Four key takeaways on MACRA from MGMA 2016

MGMA 2016

MGMA 2016 has come and gone, and what a year it was! With all the changes in healthcare today, a nervous buzz permeated the halls. Our team spoke with dozens of providers and vendors who came by our booth, and we handed out so many MIPS reference sheets that we ran out on day two! Luckily, you can find the digital copies here.

Here are our top takeaways from our conversations and education sessions at MGMA. We hope this helps you keep a thumb on the pulse of how the community is ramping up for the Quality Payment Program (QPP) with 2017 just around the corner.

1. “I’d rather get three root canals than do MIPS!”

When asked whether they were thinking about MACRA and MIPS, the vast majority of administrators told us they wished they weren’t.

The exhaustion was apparent among conference participants, many of whom feel like they have been running up hill trying to keep up with each wave of new payment reform. Administrators expressed dread at the prospect of doing it all over again and frustration that the process of getting up to speed seems never ending. One woman told us, “I would rather get three root canals than do MIPS!”

The good news is that for many provider organizations, the QPP will actually reduce requirements during the 2017 transition year. Going forward, the program will to combine and streamline disparate programs, such as the Physician Quality Reporting System (PQRS) and Meaningful Use. Hopefully this means that, even though preparing for the QPP is a heavy lift now, this investment will remain relevant and important for years to come, and the fragmentation of past programs will no longer cause additional complexity administrators and clinicians trying to keep up with multiple sets of changing requirements.

Our goal at Able Health is to provide you with information that can help ease the dread (like these quick reference PDF and Excel documents with the final MIPS quality measure list). In addition, CMS has made a big effort to provide educational resources via the QPP website. Reach out via our chat box below if you have specific questions!

2. Parsing the different QPP tracks and scoring standards is proving difficult

One of the biggest points of confusion among visitors to our booth was the different tracks under the QPP. Of course, when it comes to the requirements and scoring standards for the different tracks, the devil is in the details. Not all providers in an Advanced APM will be counted as Qualifying Participants, for example, and MIPS scoring differs between regular MIPS participants and MIPS APM participants. You can learn about the tracks using this printable QPP decision tree.

The first project for most providers is to understand where you will fall under the QPP, and then to deeply understand the requirements and scoring methodology for that track. If you start here, you will lay a foundation for success in the QPP. We have outlined the methodology for calculating the regular MIPS Composite Score, as well as the APM scoring standard for Shared Savings Program APMs to get you started.

3. Increased focus on performance

Across the board, providers expressed that tracking performance throughout the year would become critical as the QPP rolls out. Providers we spoke to expressed concern that current reporting processes would not be sufficient. Today, many groups select measures for PQRS and gather data for reporting once at the end of each year to avoid a negative payment adjustment. One administrator from a 400-doctor group told us her EHR only enables this kind of one-shot PQRS reporting, which, while compliant, does not allow the group to improve performance throughout the year. Under MIPS, she believed this would not be enough.

Luckily for providers, we found that vendors are wising up to the need to monitor performance continuously. Vendors we spoke to recognized that in order to serve providers well in value-based payment programs, they would need to provide a more robust set of quality tracking and reporting features. We can expect for the QPP to drive a new focus on performance monitoring capabilities, rather than simply on compliant reporting.

4. Relief about the transition year, but not complacency

One question we had going into MGMA was: will providers delay QPP planning due to the transition year?

While the urgency to get QPP systems and processes in place has certainly been reduced, we found that in our conversations at MGMA, provider groups were committed to setting up for success under the QPP starting now. Many recognized that 2017 would be the easiest year to earn top incentive payments, since fewer groups would be highly engaged. he overwhelming sentiment at MGMA was that preparation needed to start now.

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Further reading:
6 ways to improve MIPS quality performance with the data you already have
MIPS exceptional performance bonus: how much could you earn?

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