Thursday May 23 2019-Books Pdf

Thursday May 23 2019
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Improvement Activities performance category and then we will close our. webinar with some more information about resources technical assistance. that s available and then we will open it up to respond to some Q A through. the chat Next slide please, All right As a refresher for those on the line who have participated over. the last two years of the program or for any of those who are newly. eligible what you re seeing on the screen is the general structure of the. Quality Payment Program and you ll see this graphic throughout a lot of our. materials our fact sheets and different guides So we like to just remind. people about the structure of the program We are required under the. Medicare Access and CHIP Reauthorization Act of 2015 to implement the. Quality Payment Program which consists of the two tracks you re seeing on. the screen the Merit based Incentive Payment System known as MIPS or. the Advanced Alternative Payment Models for clinicians who are interested in. earning additional incentives for taking on additional risk related to. patient outcome So now our focus today is really on the MIPS track of the. program So on the next slide we re going to take a few minutes to review. just some high level elements about MIPS specifically And again if you re. interested in learning more about other aspects of the program or the. Advanced APM side of the program please check out our QPP Resource Library. for additional material or some more webinars we have in our Webinar. Library Next slide please Great Thanks, So as we have displayed on the screen MIPS is comprised of four. performance categories For those who are newly eligible to the program or. you re participating for the first time those performance categories are. Quality Cost Promoting Interoperability and as we re talking about today. Improvement Activities So Quality Cost and Promoting Interoperability. performance categories are similar to some of the previous legacy programs. You may have noticed some of those similarities in these different. categories So when we launched the Quality Payment Program in 2017 the. Improvement Activities category was a really new focus so one that we want. to make sure everyone is really comfortable with today and you know all you. can about that performance category and participate fully. So additionally all four performance categories add up to 100 final. points We will assign a final score for each MIPS eligible clinician and. that final score can range from zero to 100 points What we then do is. compare your final score to what we call a performance threshold which is. essentially the minimum amount of points a clinician must receive in order. to avoid a negative payment adjustment So comparing the final score to the. performance threshold will determine if a clinician receives a positive and. negative or a neutral payment adjustment in 2021 So everything we do in. the 2019 performance year will be reflected in our 2021 payment adjustment. So just so you re all tracking The performance threshold for 2019. performance is 30 points So you must receive at least 30 points in order. to avoid a negative payment adjustment in 2019 So again reflective in. that 2021 payment adjustment Next slide please Great Thanks. So we often get the question how does CMS determine if I m included in. MIPS for the 2019 performance year So first we start by identifying if. you re a MIPS eligible clinician So for 2019 MIPS eligible clinicians. include all the ones you see listed on the screen So physicians physician. assistants nurse practitioners clinical nurse specialists certified. registered nurse anesthetists clinical psychologists physical therapists. occupational therapists audiologists speech language pathologists. registered dieticians or nutrition professionals and then groups that. include these different clinician types So I just want to flag So a. lot of Several of the clinician types that you ll see on the screen on. the right hand side are new clinician types for 2019 So just wanted to. point out that we have several new resources available on the QPP Resource. Library that is really geared to these new clinicians to help them figure. out what measures or improvement activities they might want to select that. are specific to how they practice So you ll see a number of our If you. use the filter on the Resource Library you ll be able to select Specialty. Guides and then the different guides will show up for these different. clinician types So I encourage everybody to go check that out and it will. list the measures that really apply to those clinician types as well as the. improvement activities that are most applicable to those specialties. And just as a quick reminder the definition of physician includes doctors. of medicine doctors of osteopathy so including osteopathic practitioners. doctors of dental surgery and doctors of dental medicine doctors of. pediatric medicine doctors of optometry and chiropractors with respect to. certain specified treatment So a doctor of chiropractic is legally. authorized to practice by state in which he or she performs that function. Just a little more background When we say physicians those are the types. of clinicians we are referring to Next slide please Great. So we then look to see if you exceed all three elements of the low volume. threshold criteria during a specific determination period So we look to. see if you bill more than 90 000 a year in allowed charges for covered. professional services under the Medicare Physician Fee Schedule or PFS and. furnish covered professional services to more than 200 Medicare. beneficiaries and then the third element of the low volume threshold is. that you provide more than 200 covered professional services under the PFS. So you re included in MIPS and required to participate by submitting. performance data So if you meet all three of these you are If you. exceed all three of them during a specific determination period then you. are required to participate If you do not meet the criteria that s listed. on the screen here and again we ll have these slides available You. don t have to furiously write down all of these different criteria and we. also have them in a lot of our materials on the Resource Library If you do. not meet the criteria listed here then you are excluded which means you. are not required to participate in the program, Then there are a couple of options for 2019 for those who are excluded. including not participating So you re not required to participate You. could opt in or you can voluntarily participate And we have some really. good resources I don t want to go into too much detail on those because I. know people probably have some questions but we have some materials on our. Resource Library that will explain each of those in greater detail Next. slide please Thanks, So finally this is just a quick diagram to illustrate the timeline for. MIPS So as you can see we re currently in the middle of the 2019. performance year So you should be collecting data So first figure out. if you re eligible for the program and if you are or you choose to. participate and you want to opt in or voluntarily participate you should be. collecting data across the performance categories So I also want to. encourage everyone if you participated in 2018 go ahead and sign in at. qpp cms gov and right now you can already review your preliminary. performance feedback from 2018 So if you ve submitted data want to know. how you did last year figure out if you should do the same thing or try. something different in 2019 your performance feedback is available to. preview right now So you can go ahead and check that out but just note. that our final feedback will be available this summer So with that I am. going to go ahead and turn it over to Angela Foster who s going to take us. into more detail specifically about Improvement Activities. Thanks Kati Hello everyone Thanks for joining today I m Angela Foster. I lead the Improvement Activities program here for CMS I want to thank you. again for taking the time to listen to our presentation to learn more about. the Year 3 policies for Improvement Activities and on behalf of the. Improvement Activities team I would just like to say that we re really. proud of the work we ve completed to develop a meaningful program that. allows eligible clinicians to report on improvement activities that are most. relevant and meaningful to their practices So let s go ahead and dive. right in Next slide please, Here is a little snapshot of what Improvement Activities looks like in 2019.
as far as what percentage it s worth for your total MIPS score You may be. pleased to learn that we have not made substantial changes to the policies. for this performance category for Year 3 As you can see here Improvement. Activities is still worth 15 of the MIPS final score in 2019 Next slide. Improvement Activities continues to assess participation and activities that. improve clinical practice The minimum performance period is still a. consecutive 90 days and can include any 90 day period within the calendar. year January 1 2019 to December 31 2019 and each activity can be. reported only once during the 12 month performance period unless otherwise. specified within the improvement activity description Next slide please. Clinicians can participate in an APM or choose from 118 activities under the. remaining eight subcategories It is not necessary to pick activities from. each of the subcategories or to choose a set number from a certain number of. categories Also we do not mandate the activities you need to perform Our. hope is that this will make it easier for you to choose activities that are. relevant and meaningful to your practice as I mentioned previously And. here you can just see a listing of the subcategories and their titles Next. slide please, While we didn t make a lot of changes to the policies the most significant. changes we did make for 2019 were made to the improvement activities. inventory For Year 3 we ve added six new improvement activities within the. Achieving Health Equity Beneficiary Engagement Integrating Behavioral and. Mental Health Care Coordination and Patient Safety and Practice Assessment. subcategories and you can see those improvement activity titles here with. their activity IDs for your reference You would be able to look those up on. the QPP site to get a more detailed description for each one Next slide. We also made some modifications to five existing improvement activities for. the 2019 inventory and they re listed here again with their improvement. activity titles and IDs During our analysis of the IA inventory we also. found it necessary to remove one Population Management improvement activity. because it was duplicative of another improvement activity within that. subcategory and those improvement activity IDs are referenced here for you. as well Next slide please, Now let s take a look at reporting requirements Next slide Again no big. surprises to those of you already familiar with the Improvement Activities. performance category We are in Year 3 so a lot of you are probably pretty. familiar with how it works but for those of you who are not familiar I ll. just go over this very quickly The improvement activities are weighted as. either medium or high Medium weight activities are worth 10 points while. high weighted activities are worth 20 points You will receive double points. for each high or medium weighted activity submitted if you have any of. these special status designations That would be a small practice non. patient facing rural or underserved practices So just to be clear I ll. explain how this works Double points means each medium weight activity. would be worth 20 points and each high weighted activity would be worth 40. points for those who have been determined to meet that special status. designation Next slide please, Here we go into a little more detail on how this looks for special status. versus non special status MIPS eligible clinicians will have fewer. reporting requirements for Improvement Activities if they qualify for one of. these special statuses that I just mentioned So if you re in a small. practice which would be a TIN consisting of 15 or fewer eligible clinicians. during the MIPS determination period or if you re in a practice located in. rural areas or in health professional shortage areas if you re a non. patient facing clinician if you participate in an APM or MIPS APM and if. you re in a practice that is certified or recognized patient centered. medical home or comparable specialty practice Technically that s not. really considered a special status but you would be able to qualify for. credit in the Improvement Activities category When reporting as a group. I just want to note this for you or virtual group your small practice. non patient facing rural or HPSA designations must be granted at the group. or virtual group level to qualify for the reduced reporting requirements. that I just described Specifically more than 75 of the National Provider. Identifiers or NPIs billing under your group s tax identification number. or virtual group TIN must be designated as either non patient facing rural. or located in a geographic HPSA Non patient facing determinations are made. using claims and Medicare PECOS data analyzed during the two segment. registered dieticians or nutrition professionals and then groups that include these different clinician types So I just want to flag So a lot of Several of the clinician types that you ll see on the screen on the right hand side are new clinician types for 2019 So just wanted to

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