QUALITY PAYMENT PROGRAM SMALL UNDERSERVED RURAL SUPPORT (QPP SURS) WEBINARMARCH 19, 3:30 PM ET AND MARCH 21, 11:00 AM ET

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MIPS QUESTION AND ANSWER TOWN HALL EVENT FOR SOLO AND SMALL GROUP PRACTICES

MIPS QUESTION AND ANSWER TOWN HALL EVENT

HOUSEKEEPING ANNOUNCEMENTS▸

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If you are listening to this webinar through your phone, please remember to mute your computer speakers.

You can download the slides from the file pod on your screen.

For assistance, enter your issue in the chat box.

To ask a question, enter your inquiry in the chat box.

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MIPS QUESTION AND ANSWER TOWN HALL EVENT

POLLING QUESTIONWhat is your role?▸

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A clinician working in a practice with 15 or fewer clinicians

Non clinical staff from a practice with 15 or fewer clinicians

A clinician working in a practice with more than 15 clinicians

Non clinical staff in a practice with more than 15 clinicians

Quality Payment Program (QPP) contractor

Other person helping practices prepare for MIPS

Other

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MIPS QUESTION AND ANSWER TOWN HALL EVENT

POLLING QUESTIONWhat MIPS-related topics do you have the most questions about?

▸MIPS eligibility

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Data submission and Performance Thresholds

Quality measures

Improvement activities

Promoting Interoperability (PI)

Cost

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MIPS QUESTION AND ANSWER TOWN HALL EVENT

POLLING QUESTIONWhat are your biggest challenges or concerns with receiving a positive MIPS score?

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MIPS QUESTION AND ANSWER TOWN HALL EVENT

CMS WELCOME6

MIPS QUESTION AND ANSWER TOWN HALL EVENT 7

Bruce Spurlock, MDPresident & CEO,Cynosure Health

Donna Cohen, Deputy Director Population Health

QIN-QIO, Alliant Health Solutions

Temaka S. Williams, MPH, MBA

Senior Health Information Technology Advisor

Telligen

Robert Mencunas, Senior Program Coordinator, Healthcentric Advisors

MIPS QUESTION AND ANSWER TOWN HALL EVENT

SETTING THE STAGE▸

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Answer frequently asked questions from small group practices that will help them succeed in MIPS.

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Questions submitted by you when registering for this event

Questions we have received on prior webinars

Questions you submit during the event in the chat box

Focus is on what works best for small group practicesAnswers in three forms:▸

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Oral responses from panelists

Responses from Technical Assistance Organizations (TAOSs) and panelists through the chat box

Follow-up responses from TAOs that provide free support

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MIPS 101

FIND YOUR LOCAL TECHNICAL ASSISTANCE ORGANIZATION FOR FREE ASSISTANCE

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Location of Practice Technical Assistance Organization

Contact Information

FL, GA, NC, SC, Alliant GMCF QPPSURS@alliantquality.orgIL, IN, KY, MI, MN, OH, WI Altarum qppinfo@altarum.orgCT, MA, ME, NH, RI, VT Healthcentric Advisors NEQPPSURS@healthcentricadvisors.orgAZ, CA, HI, NM, VI HSAG HSAGQPPSupport@hsag.comDC, MD, NY, VA IPRO ny-qppsupport@atlanticquality.orgAK, MT, NV, OR, UT, WY NRHI qpp@healthinsight.orgAL, TN QSource techassist@qsource.orgID, WA Qualis Health QPP-SURS@qualishealth.orgDE, NJ, PA, WV Quality Insights qpp-surs@qualityinsights.orgIA, NE, ND, SD Telligen qpp-surs@telligen.comAR, CO, KS, LA, MO, MS, OK, PR, TX

TMF QPP-SURS@tmf.org

EVENT STRUCTURE:▸ Questions organized into six general categories:▸

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Eligibility and Reporting Options

Data submission and Performance Thresholds

Quality measures

Improvement activities

Promoting Interoperability

Cost

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Begin with questions received in advance

Respond to questions participants enter in chat box

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MIPS QUESTION AND ANSWER TOWN HALL EVENT

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I am a clinician associated with 2 practices. Do I need to submit MIPS data for each practice?

We are a Podiatrist office with six providers, and we did not participate in MIPS in 2017. In 2018, two of our providers are eligible to participate. Would the 2018 performance year be our year 1 even though MIPS is in its second year?

What happens if we add a physician after July 2019? Does that physician need to participate?

If we have not participated before can we still submit partial year data?

ELIGIBILITY AND REPORTING OPTIONS QUESTIONS

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MIPS QUESTION AND ANSWER TOWN HALL EVENT

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What would be the difference in opting in or just reporting as a group? We are a two-provider small practice. One of our clinicians was eligible last year and did very well but wasn’t eligible as an individual this year so we decided to report as a group.

If we are a single provider office and sometimes bill under a group, should we report as an individual or both an individual and a group?

If we are not required to participate in MIPS yet (due to volume) and do not have an EHR, what are the benefits of participating?

ELIGIBILITY AND REPORTING OPTIONS QUESTIONS

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ELIGIBILITY AND REPORTING OPTIONS FOLLOW UP QUESTIONS

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MIPS QUESTION AND ANSWER TOWN HALL EVENT

DATA SUBMISSION AND PERFORMANCE THRESHOLD QUESTIONS ▸

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Our practice is a 12 provider ophthalmology practice in MA. We have both an EHR and also use the IRIS registry that is available through the American Association of Ophthalmology. The registry is helpful in that it automatically pulls data from our EHR every quarter. However, given that most ophthalmologists are using the registry, three of the six measures are already topped out. Can you clarify what categories will be covered by the registry? Also, should I also submit measures directly from our EHR for better performance scores?

If I submitted MIPS in 2017, will my claims start to show the incentive beginning now in January 2019?

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MIPS QUESTION AND ANSWER TOWN HALL EVENT

DATA SUBMISSION AND PERFORMANCE THRESHOLD QUESTIONS ▸

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We signed up with an ACO (MSSP) for 2018. They are reporting several measures for us, but we also have a clinician submitting to CMS as an individual through a registry. Will CMS take both submissions? Will they take the highest of the two scores or just the ACO (MSSP) score?

I am in an ACO, what do I need to do? Will my ACO submit on my behalf?

If we plan on meeting the performance threshold of 30 points for 2019, can the 30 points be from one category?

We plan to submit data via claims, do I still need to access the QPP Portal? Why do I need an account?

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DATA SUBMISSION AND PERFORMANCE THRESHOLD UP QUESTIONS

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QUALITY MEASURE QUESTIONS17MIPS QUESTION AND ANSWER TOWN HALL EVENT

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We have three doctors in my practice. Can we submit one doctor’s codes for the entire group?

If my clinician is a cardiologist, can I submit measures for other specialties or just cardiology?

How well can you score if you only submit for the Quality category?

QUALITY MEASURE QUESTIONS18MIPS QUESTION AND ANSWER TOWN HALL EVENT

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If you submit as a group, do all clinicians have to perform the same Quality measures?

What does data completeness for quality measures mean?

If there are not enough reportable measures due to your specialty and the CPT codes that you report, what alternative do you have?

QUALITY MEASURE FOLLOW UP QUESTIONS

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IMPROVEMENT ACTITY QUESTIONS 20MIPS QUESTION AND ANSWER TOWN HALL EVENT

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What documentation is required for data validation (for IA)?

I need to report for 90 consecutive days, what about weekends or when the office is closed?

We are not in small, underserved, or rural areas, but my doctor acts as a preceptor for the residents at the community hospital. Does the IA "Provide Education Opportunities for New Clinicians" apply to us?

For the IA I have received 40 points by submitting two medium-weighted activities. Do I still have to submit the required 4 medium-weighted activities, since I have the 40 max points for this category?

IMPROVEMENT ACTIVITY FOLLOW UP QUESTIONS

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MIPS QUESTION AND ANSWER TOWN HALL EVENT

PROMOTING INTEROPERABILITY QUESTIONS▸

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I am a solo cardiology practice in Nevada. We have an EHR but we are still getting used to it. We had heard from the Technical Assistance Contractor that we are eligible for an exclusion on the Promoting Interoperability category, which sounds great! But we still tried to achieve some of the measures for that category. Do you think we should still submit measures for that category to improve our final score?

What happens if we are not able to get our 2015 edition CEHRT until June?

Can you get a hardship exemption for switching EHR platforms in the middle of 2019?

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MIPS QUESTION AND ANSWER TOWN HALL EVENT

PROMOTING INTEROPERABILITY QUESTIONS▸

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Is the new opioid measure a requirement for the PI category on 2019? If so, what should we do if we don’t prescribe opioids in our practice?

What is the best way to explain the differences between the PI MIPS category and the PI hospital program for objectives and measures?

Will FHIR be required to submit Promoting Interoperability measures for 2019?

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PROMOTING INTEROPERABILITY FOLLOW UP QUESTIONS

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COST QUESTIONS25MIPS QUESTION AND ANSWER TOWN HALL EVENT

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How are beneficiaries attributed to specialist practitioners such as Dermatology providers?

Where do we go to find our cost performance?

COST QUESTIONS26MIPS QUESTION AND ANSWER TOWN HALL EVENT

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What is an episode based cost measure?

For the MSPB measure, are Part B or Part D drugs excluded?

Will the cost measure continue to be applied to quality if we have too few numbers to qualify?

How do I, as a solo practitioner, control costs?

COST FOLLOW UP QUESTIONS27MIPS QUESTION AND ANSWER TOWN HALL EVENT

OTHER FOLLOW UP QUESTIONS28MIPS QUESTION AND ANSWER TOWN HALL EVENT

QUESTION:

If I still need help, where can I go?

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FREE RESOURCES FOR ASSISTANCE FROM CMS▸

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QPP website: https://qpp.cms.gov/--includes information tailored for the needs of small practices

Contact the Quality Payment Program at: QPP@cms.hhs.gov or call 1-866-288-8292

Support and Available resources for Small, Underserved, and Rural Practices: https://qualitypaymentprogram.cms.gov/about/small-underserved-rural-practices

Small Underserved Rural Support Technical Assistance Organizations (see list on slide 9)

Contact information is available at: https://qpp.cms.gov/about/small-underserved-rural-practices

Available websites of each Technical Assistance Organization

Types of help: needs assessments, webinars, technical support, links to peers you can talk with, assistance getting signed up to report through an approved channel that meets your practice’s needs

FREE Technical Assistance funded by CMS is also available for larger group practices and for clinicians interested in participating in an Alternative Payment Model. More information on those programs is available at: https://qpp-cm-prod-content.s3.amazonaws.com/uploads/25/TA%20Resource%20Guide%202017%2004%2024_Remediated.pdf

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FREE RESOURCES FOR ASSISTANCE FROM CMS▸

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2019 Final RuleResource Library2019 Qualified Clinical Data Registries (QCDRs) and Qualified Registries2019 Cross-Cutting Quality Measures2019 Medicare Part B Claims Measure Specifications and Supporting Documents 2019 Clinical Quality Measure Specifications and Supporting Documents2019 Promoting Interoperability Measure Specifications2019 Merit-based Incentive Payment System (MIPS): Summary of Cost Measures 2019 Improvement Activities Inventory

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WRAP-UP ACTIVITIES▸

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Links to Q&A documents, transcripts, and recordings of the event are available here: https://qppsurs.wordpress.com/resources/April: Lessons Learned: How to be Successful in MIPS for Solo and Small Group Practices

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Tuesday, April 16, 2019, 11:00 a.m. – 12:00 p.m. ET

Thursday, April 18, 2019 3:30 p.m. – 4:30 p.m. ET

Please provide feedback on this event: Feedback Form

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REFERENCESSlide decks created by event panelists also provided information reflected in this presentation. The input from project panelists is gratefully acknowledged.Other documents on the https://qpp.cms.gov/ and https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/Resource-library.html website provide additional detail about the MIPS program.Disclaimer: This presentation was current at the time it was published or uploaded onto the web. Medicare policy changes periodically so links to the source documents have been provided within the document for your reference. This presentation was prepared as a service to the public and is not intended to grant rights or impose obligations. This presentation may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations, and other interpretive materials for a full and accurate statement of their contents.

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ACRONYMSAPM – Alternative Payment ModelACO – Accountable Care Organization CAHPS— Consumer Assessment of Healthcare Providers and SystemsCMS – Centers for Medicare & Medicaid ServiceseCQM— Electronic Clinical Quality MeasuresER— Emergency RoomEOB— Explanation of BenefitsEIDM— Enterprise Identity Data Management HARP— Healthcare Quality Information Systems Access Roles and Profile SystemMIPS – Merit-based Incentives Payment System

NPI— National Provider IdentifierPCHM— Patient Centered Medical HomePCP— Primary Care ProviderPI— Promoting Interoperability PQRS— Physician Quality Reporting SystemPFS – Physician Fee ScheduleIA – Improvement ActivitiesEHR – Electronic Health Records QCDR—Qualified Clinical Data RegistryQPP – Quality Payment ProgramQRUR— Quality and Resource Use ReportsSURS - Small Underserved Rural Support TIN—Tax Identification Number

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