MACRA Minute July 2018 Newsletter

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New: Final Scores Are In…Now What?

MIPS performance feedback & final scores for 2017 are now available to ECs that submitted data via the QPP website.

Here’s What You Need to Do Next:

  • Review Your Final Score & Feedback: Go to the QPP website & login with your EIDM credentials (the same credentials you used when submitting your MIPS data).
    • If you participated in a MIPS APM in 2017, specifically in a Medicare Shared Savings Program or Next Generation ACO, your performance feedback is now available to your ACO (APM entity) via the QPP website.
  • Learn About the Targeted Review Process: If you think your final score was calculated incorrectly, you can request a Targeted Review (read full details below)
  • Get Ready to Improve: A higher MIPS score means higher Medicare payments, potential bonuses for high performers, & increased revenue for your practice. Telligen’s QPP Resource Center can help solo & small group practices:
    • Identify measures that align with the practice’s goals & gaps that may surface as the program evolves
    • Prepare for the Cost category and select Improvement Activities
    • Re-visit past program decisions, such as individual versus group reporting and data submission method
    • Create a roadmap for moving to the APM track

You can reach the Telligen QPP Resource Center at 844-358-4021 or email qpp-surs@telligen.com.

Important Reminders:

  • For MIPS APM Participants: As all clinicians in the Next Generation ACO were Qualifying APM participants, 2017 performance feedback will not be provided. Performance feedback will be based on the APM entity score and is applicable to all ECs within the APM entity group.
  • Adios VBM & PQRS: Remember that 2016 was the final performance year for the VBM & PQRS programs; therefore, reports for those programs will no longer be provided. The final reports for both programs were provided in September 2017 and remain available for download through 2018.

For QPP Website Questions: Email CMS at qpp@cms.hhs.gov or reach them toll-free at 1-866-288-8292 (TTY: 1-877-715-6222).

New: Request a Targeted Review

ECs who participated in the first year of MIPS have until September 30 to dispute their score through CMS’ targeted review process.

What is a Targeted Review?

The targeted review enables ECs — or the person authorized to act on the ECs behalf — to request CMS review their performance feedback & final score.

Who Should Request a Targeted Review?

Reasons an EC might request a targeted review include:

  • Calculation errors or data quality issues on measures & activities
  • Eligibility issues (e.g., you fall below the low-volume threshold & should not have received a payment adjustment)
  • Being erroneously excluded from the APM participation list & not being scored under the APM scoring standard
  • Not being automatically reweighted even though you qualify due to the 2017 extreme & uncontrollable circumstances policy

Note: This is not a comprehensive list of circumstances. CMS encourages ECs who believe a targeted review is warranted to submit a request form.

What Should I Expect During the Review Process?

When evaluating a request, CMS will generally require documentation to support the request. If your request is approved, CMS will update your final score & associated payment adjustment (if applicable), as soon as technically feasible.

CMS will determine the amount of the upward payment adjustments after the conclusion of the targeted review submission period. Please note that targeted review decisions are final and not eligible for further review.

For more information about how to request a targeted review, please refer to the Targeted Review of 2019 MIPS Payment Adjustment User Guide.

New: Opportunities for Podiatrists & Optometrists

Are you part of a Podiatry practice or Optometry group looking for a QPP Improvement Activity? 

Do you have patients who could benefit from free diabetes self-management education (DSME) classes? 

If so, you’re in luck! The Telligen QIN-QIO provides a six-week DSME series designed to give patients the skills they need to control their diabetes & lower blood sugar levels.

All you need to do is refer your patients & provide a place to hold the class. It’s easier than you think!

Check out these resources for more information:

Events: Mark Your Calendar

July 17 & 19

What: CMS Lan Webinar: Understanding MIPS for Specialties

Description: This event will feature a panel of experts offering practical advice to specialists in solo & small group practices related to choosing quality measures, optimizing the cost category, and submitting MIPS data.

Register Now:

July 24 & 26

What: CMS Webinar: What You Need to Know About Public Reporting on Physician Compare

Description: CMS is hosting two webinars related to public reporting on Physician Compare. Information includes potential additions for 2018 & Year 1 QPP performance.

Objectives:

  • Overview of public reporting on Physician Compare
  • MIPS & APMs on Physician Compare
  • Upcoming 30-day Preview Period

Register Now:

July 24 & 25

What: CMS Webinar Series: Cost Performance Category for Year 2

Objectives:

  • Provide a brief overview of MIPS requirements for QPP Year 2
  • Explain how CMS will use Cost measures
  • Discuss how the category will impact the final score

Register Now: Wednesday, July, 25; Noon to 1 p.m., CT

New Webinar Series: The Opioid Safety Project

Did You Know?

According to the Centers for Disease Control and Prevention, an average of 115 Americans die every day from an opioid overdose.

The Telligen QIN-QIO & the American Medical Association are launching the Opioid Safety Project, a webinar series offering a deeper dive into safely managing patients with opioids.

Register Now:

For those unable to attend, all opioid-related webinars will be recorded and posted on this website. For more information, contact Sandy Swallow at sandy.swallow@area-d.hcqis.org or 515-223-2105.

More Events: Coming August & September

August

What: CMS Webinar Series: QPP Performance Categories for Year 2

Register Now:

What: CMS LAN Webinar: Maximizing Your EHR to Succeed in MIPS: Advice for Solo & Small Group Practices

Register Now:

September

What: CMS LAN Webinar: Understanding Advanced APMs: Advice for Solo and Small Group Practices

Register Now:

QPP Resources: Now Available on CMS.gov

The QPP Resource Library was updated in June with new resources, including:

 

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