2. Getting to Know Your Reporting Options for 2017
PURDUE HEALTHCARE ADVISORS

3. ELIGIBILITY

4. TO MIPS OR NOT TO MIPS? Who will participate in MIPS?
Who will NOT participate in MIPS?
Clinicians in their first year of Medicare Part B participation
Clinicians below the low patient volume threshold
Clinicians participating in Advanced APMs that are Qualified Participants (QP)
MIPS does not apply to hospitals/facilities or providers that do not bill Medicare Part B
2019+
Physicians (MD/DO & DMD/DDS)
Physician Assistants
Nurse Practitioners
Clinical Nurse Specialists
Certified Nurse Anesthetists
Physicians (MD/DO & DMD/DDS)
Physician Assistants
Nurse Practitioners
Clinical Nurse Specialists
Certified Nurse Anesthetists
Physical Therapists
Occupational Therapists
Speech/Language Pathologists
Audiologists
Nurse Midwives
Clinical Social Workers
Clinical Psychologists
Dietitians & Nutritional Professionals
This is a choose your own adventure story, but the adventure is kind of already chosen for you – at least for the first few years….
Since the majority of providers will fall into the MIPS category at first, we’re focusing mostly on this right now.

5. LOW VOLUME THRESHOLD
Clinicians can be excluded from MIPS participation based on Part B claims volume or Medicare Part B beneficiary volume OR
LVT Determination Periods for 2017:
September 1, 2015 to August 31, 2016
and
September 1, 2016 to August 31, 2017
< $30,000 Medicare Part B Allowable Charges
< 100
Medicare Part B Beneficiaries

6. PICK YOUR PACE

7. MIPS Performance Year 2017 ONLY
“PICK YOUR PACE”
MIPS Performance Year 2017 ONLY
2017 is designated as a transitional year
Eligible Clinicians (ECs) participating in MIPS will have multiple options
Choosing one of these participation options and fulfilling the necessary requirements ensures you do not receive a negative payment adjustment in 2019

8. MIPS Performance Year 2017 ONLY
“PICK YOUR PACE”
MIPS Performance Year 2017 ONLY
Don’t Participate
Don’t send in any 2017 data  receive a -4% payment adjustment in 2019
OPTION 1: “Test” the QPP
Submit minimum amount of data in 2017  receive no adjustment
OPTION 2: Partial Participation
Submit 90 days of 2017 data  receive neutral or small positive payment adjustment in 2019
OPTION 3: Full Participation
Submit full year of 2017 data  receive moderate positive payment adjustment in 2019

9. First Option: Test the QPP
“PICK YOUR PACE”
First Option: Test the QPP
Submit one of the following to QPP:
1 quality measure
5 required ACI objectives
1 IA
Minimum 90 day reporting period
Avoid negative payment adjustment
This first option is designed to ensure that your system is working and that you are prepared for broader participation in 2018 and 2019 as you learn more.

10. Second Option: Partial Participation
“PICK YOUR PACE”
Second Option: Partial Participation
Submit a partial set of data to the QPP
1-5 Quality measures
5 required ACI objectives
1 or more CPIA
Minimum 90 day reporting period
You can start submitting on a date after 1/1/17
Must start by October 2, 2017
Small positive payment adjustment possible
Avoid the negative payment adjustment

11. Third Option: Full Participation
“PICK YOUR PACE”
Third Option: Full Participation
Participate in QPP for the full* calendar year beginning on 1/1/17 and submit all required data
6 Quality Measures or 1 Measures Set
5 required ACI objectives
Report additional measures for performance score
IA- up to four activities
Possible modest positive payment adjustment
Avoid the negative payment adjustment
* Does not need to be exactly 365-days, but the longer the reporting period, the higher the potential incentive

12. Fourth Option: Participate in Advanced APM
“PICK YOUR PACE”
Fourth Option: Participate in Advanced APM
Join an AAPM (track 2 or 3)
Receive 5% lump sum bonus in 2019

13. SUMMARY: PICK YOUR PACE OPTIONS

14. REPORTING METHODS

15. REPORTING METHODOLOGY
Quality*
Cost
Advancing Care Information
Improvement Activities
Year 1 Weighting
No Weighting
Individuals
QCDR
Qualified Registry
EHR
Administrative Claims (no submission required)
Claims
Administrative Claims
(no submission required)
Attestation
Groups
CMS Web Interface** (Groups of 25+)
CAHPS for MIPS Survey
*Reporting must cover a minimum of 50% of Medicare Part B beneficiaries
**Groups reporting Web Interface must register by June 30, 2017

17. Get Ready for 2017 Pick Your Pace!!
Make sure your Certified EHR Technology is MIPS ready
Consider using a qualified clinical data registry or a registry to extract and submit your quality data.
Review quality metrics to prepare for measure selection

18. MIPS & MEDICAID MU PROGRAM
Don’t Forget!
MIPS does not change the requirements under the Medicaid EHR Incentive Program!!
If you are participating in Medicaid MU:
You must still comply with the established requirements under that program
And also have Medicare Part B claims, then you will report to BOTH programs

19. Presenter Allison Bryan-Jungels MS, CHES
Senior Advisor, GLPTN Quality Lead and IN Program Manager
(765)