Partnership for MACRA Success
Plexus TG’s View on Capture and Reporting of Quality Data
For years, high quality anesthesia groups and the facilities where they work have sought ways to track and measure the quality and cost efficiency of surgical anesthesia care. This pursuit of quantifiable data was among the reasons early visionaries pushed anesthesia documentation from paper to computerized records.
As a vendor of electronic records for anesthesia, it should come as no surprise that we advocate digital capture and reporting of quality measures. Why?
- A better user experience. Nobody likes double-documentation; yet recording in a “quality sheet” often asks for information that’s already been recorded in the clinical chart. Our measure-capture technology automatically transfers the quality data from the anesthesia record. Instead of filling out yet another form, you simply review and confirm.
- More complete and accurate. Paper may seem simple, but that simplicity makes it all too easy for transcription errors, omissions, and illegible handwriting to adversely impact the accuracy of results. The Quality Payment Program’s minimum reporting levels increase each year, and insufficient data will result in failing scores.
- More efficient. A direct-to-digital approach eliminates the hassle and expense of collating paper forms. Equally important, the results are available for immediate feedback, so you always know your personal and practice-level performance. Any necessary course corrections can be made sooner rather than later.
MACRA and the Quality Payment Program
Fee-for-service has been the traditional model for reimbursements, but as CMS transitions to a pay-for-performance approach, it is easy to get lost in the acronyms. The MACRA legislation passed by Congress in 2015 instructed CMS to change how Medicare payments are calculated. Payments are changing from fee-for-service to the beginning of value-based payment, under the Quality Payment Program or QPP, which started on January 1st, 2017. The QPP has two tracks: Advanced APMs and MIPS.
CMS’ long-term goals appear to favor the Advanced Alternative Payment Models (Advanced APMs) track, where practices take on more risks related to patient outcomes and cost of care, but earn rewards by providing high-quality, cost-efficient care. However, CMS admits that most Medicare clinicians will initially participate via the MIPS track.
The Merit-based Incentive Payment System (MIPS) track will be how most anesthesia clinicians choose to participate in QPP. As the name implies, this track is based on a payment system where incentives – both positive and negative – are applied to encourage behaviors that CMS aligns with high quality, cost-efficient care. MIPS performance is calculated as a composite 0-to-100 score, based on four categories: Quality, Improvement Activities, Advancing Care Information, and Cost. For more information, visit eAlert: Your 2017 MACRA MIPS Composite Score: A Guide for Anesthesia Practitioners
More of the same, or not?
The Quality Payment Program replaces several previous programs. It’s important to note two key differences: Unlike previous pay-for-reporting programs, this one is pay-for-performance, ushering in the start of value-based purchasing. Second, the word ‘incentive’ in MIPS doesn’t necessarily mean bonus. The MIPS program is designed to stratify clinicians and adjust payments both up and down.
Does it affect me? How?
Most anesthesia clinicians who bill over $30,000 yearly in Medicare Part B charges and see over 100 Medicare Part B patients annually are already part of the QPP, and will typically choose the Merit-based Incentive Payment System (MIPS) performance track. While any new program brings some unavoidable disruptions, clinicians should embrace the new program for two key reasons:
- The QPP affects your payments. With 2017 as a transition year, CMS has made it relatively easy to avoid penalties in this first year of the program. However, not participating this year will result in a 4% negative adjustment to your Medicare payments in 2019. Each year, participation requirements increase along with larger bonuses and penalties. Exceptional performers (for 2017, MIPS scores of 70+) can tap into an extra $500M per year of bonus money.
- The QPP affects your professional reputation. MIPS Performance scores will be posted for anyone to see on CMS’ Physician Compare and other ratings websites. Your individual performance scores will follow you for two years, including if you move to a new location or practice.
Provider Resource Tool
Visit the Quality Payment Program website at https://qpp.cms.gov to access an interactive tool used to determine whether or not you should participate in MIPS this year. Additional resources are also available on the Quality Payment Program website.
A solution: Plexus TG's MACRA MadeEasy
To help clinicians meet the rising challenges of the MACRA legislation, Plexus TG and the MiraMed QCDR Registry have joined together to offer a consultative solution for anesthesia groups who want personalized assistance across all four MIPS scoring categories. From legacy quality measures to the latest certified EHR technology requirements, rely on the expertise of MACRA MadeEasy for answers to the complexities of the Quality Payment Program and its evolving impact on the anesthesia specialty.
Contact us today to learn more about the MACRA MadeEasy program offered by Plexus TG.
Related Press Release
New Platform, MACRA MadeEasy, Simplifies CMS Quality Payment Program Compliance for Anesthesia Practices
(March 16, 2016) Plexus Technology Group, LLC (Plexus TG) and MiraMed Global Services (MiraMed) are pleased to announce the launch of MACRA MadeEasy. This new suite of services provides comprehensive support to anesthesia clinicians seeking to comply with the evolving requirements of Medicare reimbursement. MACRA MadeEasy program allows clinicians to capture their quality measures through Anesthesia Touch and then automatically send the measures to the CMS-approved MiraMed QCDR registry. Enrolled individuals have access to the MACRA MadeEasy secure portal for instantaneous personalized performance insights.