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Volume Driven Health Care Value Driven Health Care 2
Over 2,400 pages of the final ruling, released October 14th, 2016 3
2019 2018 2017 2020 Baseline (budget neutral) -4% -5% -7% -9% 4
5 Your data is public
2017 pick your reporting pace year TRACK ONE Report some data (from certain categories) TRACK TWO TRACK THREE Report for a partial year 90 days Full year of reporting athena Clients
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4 MIPS Reporting Categories Quality EHR Use (Advancing Care Information) Care Coordination (Improvement Activities) Cost 10
Quality Measuring the standard of care provided to your patients
6 reported measures 20 case minimum for all measures Quality Measure Quality Measure Each individual measure worth up to 10 points Quality Measure Quality Measure Outcomes Measure High Priority Measure At least one must be an Outcome Measure OR a High Priority Measure 12
6 Selected Measures Points Earned Bonus Points (performance weighted) Dr. Samuel CEHRT Optimal Asthma Control 5.1 1 13 clinician CEHRT practice CEHRT High Priority Childhood Immunization Status Tobacco Use: Screening and Cessation Intervention Breast Cancer Screening Falls: Risk Assessment 9.3 1 61 7.3 8.5 1 Quality points points total subtotal = = 43.2 39.2 (out of possible 60) Use of Imaging Studies for Low Back Pain 3 13
Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy - Avoidance of Inappropriate Use Acute Otitis Externa (AOE): Topical Therapy ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication Adherence to Antipsychotic Medications For Individuals with Schizophrenia Adult Kidney Disease: Blood Pressure Management Adult Kidney Disease: Catheter Use at Initiation of Hemodialysis Adult Kidney Disease: Catheter Use for Greater Than or Equal to 90 Days Adult Kidney Disease: Referral to Hospice Adult Major Depressive Disorder (MDD): Coordination of Care of Patients with Specific Comorbid Conditions Adult Major Depressive Disorder (MDD): Suicide Risk Assessment Adult Primary Rhegmatogenous Retinal Detachment Surgery: No Return to the Operating Room Within 90 Days of Surgery Adult Primary Rhegmatogenous Retinal Detachment Surgery: Visual Acuity Improvement Within 90 Days of Surgery Adult Sinusitis: Antibiotic Prescribed for Acute Sinusitis (Overuse) Adult Sinusitis: Appropriate Choice of Antibiotic: Amoxicillin With or Without Clavulanate Prescribed for Patients with Acute Bacterial Sinusitis (Appropriate Use) Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse) 1 Adult Sinusitis: More than One Computerized Tomography (CT) Scan Within 90 Days for Chronic Sinusitis (Overuse) Age Appropriate Screening Colonoscopy Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement Age-Related Macular Degeneration (AMD): Dilated Macular Examination All-cause Hospital Readmission Amyotrophic Lateral Sclerosis (ALS) Patient Care Preferences Anastomotic Leak Intervention Anesthesiology Smoking Abstinence Annual Hepatitis C Virus (HCV) Screening for Patients who are Active Injection Drug Users Anti-Depressant Medication Management Appropriate Assessment of Retrievable Inferior Vena Cava (IVC) Filters for Removal Appropriate Follow-up Imaging for Incidental Abdominal Lesions Appropriate Follow-up Imaging for Incidental Thyroid Nodules in Patients Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients Appropriate Testing for Children with Pharyngitis Appropriate Treatment for Children with Upper Respiratory Infection (URI) Appropriate Treatment of Methicillin-Sensitive Staphylococcus Aureus (MSSA) Bacteremia Appropriate Workup Prior to Endometrial Ablation Atrial Fibrillation and Atrial Flutter: Chronic Anticoagulation Therapy Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis Barrett's Esophagus Basal Cell Carcinoma (BCC)/Squamous Cell Carcinoma: Biopsy Reporting Time - Pathologist to Clinician Biopsy Follow-Up Bipolar Disorder and Major Depression: Appraisal for alcohol or chemical substance use Breast Cancer Resection Pathology Reporting: pt Category (Primary Tumor) and pn Category (Regional Lymph Nodes) with Histologic Grade Breast Cancer Screening CAHPS for PQRS Clinician/Group Survey Cardiac Rehabilitation Patient Referral from an Outpatient Setting Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Preoperative Evaluation in Low Risk 3Surgery Patients Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Routine Testing After Percutaneous Coronary Intervention (PCI) Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Testing in Asymptomatic, Low-Risk Patients Care Plan Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures Cataracts: Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery Cataracts: Patient Satisfaction within 90 Days Following Cataract Surgery Cataract Surgery: Difference Between Planned and Final Refraction Optimal Asthma Control Ischemic Vascular Disease (IVD) All or None Outcome Measure (Optimal Control) Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet KRAS Gene Mutation Testing Performed for Patients with Metastatic Colorectal Cancer who receive Anti-epidermal Growth Cataract Surgery with Intra-Operative Complications (Unplanned Rupture of Posterior Capsule Requiring Unplanned Vitrectomy) Factor Receptor (EGFR) Monoclonal Antibody Therapy Cervical Cancer Screening Lung Cancer Reporting (Biopsy/Cytology Specimens) Child and Adolescent Major Depressive Disorder (MDD): Cessation Suicide Risk Assessment Intervention Lung Cancer Reporting (Resection Specimens) Childhood Immunization Status Maternal Depression Screening Children Who Have Dental Decay or Cavities Maternity Care: Elective Delivery or Early Induction Without Medical Indication at >= 37 and < 39 Weeks (Overuse) Chlamydia Screening and Follow Up Maternity Care: Post-Partum Follow-Up and Care Coordination Chlamydia Screening for Women Medication Management for People with Asthma Chronic Obstructive Pulmonary Disease (COPD): Long-Acting Inhaled Bronchodilator Therapy Medication Reconciliation Post-Discharge Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation Melanoma: Continuity of Care - Recall System Clinical Outcome Post Endovascular Stroke Treatment Melanoma: Coordination of Care Closing the Referral Loop: Receipt of Specialist Report Melanoma: Overutilization of Imaging Studies in Melanoma Colonoscopy Interval for Patients with a History of Adenomatous Polyps - Avoidance of Inappropriate Use Melanoma Reporting Colorectal Cancer Resection Pathology Reporting: pt Category (Primary Tumor) and pn Category (Regional Lymph Nodes) with Non-Recommended Cervical Cancer Screening in Adolescent Females Histologic Grade Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy Colorectal Cancer Screening Oncology: Medical and Radiation - Pain Intensity Quantified Communication with the Physician or Other Clinician Managing On-going Care Post-Fracture for Men and Women Aged 50 Years and Older Controlling High Blood Pressure Coronary Artery Bypass Graft (CABG): Deep Sternal Wound Infection Rate Coronary Artery Bypass Graft (CABG): Postoperative Renal Failure Coronary Artery Bypass Graft (CABG): Preoperative Beta-Blocker in Patients with Isolated CABG Surgery Coronary Artery Bypass Graft (CABG): Prolonged Intubation Coronary Artery Bypass Graft (CABG): Stroke Coronary Artery Bypass Graft (CABG): Surgical Re-Exploration Coronary Artery Bypass Graft (CABG): Use of Internal Mammary Artery (IMA) in Patients with Isolated CABG Surgery Coronary Artery Disease (CAD): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - Optimizing Patient Exposure to Ionizing Radiation: Count of Potential High Dose Radiation Imaging Studies: Computed Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%) Tomography (CT) and Cardiac Nuclear Medicine Studies Coronary Artery Disease (CAD): Antiplatelet Therapy Optimizing Patient Exposure to Ionizing Radiation: Reporting to a Radiation Dose Index Registry Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction Optimizing Patient Exposure to Ionizing Radiation: Search for Prior Computed Tomography (CT) Studies Through a Secure, (LVEF <40%) Authorized, Media-Free, Shared Archive Dementia: Caregiver Education and Support Optimizing Patient Exposure to Ionizing Radiation: Utilization of a Standardized Nomenclature for Computed Tomography (CT) Dementia: Cognitive Assessment Dementia: Counseling Regarding Safety Concerns Dementia: Functional Status Assessment Dementia: Management of Neuropsychiatric Symptoms Dementia: Neuropsychiatric Symptom Assessment Depression Remission at Six Months Depression Remission at Twelve Months Depression Utilization of the PHQ-9 Tool Diabetes: Eye Exam Diabetes: Foot Exam Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) Diabetes: Medical Attention for Nephropathy Diabetes Mellitus: 14Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention - Evaluation of Footwear Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy Documentation of Current Medications in the Medical Record Documentation of Signed Opioid Treatment Agreement Door to Puncture Time for Endovascular Stroke Treatment Elder Maltreatment Screen and Follow-Up Plan Emergency Medicine: Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 18 Years and Older Emergency Medicine: Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 2 Through 17 Years Epilepsy: Counseling for Women of Childbearing Potential with Epilepsy Evaluation or Interview for Risk of Opioid Misuse Falls: Plan of Care Falls: Risk Assessment Falls: Screening for Future Fall Risk Follow-Up After Hospitalization for Mental Illness (FUH) Functional Outcome Assessment Functional Status Assessment for Total Hip Replacement Functional Status Assessment for Total Knee Replacement Functional Status Assessments for Congestive Heart Failure Functional Status Change for Patients with Elbow, Wrist or Hand Impairments Functional Status Change for Patients with Foot or Ankle Impairments Functional Status Change for Patients with General Orthopaedic Impairments Functional Status Change for Patients with Hip Impairments Functional Status Change for Patients with Knee Impairments Functional Status Change for Patients with Lumbar Impairments Tobacco Use: Screening and 5 Functional Status Change for Patients with Shoulder Impairments Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) Hematology: Chronic Lymphocytic Leukemia (CLL): Baseline Flow Cytometry Hematology: Multiple Myeloma: Treatment with Bisphosphonates Hematology: Myelodysplastic Syndrome (MDS) and Acute Leukemias: Baseline Cytogenetic Testing Performed on Bone Marrow Hematology: Myelodysplastic Syndrome (MDS): Documentation of Iron Stores in Patients Receiving Erythropoietin Therapy Hepatitis C: Discussion and Shared Decision Making Surrounding Treatment Options Hepatitis C: Screening for Hepatocellular Carcinoma (HCC) in Patients with Cirrhosis HER2 Negative or Undocumented Breast Cancer Patients Spared Treatment with HER2-Targeted Therapies HIV/AIDS: Pneumocystis Jiroveci Pneumonia (PCP) Prophylaxis HIV/AIDS: Sexually Transmitted Disease Screening for Chlamydia, Gonorrhea, and Syphilis HIV Medical Visit Frequency HIV Viral Load Suppression HRS-12: Cardiac Tamponade and/or Pericardiocentesis Following Atrial Fibrillation Ablation HRS-3: Implantable Cardioverter-Defibrillator (ICD) Complications Rate HRS-9: Infection within 180 Days of Cardiac Implantable Electronic Device (CIED) Implantation, Replacement, or Revision Hypertension: Improvement in Blood Pressure Image Confirmation of Successful Excision of Image-Localized Breast Lesion Immunizations for Adolescents Inflammatory Bowel Disease (IBD): Assessment of Hepatitis B Virus (HBV) Status Before Initiating Anti-TNF (Tumor Necrosis Factor) Therapy Inflammatory Bowel Disease (IBD): Preventive Care: Corticosteroid Related Iatrogenic Injury - Bone Loss Assessment Initiation and Engagement of Alcohol and Other Drug Dependence Treatment Oncology: Medical and Radiation - Plan of Care for Pain Oncology: Radiation Dose Limits to Normal Tissues One-Time Screening for Hepatitis C Virus (HCV) for Patients at Risk 271 Operative Mortality Stratified by the Five measures STS-EACTS Mortality Categories Opioid Therapy Follow-up Evaluation Optimal Asthma Control Optimizing Patient Exposure to Ionizing Radiation: Appropriateness: Follow-up CT Imaging for Incidentally Detected Pulmonary Nodules According to Recommended Guidelines Optimizing Patient Exposure to Ionizing Radiation: Computed Tomography (CT) Images Available for Patient Follow-up and Comparison Purposes Falls: Risk Assessment Imaging Description Osteoarthritis (OA): Function and Pain Assessment Osteoporosis Management in Women Who Had a Fracture Overuse Of Neuroimaging For Patients With Primary Headache And A Normal Neurological Examination Pain Assessment and Follow-Up Pain Brought Under Control Within 48 Hours Parkinson's Disease: Cognitive Impairment or Dysfunction Assessment Parkinson's Disease: Parkinson's Disease Medical and Surgical Treatment Options Reviewed Parkinson's Disease: Psychiatric Symptoms Assessment for Patients with Parkinson's Disease Parkinson's Disease: Rehabilitative Therapy Options Patient-Centered Surgical Risk Assessment and Communication Patients with Metastatic Colorectal Cancer and KRAS Gene Mutation Spared Treatment with Anti-epidermal Growth Factor Receptor (EGFR) Monoclonal Antibodies Pediatric Kidney Disease: Adequacy of Volume Management Pediatric Kidney Disease: ESRD Patients Receiving Dialysis: Hemoglobin Level < 10 g/dl Pelvic Organ Prolapse: Preoperative Assessment of Occult Stress Urinary Incontinence Pelvic Organ Prolapse: Preoperative Screening for Uterine Malignancy Performing Cystoscopy at the Time of Hysterectomy for Pelvic Organ Prolapse to Detect Lower Urinary Tract Injury Perioperative Anti-platelet Therapy for Patients Undergoing Carotid Endarterectomy Perioperative Care: Selection of Prophylactic Antibiotic - First OR Second Generation Cephalosporin Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients) Perioperative Temperature Management Persistence of Beta-Blocker Treatment After a Heart Attack Photodocumentation of Cecal Intubation Pneumococcal Vaccination Status for Older Adults Post-Anesthetic Transfer of Care Measure: Procedure Room to a Post Anesthesia Care Unit (PACU) Post-Anesthetic Transfer of Care: Use of Checklist or Protocol for Direct Transfer of Care from Procedure Room to Intensive Care Unit (ICU) Pregnant women that had HBsAg testing Preoperative Diagnosis of Breast 2Cancer Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections Prevention of Post-Operative Nausea and Vomiting (PONV) - Combination Therapy Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan Preventive Care and Screening: Influenza Immunization Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care Status Proportion Admitted to Hospice for less than 3 days Proportion Admitted to the Intensive Care Unit (ICU) in the Last 30 Days of Life Proportion Not Admitted To Hospice Proportion of Patients Sustaining a Bladder Injury at the Time of any Pelvic Organ Prolapse Repair Proportion of Patients Sustaining a Bowel Injury at the time of any Pelvic Organ Prolapse Repair Childhood Immunization Proportion of Patients Sustaining a Ureter Injury at the Time of any Pelvic Organ Prolapse Repair Proportion of Patients who Died from Cancer with more than One Emergency Department Visit in the Last 30 Days of Life Proportion Receiving Chemotherapy in the Last 14 Days of Life Prostate Cancer: Adjuvant Hormonal Therapy for High Risk or Very High Risk Prostate Cancer Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients Psoriasis: Clinical Response to Oral Systemic or Biologic Medications Quality of Life Assessment For Patients With Primary Headache Disorders Quantitative Immunohistochemical (IHC) Evaluation of Human Epidermal Growth Factor Receptor 2 Testing (HER2) for Breast Cancer Patients Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques Radical Prostatectomy Pathology Reporting Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy Radiology: Inappropriate Use of Probably Benign" Assessment Category in Screening Mammograms" Radiology: Reminder System for Screening Mammograms 4 Radiology: Stenosis Measurement in Carotid Imaging Reports Rate of Carotid Artery Stenting (CAS) for Asymptomatic Patients, Without Major Complications (Discharged to Home by Post- Operative Day #2) Rate of Carotid Endarterectomy (CEA) for Asymptomatic Patients, without Major Complications (Discharged to Home by Post- Operative Day #2) Rate of Endovascular Aneurysm Repair (EVAR) of Small or Moderate Non-Ruptured Infrarenal Abdominal Aortic Aneurysms (AAA) Who Die While in Hospital Rate of Endovascular Aneurysm Repair (EVAR) of Small or Moderate Non-Ruptured Infrarenal Abdominal Aortic Aneurysms (AAA) without Major Complications (Discharged to Home by Post Operative Day #2) Breast Cancer Screening Rate of Open Repair of Small or Moderate Abdominal Aortic Aneurysms (AAA) Where Patients Are Discharged Alive Rate of Open Repair of Small or Moderate Non-Ruptured Infrarenal Abdominal Aortic Aneurysms (AAA) without Major Complications (Discharged to Home by Post-Operative Day #7) Rate of Postoperative Stroke or Death in Asymptomatic Patients Undergoing Carotid Artery Stenting (CAS) Rate of Postoperative Stroke or Death in Asymptomatic Patients Undergoing Carotid Endarterectomy (CEA) Rate of Surgical Conversion from Lower Extremity Endovascular Revascularization Procedure Referral for Otologic Evaluation for Patients with Acute or Chronic Dizziness Rheumatoid Arthritis (RA): Assessment and Classification of Disease Prognosis Rheumatoid Arthritis (RA): Functional Status Assessment Rheumatoid Arthritis (RA): Glucocorticoid Management Rheumatoid Arthritis (RA): Periodic Assessment of Disease Activity Rheumatoid Arthritis (RA): Tuberculosis Screening Rh Immunoglobulin (Rhogam) for Rh-Negative Pregnant Women at Risk of Fetal Blood Exposure Risk-Adjusted Operative Mortality for Coronary Artery Bypass Graft (CABG) Screening Colonoscopy Adenoma Detection Rate Screening for Osteoporosis for Women Aged 65-85 Years of Age Sentinel Lymph Node Biopsy for Invasive Breast Cancer Sleep Apnea: Assessment of Adherence to Positive Airway Pressure Therapy Sleep Apnea: Assessment of Sleep Symptoms Sleep Apnea: Positive Airway Pressure Therapy Prescribed Sleep Apnea: Severity Assessment at Initial Diagnosis 6 Statin Therapy at Discharge after Lower Extremity Bypass (LEB) Statin Therapy for the Prevention and Treatment of Cardiovascular Disease Stroke and Stroke Rehabilitation: Discharged on Antithrombotic Therapy Stroke and Stroke Rehabilitation: Thrombolytic Therapy Surgical Site Infection (SSI) Tobacco Use and Help with Quitting Among Adolescents Total Knee Replacement: Identification of Implanted Prosthesis in Operative Report Total Knee Replacement: Preoperative Antibiotic Infusion with Proximal Tourniquet Total Knee Replacement: Shared Decision-Making: Trial of Conservative (Non-surgical) Therapy Total Knee Replacement: Venous Thromboembolic and Cardiovascular Risk Evaluation Use of Imaging Studies for Low Back Pain Trastuzumab Received By Patients With AJCC Stage I (T1c) - III And HER2 Positive Breast Cancer Receiving Adjuvant Chemotherapy Tuberculosis (TB) Prevention for Psoriasis, Psoriatic Arthritis and Rheumatoid Arthritis Patients on a Biological Immune Response Modifier Ultrasound Determination of Pregnancy Location for Pregnant Patients with Abdominal Pain Unplanned Hospital Readmission within 30 Days of Principal Procedure Unplanned Reoperation within the 30 Day Postoperative Period Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older Use of High-Risk Medications in the Elderly Use of Imaging Studies for Low Back Pain Varicose Vein Treatment with Saphenous Ablation: Outcome Survey Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
15 Advancing Care Information Measuring the use of secure technology helping to engage your patients
ACI Reporting Dependent upon the certification of your EHR Option 1 Option 2 16 Clinical Data Registry Reporting 15 Clinical Information Reconciliation Measures Electronic Case Reporting e-prescribing Immunization Registry Reporting 5 Patient-Generated Health Data required Patient-Specific Education Provide Patient Access Public Health Registry Reporting Secure Messaging Base Score Security Risk Analysis Send Measured a Summary of with Care a Record Yes/No metric Summary of Care Measure Syndromic Surveillance Reporting 50 total View, Download points and Transmit (VDT) 155 possible total points, capped at 100 Performance Score Measured on a 0 100 scale 90 total points e-prescribing 2017-specific Health Information Exchange 11 Immunization Registry Reporting Measures Medication Reconciliation Patient-Specific Education Provide Patient Access Secure Messaging 4 Security Risk Analysis Specialized required Registry Reporting Syndromic Surveillance Reporting View, Download, or Transmit (VDT) Bonus Score Measured on a 0 or 10 basis 15 total points
Option 2 Dr. Samuel 13 clinician practice Auto 4 Required Base Points measures for base score 50 Health Information Exchange Provide Patient Access Security Risk Analysis e-prescribing Total Performance Base Points 21 17 Auto Base Points 50 7 Optional measures for additional performance score View, Download, or Transmit (VDT) Total Total Performance Performance Base Points Medication Reconciliation Score Points 21 Patient-Specific Education 18 Immunization Registry Reporting Secure Messaging Total ACI points = 94 Syndromic Surveillance Reporting Capped at 100 if higher Specialized Registry Reporting Total Bonus Points 5 Total Performance Score Points 18 Total Bonus Points 5
Historically, our clients perform better 2015 Meaningful Use Stage 2 attestation % of HCPs avoiding PQRS penalties in 2016 NATIONAL AVERAGE ATHENAHEALTH CLIENTS NATIONAL AVERAGE ATHENAHEALTH CLIENTS 53% 97.6% 60% 95.6%
Improvement Activities Measuring and ensuring your proactive management of patient care 19
93 possible activities High Weight Medium Weight 14 Activities 20 points each 79 Activities 10 points each Maximum credit 40 points 20
High Weight Medium Weight Medium Weight Dr. Samuel 13 clinician practice 1 2 Anticoagulant management improvements Use of Patient Safety Tools 3 Regular Training in Care Coordination Total IA points = 40 21
Currently estimating our clients performance in real-time
4,752 employees Specialized teams across the country have your back. 8 locations 5 services 23
24Cost Used to help lower healthcare spending without sacrificing quality
Individual (Medicare spending per beneficiary MSPB) Group (Total per capita costs for all attributed beneficiaries) Specific Conditions (episode-based measures) Auto calculated by CMS in 2017 25
Cost performance category will weigh more in relation to the MIPS final score in subsequent years 2017 2018 2019 0% of total score 10% of total score 30% of total score 26
Calculating a MIPS Final Score Quality points = 43.2 60% ACI points = 94 IA points 25% 15% = 40 27
MIPS Final Score Quality 43.2 ACI 81.7 23.5 IA 15 28
Industry change is a constant MIPS CPC+ MU3 PCMH PCSP HEDIS measures Bundled Payments 29
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VISION: To build an information backbone that helps healthcare work as it should. 99K+ providers 9,910 lab and imaging endpoints 13% of Americans seen by athenahealth providers last year 140 MDP partners contracted 2.8M 317K MDs served on Epocrates 150K total network endpoints covered lives
With an integrated suite of services athenaone athena Collector athena Communicator athena Clinicals athena Coordinator Population Health Epocrates Revenue cycle management Patient engagement Medical record management Network connectivity Care coordination and risk management Medical reference
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