 222 Functional Status Change for Patients with Elbow, Wrist or Hand Impairments Outcome 223 Functional Status Change for Patients with General Orthopedic Impairments Outcome *The Next Webinar Will Go Into Detail On All These Measures
15 Improvement Activities New Category for MIPS, no tie to a previous program. The Improvement Activities category is required in 2019, and while carrying a less weight than Quality, is still important to do if you are looking to get the exceptional performance bonus. Least rigid structure of all of the categories. Perform an activity over a 90 day period and then attest to CMS that you performed it.
16 APTA Suggested Improvement Activities Activity Name Promote use of patient-reported outcome tools Use of QCDR for feedback reports that incorporate population health Collection and follow-up on patient experience and satisfaction data on beneficiary engagement Improved practices that disseminate appropriate self-management materials Regular training in care coordination Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms. Use group visits for common chronic conditions (eg. Diabetes) Implementation of fall screening and assessment programs Implementation of practices/processes for developing regular individual care plans Use of tools to assist patient self-management Weight High High High Medium Medium Medium Medium Medium Medium Medium *The Next Webinar Will Go Into Detail On All These Activities
17 Submission Options Three decisions to make: Am I participating? Am I submitting through claims or registry? Am I submitting individually or as a group?
18 Claims vs Registry Claims ONLY available to Small Practices (15 or less providers) Requires that you perform the Quality measures on only Medicare patients. No cost to submitting this way Outcome measures not available Registry Requires that you perform the Quality measures on ALL patients. Requires an annual fee All measures are available
19 Why Should I Use a Registry? Registries will offer quarterly status reports and work with you on ensuring your success in the program. No need to adjust off the charges on claims or audit your own providers for compliance. No surprise payment adjustments years later. CMS is slowly making the full transition to electronic submission. In previous years of PQRS, it was available to anyone. Now, only for small practices. This option could eventually be fully phased out.
20 TheraOffice Registry Happy to announce that we have been approved to be a Qualified Registry for the 2019 reporting year. Additional details will be announced when they become available. If you would like more information on the registry, please respond to the poll in the webinar interface and we will make sure to follow-up with additional details.
21 Individual vs Group Individual Payment Adjustments are made to each individual NPI/TIN combination. Good option for companies that are looking to test the water with MIPS instead of full participation. Group Payment Adjustments are made to the full TIN based on an aggregate score of all NPIs submitted under that TIN. Good option for companies looking for full participation.
22 TheraOffice In addition to becoming a registry, TheraOffice will be releasing the.11 update before the end of the year. This update will include MIPS-specific changes that should make for participation being greatly simplified.
23 MIPS Timeline By December 31 st, 2018 TheraOffice.11 Release TheraOffice Registry Sign-Up January 1 st, 2019 FLR Phases Out Start Collecting Data on Quality Measures April 1 st, 2019 First Status Update from TheraOffice Registry December 31 st, 2019 Reporting Period Ends Q Registry submits data on behalf of clinics for 2019 Reporting Year
24 Questions Thank you for attending today s webinar! If your question is not answered during the Q&A portion, we will be following up with you over the next week. For any additional questions that come up later, please contact our support department. MIPS Measures & Scoring Summary November 20 1:00 PM 2:00 PM CST 2019 Preview & TheraOffice.11 Release November 1:00 PM - 2:00 PM CST TheraOffice Support x2 support@theraoffice.com Keep up with TheraOffice on Twitter, Facebook, & LinkedIn for more updates!
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