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QCDR Signup

We are excited to announce Best Practices Academy’s, in collaboration with iPatientCare, Qualified Clinical Data Registery (QCDR) for reporting under MACRA’s Medicare payment system.

Starting in 2017, the optimal choice for reporting Medicare payment will be through our QCDR.  Why?

  • Our QCDR will allow clinicians to report performance on Quality, Advancing Care Information and Improvement Activities.
  • Claims-based reporting will no longer be satisfactory in reporting across the performance categories for MIPS performance.
  • Our QCDR is the most efficient method for reporting measures – let your EHR do the reporting work!
  • Our QCDR will harness data to promote the full scope of chiropractic care in the delivery system.

Your registration here indicates an interest in the QCDR,  there is no financial commitment at this time. 

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What EHR do you use?

2016 EHR Incentive Program

What a gorgeous fall day it is here in the Midwest and we even have some good news to share. The Centers for Medicare and Medicaid Services published a final rule on 11-2-16 allowing providers in the Medicare EHR Incentive Program to report based on a 90-day reporting period in 2016 and 2017, instead of a full calendar year.  That’s a nice bit of news for those who have been a bit slow in starting this year.

This had first been proposed in July, but was finally approved this week.  In addition to changes allowing all returning participants in the EHR Incentive Programs to report on a 90-day EHR reporting period in 2016 and 2017, CMS is also showing flexibility in other Meaningful Use requirements. Starting in 2017, they will be eliminating the Clinical Decision Support (CDS) and Computerized Order Entry (CPOE) objectives, so for DCs that do both labs and x-rays, you will no longer have to track those. You can read the final rule here

All that good news and more, we have read through the 2400 page MACRA final rule here at the Academy and have the updated information ready for you in our Quality Payment Program.  Healthcare is in a massive transition away from fee for service to a value-based reimbursement and the MACRA law lays out the blue prints of successfully reporting under that new reimbursement model. It is important for all of you to understand.  Ignorance is not bliss. Empower yourself by learning what you can do now to participate in this movement toward value and patient centeredness.

As CMS Acting Administrator, Andy Slavitt stated yesterday at the American Academy of Actuaries annual meeting, “We can’t expect to do things the same way and make progress. And we have to take the opportunities we have for progress. Unlike many periods over the last 20 years, our opportunity for progress is richer than ever.” At the Academy, we believe there are tremendous opportunities for chiropractic in the value-based model,  DCs can add new service lines to their practice that branch out from doing these measures, and they set themselves up for better care coordination and relationships with other provider types and health systems. You can read the rest of his address here.

Call Best Practices Academy and let us help you thrive in the new healthcare environment.

The New Macra Law and MIPS: Read carefully.

Many of us are familiar with the annual Medicare sustained growth rate discussion that Congress has regarding the provider fee schedule. What most do not realize is that this formula has now been replaced.

Why would Congress, in a bipartisan and nearly unanimous vote, replace an existing formula for payment to providers for Medicare? Clearly costs of care have been skyrocketing without the quality of care understood and now pay for performance has finally arrived. For years we have heard of pay for performance, reimbursement based on outcomes, value-based reimbursement, etc. For years we have not seen any substantial progress towards coming up with a way to make this work, but in April 2015, President Obama signed into law the Medicare Access and CHIP Reauthorization Act 2015 (MACRA). This is an act to amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate and strengthen Medicare access by improving physician payments and making other improvements, to reauthorize the Children’s Health Insurance Program, and for other purposes. Within this law are two different payment options, one is the Advanced Payment Model (APM) and the other is the initiation of the Merit-based Incentive Payment System (MIPS). This is the blueprint for pay for performance by Medicare.

There are five key principles of the MACRA law you should understand:

1. Every Medicare enrollee needs a dedicated and well-organized primary care team.

MACRA actively promotes patient-centered medical homes (PCMH) and patient-centered specialty practices (PCSP). These are types of practice recognition programs accredited by organizations such as the NCQA to validate that these practices meet specific qualifications for value-based reimbursement.

2. Measurement must be specified appropriately for each different unit of accountability.

If you are familiar with clinical quality measures and meaningful use, then you will have a basis to help you understand this aspect of the MACRA. The MACRA states that measures must be specified for each payment model, or unit of accountability, yet still facilitate comparison between and among all payment models. Measures also must be tailored for the different types of care furnished by clinicians in different payment models.

3. Measurement should support rapid improvement and clinical decision making.

Beyond assessing and paying for value, measurement also needs to help clinicians rapidly identify gaps in quality in order to improve their performance. The EHR “Meaningful Use” program that MACRA incorporates into MIPS already encourages use of data for population health, decision support, and measuring quality. Meaningful Use requirements must include accurate, prompt reports for clinician quality improvement efforts.

4. A core set of measures will let all stakeholders make comparisons across programs.

Core measures will be specified appropriately for the differing situations for individual clinicians, practice teams, accountable care organizations (ACOs) and Medicare Advantage plans, yet aligned in concept and intent to allow meaningful comparisons. The measures will draw from data in claims, electronic health records (EHRs) and patient surveys to aggregate up to levels that matter most to consumers, clinicians, plans, the community or state. Measures also must continually transform for advances in clinical evidence.

5. Quality measure results should be easy for consumers and payers to get and use.

MACRA provides for transparency through the Physician Compare website. All stakeholders need user-friendly information to make meaningful comparisons across all payment models. Clinicians need more specific data about how they compare to local and national peers to identify improvement opportunities and achieve value-based payment rewards. Clinicians also need timely, actionable feedback as close as possible to delivery of care. Embedding results in clinical care workflow is essential.

Doctors of chiropractic must begin now to understand this new payment environment that is quickly approaching, as 2016 is setting the stage for the MIPS program going into effect January of 2017. The draft rules for MIPS will come out by June or July and the final rule by November of 2016. Stay tuned for more on the MACRA law and MIPS in upcoming articles from the Best Practices Academy.

Dr. Scott Munsterman is founder and CEO of Best Practices Academy (BPA) and is an acknowledged expert on the transforming model of health care delivery with a commitment to the promotion and advancement of the chiropractic profession. BPA assists chiropractic physicians to focus on growth, risk management, technology and quality improvement through a value-based practice management system.

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