(877) 243-8881 MIPS 2020 AUGUST 27, 2020 PRESENTER: MAGGIE DELCAMP, RN EHR SPECIALIST & MIPS CONSULTANT 1 8/28/2020 AZCOMP.COM
(877) 243-8881 MIPS 2 S 2020 : : I Inf nformation n & Planni nning ng What will this webinar include? MIPS in a Minute overview Potential financial impact 2019 finalized scores are in Minimum requirements for 2020 Hardship Application MIPS Training & Assistance Available Q & A 2 8/28/2020 AZCOMP.COM
(877) 243-8881 LET’S GET STARTED! 3 8/28/2020 AZCOMP.COM
(877) 243-8881 Disclaimer Please note that his information was current as of April 9, 2020 at 11am, however new guidance is being delivered daily, please check cited resources frequently for updates! Disclaimer: Although AZCOMP Technologies, Inc. makes every effort to ensure that information regarding MIPS and other government programs are checked and accurate in both our documentation and training, the Medicare/Medicaid programs are constantly changing and individual providers may have unique circumstances that go beyond the typical guidelines laid out in the respective programs they are participating in. Therefore, it is the sole responsibility of each provider to study, interpret and remain abreast of the Medicare/Medicaid program requirements and deadlines, contacting program administrators directly as needed. Any documentation and training provided by AZCOMP Technologies, Inc. is based on our interpretation of the programs and certification rules published by the Department of Human Services and are subject to change. Information and training provided is “as is” and without any express or implied warranties. AZCOMP Technologies, Inc. assumes no responsibility for any inaccuracies, errors, or omissions, expressly disclaiming liability for damages of any kind arising out of the use of, reference to or reliance on any content provided. Using certified electronic health record (EHR) systems and other certified health IT to provide and attest to meaningful use is the sole responsibility of the eligible provider. The latest MIPS regulations can be found on the CMS web site at https://qpp.cms.gov/ EHR Incentive Program Information Center - Phone: 1-866-288-8292 Email: QPP@cms.hhs.gov 4 8/28/2020 AZCOMP.COM
(877) 243-8881 MIPS REVIEW IN A MINUTE 5 8/28/2020 AZCOMP.COM
(877) 243-8881 The Beginning: MIPS IS INTRODUCED Medicare Meaningful Use MIPS PQRS (Physician Quality Reporting System) Value Based Payment Modifier 6 8/28/2020 AZCOMP.COM
(877) 243-8881 SUMMARY OF PARTICIPATION Feedback Payment Collect Data Report Data Available Adjustment • Performance period during • Historically Q1 of the • Generally in the • Begins 2 years after calendar year following year Summertime performance year • Jan 4 – Mar 31, 2021. Jan – Dec 2020 Jan 4 - March 31, 2021 TBD Adjustment applies 2022 7 8/28/2020 AZCOMP.COM
(877) 243-8881 CATEGORIES & WEIGHTS CHANGE 2018 2019 2017 Cost Cost IA 10% 15% 15% IA 15% IA Quality Quality Quality 15% 45% ACI 50% 60% 25% PI PI 25% 25% Quality - 50% Quality - 60% Quality - 45% Promoting Interoperability (PI) - 25% Advancing Care Information (ACI) - 25% Promoting Interoperability (PI) - 25% Improvement Activities (IA) - 15% Improvement Activities (IA) - 15% Improvement Activities (IA) - 15% Cost - 10% Cost - 15% 8 8/28/2020 AZCOMP.COM
(877) 243-8881 PRELIMINARY SCORE 9 8/28/2020 AZCOMP.COM
(877) 243-8881 | THRESHOLDS . INCREASE Adjustment is based on MIPS Final Score 0 - % - % + % + % PARTIAL Negative POSITIVE FULL Negative Payment NEUTRAL POSITIVE Adjustment + YEAR Payment Adjustment Adjustment Adjustment Exceptional Adjustment Performer Bonus 2019 0 Points (-7%) 1 – 29 points 30 points 30 – 75 points > 75+ points [applies 2021] 2018 0 Points (-5%) 1 – 14 points 15 points 16 – 69 points > 70+ points [applies 2020] 2017 0 Points (-4%) 1 – 3 points 3 points 4 – 69 points > 70+ points [applies 2019] 10 8/28/2020 AZCOMP.COM
(877) 243-8881 PAYMENT ADJUSTMENT TIMELINE 11 8/28/2020 AZCOMP.COM
(877) 243-8881 Have you decided how you will participate in MIPS for 2020? 12 8/28/2020 AZCOMP.COM
(877) 243-8881 NOW AVAILABLE: 2019 Feedback 13 8/28/2020 AZCOMP.COM
(877) 243-8881 THE FINANCIAL IMPACT 14 8/28/2020 AZCOMP.COM
(877) 243-8881 MIPS Payment Adjustment TOTAL Annual Medicare Part B 2017 (4%) 2018 (5%) 2019 (7%) 2020 (9%) (if no MIPS data was reported 2017- Reimbursement 2020) $22,500 $90k $3,600 $4,500 $6,300 $8,100 $30,000 $120k $4,800 $6,000 $8,400 $10,800 $37,500 $150k $6,000 $7,500 $10,500 $13,500 $50,000 $200k $8,000 $10,000 $14,000 $18,000 15 8/28/2020 AZCOMP.COM
(877) 243-8881 COVID-19 Response: Additional Flexibilities Expanded availability to apply for exception Doubled Complex Patient Bonus for 2020 NEW Improvement Activity COVID-19 Clinical Trials CMS COVID-19 Response & added flexibilities : https://qpp.cms.gov/about/covid19 16 8/28/2020 AZCOMP.COM
(877) 243-8881 2020 STRATEGY Learn, Plan & Manage 17 8/28/2020 AZCOMP.COM
(877) 243-8881 2020 MIPS Breakdown 18 8/28/2020 AZCOMP.COM
(877) 243-8881 * Applies to MOST Clinicians. Measures & Activities PROMOTING IMPROVEMENT QUALITY INTEROPERABILITY ACTIVITIES • Will need to select 2 – 4 • Collect data on the 6 • Will need to select and required measures AND activities report at least 6 measures submit “yes” to 3 attestation • Perform and report for the statements. • Collect data for each SAME continuous 90-day measure for the 12-month • Collect and report for the reporting period (Jan-Dec) SAME continuous 90-day period in CY 2020 (or as indicated by the measure performance period in CY description) 2020 Clinicians do not need to collect or submit and data for cost measures. COST CMS collects and evaluates that data for you. 19 8/28/2020 AZCOMP.COM
(877) 243-8881 Promoting Interoperability (PI) (Your application must be approved by CMS to qualify for reweighting.) 20 8/28/2020 AZCOMP.COM
(877) 243-8881 (877) 243-8881 PI Requirements 2020 Promoting Interoperability Quick Start Guide: https://qpp-cm-prod-content.s3.amazonaws.com/uploads/822/2020%20Promoting%20Interoperability%20Quick%20Start%20Guide.pdf 21 8/28/2020 AZCOMP.COM
(877) 243-8881 2020 EXCEPTION OPTIONS MIPS PROMOTING INTEROPERABILITY EXTREME AND UNCONTROLLABLE PERFORMANCE CATEGORY HARDSHIP CIRCUMSTANCES EXCEPTION EXCEPTION Allows you to request reweighting— Allows you to request one or more specifically for the PI category (to 0%) . performance categories be reweighted to 0% . Eligible Clinicians – Individual Clinicians, Eligible Clinicians – Individual Clinicians, Groups & Virtual Groups Groups & Virtual Groups Circumstances to Apply – Circumstances to Apply – • You're a small practice • If you believe you have been affected by an extreme and • You have decertified EHR technology uncontrollable circumstance (such as the public health • You have insufficient Internet connectivity emergency triggered by the COVID-19 pandemic), you can • You face extreme and uncontrollable circumstances such as apply for this exception. disaster, practice closure, severe financial distress or vendor issues • You lack control over the availability of CEHRT * Lacking 2015 Edition CEHRT does not qualify as a reason to submit an application. Both applications are available through QPP website using HARP account. https://qpp.cms.gov/login December 31, 2020 at 8 pm (ET) is the Deadline to Apply 22 8/28/2020 AZCOMP.COM
(877) 243-8881 Will CMS automatically apply any of the exceptions? MIPS Promoting Interoperability Performance Category Hardship Exception (qualifying clinician types) Extreme and Uncontrollable Circumstances Exception (Groups/Virtual Groups) Extreme and Uncontrollable Circumstances Exception (Individual clinicians) 23 8/28/2020 AZCOMP.COM
(877) 243-8881 CMS Documentation Says… 24 8/28/2020 AZCOMP.COM
(877) 243-8881 Checking Provider Status & Eligibility https://qpp.cms.gov/participation-lookup 25 8/28/2020 AZCOMP.COM
(877) 243-8881 (877) 243-8881 Wash your hands of potential surprises later 26 8/28/2020 AZCOMP.COM
(877) 243-8881 (877) 243-8881 Reweighting Reweighting categories varies based on the categories for which the waiver is requested. https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1054/2020%20MIPS%20Exception%20Applications%20Fact%20Sheet.pdf 27 8/28/2020 AZCOMP.COM
(877) 243-8881 Example of PI Hardship Reweighting 28 8/28/2020 AZCOMP.COM
(877) 243-8881 Report data for ALL Categories [Quality, Promoting Interoperability, Improvement Activities] Options for MIPS Report Some Categories & Will NOT apply for hardship 2020 Reporting Which option is right for YOU? Apply for hardship AND report SOME categories Apply for hardship AND may not report ANY categories. Do Nothing (no hardship application/no reporting) 29 8/28/2020 AZCOMP.COM
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