Partnership for MACRA Success

Quality Touch 

Quality Touch is now available for participants in the MiraMed QCDR registry. MiraMed registry participants can use the application to complete their quality documentation electronically instead of documenting on paper, making it quick and easy to capture the necessary data in real-time. Learn More.

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. 

Advanced APMs

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:

  1. 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.
  1. 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.

          QPP Chart


Provider Resource Tool

Visit the Quality Payment Program website at 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.

Quality Touch AppContact us today to learn more about the MACRA MadeEasy program offered by Plexus TG.

Quality Touch Application

Participants in the MiraMed QCDR registry have access to the Quality Touch application to complete their quality documentation electronically instead of documenting on paper, making it quick and easy to capture the necessary data in real-time.  MiraMed registry participants may access Quality Touch from iOS devices, Android devices and web browsers. The application removes the need for paper quality documentation where Anesthesia Touch isn’t available. Learn more.


Related Press Release

(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.

Preoperative Assessment:  Evidence-based Personalized Patient Risk Score

Effective preoperative assessment and health evaluation is an essential part of planned care pathways and the foundation for safe, efficient care. Touch IQ, an integrated add-on to Anesthesia Touch™, is a complete approach to preoperative assessment. Touch IQ covers the entire process from initial questionnaire right through to post-op outcomes. Clinicians can work from any device in their organization and enjoy instant access to patient records, decision support, communication with colleagues and an “always on” system. 

Touch IQ includes a wide range of scores and assessments, including a personalized, evidence-based ASA risk score for every patient.  A clear and comprehensive summary of the assessment is automatically generated with a recommended ASA score based on the answer tree analysis.


Touch IQ enables better patient outcomes and reduced cost by:

  • Replacing current paper-based preoperative assessment
  • Reducing cancellation rates
  • Improving staff utilization
  • Providing the tools and workflow to assess all patients
  • Automating time-consuming tasks
  • Including decision support
  • Triaging patients faster

Using Touch IQ allows patients, nursing staff and anesthesia teams to efficiently complete pre-anesthesia testing documentation together. Once complete, the information flows seamlessly into the Anesthesia Touch perioperative workflow and can be used for reporting in Touch Analytics to understand the patient population or case mix more fully.


About the Patient Questionnaire

The patient questionnaire is a comprehensive and structured history including lifestyle factors, social circumstances, previous surgical experiences, medications, existing conditions and much more. The questionnaire captures both basic and detailed information and can be completed by staff or patient, enabling you to plan ahead and anticipate complications. If the patient is completing the questionnaire, it can be presented in any language so that the patient is comfortable and informed when completing their responses; Once completed, Touch IQ displays the responses in English to the clinical team. This automation from patient to clinical team and through the preoperative workflow can create a huge cost savings to any organization working with diverse patient populations.

Touch IQ Features include:

  • Patient Screening to capture clear and accurate information, with options for patient self-completion (at a web or kiosk)
  • Triage points to streamline patients based on evidence, allowing the clinicians to begin planning right away
  • Clinical assessment for high risk patients, including in-depth clinical and anesthetic investigations and labs
  • Risk Assessment highlighting risks associated with procedure, tailored for the individual patient
  • Planning covering setup, monitoring and protocols; evidence- based preparation for the procedure
  • Follow Up questionnaire recording post-operative outcomes and patient satisfaction

How can I use Touch IQ?

  • Touch IQ can be used from any networked device (e.g. laptop, PC, iPad, kiosk etc.)
  • Patients can complete their questionnaire remotely – from home, clinic, other location
  • Touch IQ presents questions in the patient’s native language – save on translation costs 
  • Touch IQ can be tailored to your working practices and approaches
  • Touch IQ is secure and reliable
  • Touch IQ can send pertinent preoperative data directly to Anesthesia Touch to support the preoperative workflow


Related Press Release

Plexus Technology Group and Synopsis Healthcare Partner Together to Offer a Fully Integrated Anesthesia Perioperative Solution in the US and Europe
(May 16, 2018) Plexus Technology Group, LLC (Plexus TG) announces a strategic partnership with Synopsis Healthcare, a leading supplier of digital pre-operative assessment for National Health Service (NHS) and private hospitals in the UK. By merging their technologies and software expertise, together they will deliver a state-of-the-art anesthesia perioperative solution unlike anything available on the market today. Both companies will market, sell and implement Plexus TG’s innovative electronic anesthesia documentation and medication management solutions, Anesthesia Touch™and Pharmacy Touch™, as a fully integrated solution with Synopsis Healthcare’s pre-operative assessment software system, Synopsis iQ, to improve workflow efficiencies and enhance the overall perioperative experience. 

Our approach to product development, implementation, and support is grounded in being a trusted partner. Like many AIMS systems, an anesthesiologist designed our product, but at Plexus TG, the degrees of expertise go even further.

Our Implementation team is committed to client success. We will be by your side throughout the Implementation process – delivering the industry's best practices tailored specifically to your organization's unique patient and business workflow.

It's our goal to make the transition from implementations to support as seamless as possbile. We understand that the implementation is only the beginning and our commitment to excellence is what separates us from our competitors.

Plexus TG's complete AIMS solution is designed to advance the goals of a practice, as quickly as possible. Our clients optimize based on data analytics, eliminate workflow inefficiencies to focus on patient care, and report quality data easily.