Society of Gynecologic Oncology Member Forum Speakers & Verbal Disclosures Carol L. Brown None Eva Chalas Speaker Astra Zeneca Laurel W. Rice Clinical trials funded by Astra Patrick Timmins Zeneca, Pfizer, Clovis Steve Rose Angeles Alvarez-Secord Robert Holloway Speaker honoraria Intuitive Inc. AstraZeneca, Clovis, Jannsen Renata Urban Emily Ko Amanda Jackson Jason D. Wright Elizabeth Jewell Covidien-speaker, teacher Laura Havrilesky Research Grant Astra Zeneca laparoscopic courses
SGO Member Forum Welcome everyone! will cover critical and important issues to your practice and future of our specialty – MACRA • What you know and don’t know about MACRA ( Angeles Alvarez -Secord, Renata Urban, Amanda Jackson) • What you need to know about MACRA and how you can comply for 2017 (Elizabeth Jewell, Eva Chalas,Robert Holloway, Steve Rose, Patrick Timmins) • Why you need to know it: ACA may go away, MACRA is here to stay ! – Endometrial Cancer APM Update ( Emily Ko, Laura Havrilesky, Jason D. Wright) – GYN Clinical Trials Crisis ( Laurel W. Rice) We have great speakers, audience participation, and lots of time for Q&A, so lets get started!
What do SGO Members know about MACRA? • 37% of SGO members don’t know anything! • Here is your pre test – What does MACRA stand for? – If given a choice between complying with MIPS in 2017 or attending another 80s SGO Party which would you choose? – Does APM stand for: advanced practice metrics, advanced payment model, or all popsicles melt?
Introduction to MIPS and APMs MACRA establishes two paths for receiving payment adjustments in the future. Merit-based Incentive Payment Alternative Payment Models System (MIPS) (APMs) • MIPS payment adjustments are percentage • Providers who participate in APMs may increases or decreases to the physician fee receive a 5% lump sum incentive payment schedule • Only participation in certain APMs will exclude • Each clinician will receive an individual MIPS providers from MIPS score, but may report as an individual or a • group Includes programs such as Accountable Care Organizations • The MIPS score is compared to national • averages to determine a payment adjustment At least 25% of Medicare revenue must come from an APM to be eligible for an incentive • MIPS scores will be shared publicly via payment in 2017 and 2018 Physician Compare In 2017, all AHS providers will report for MIPS
High Level MACRA Timeline: 2017 - 2019 Oct 3 Jan 1 Last day to begin MIPS Start of 2018 Mar 31 reporting to complete Performance minimum 90 day Period Deadline to submit reporting period in data for MIPS in 2017 2017 2017 2018 2019 July 2018 July 2017 Anticipated deadline to Anticipated deadline to enroll providers in enroll providers in AAPMs (MSSP 2 and 3) AAPMs (MSSP 2 and 3) for 2019 for 2018 Key Takeaway: There is only one opportunity per year to increase APM participation
MACRA Plan from a Large Private Hospital System: employed model Robert W Holloway, MD, FACOG, FACS Prof. UCF College of Medicine & Asst. Prof. FSU College of Medicine Director Gynecologic Oncology Florida Hospital Cancer Institute Orlando, Florida robhollowaymd@gmail.com
MACRA Landscape at AHS % of employed providers participating in APMs Vast majority of providers are NOT % of employed providers not participating in APMs in participating in APMs 2017 2017 Advanced APM Options 5. Comprehensive End-Stage Renal 1. Medicare Shared Savings Program (MSSP) Disease (ESRD) Care (CEC) - Large Track 2 Dialysis Organization (LDO) arrangement 2. MSSP Track 3 6. Comprehensive ESRD Care Model 3. Next Generation Accountable Care (non-LDO arrangement) Organization (ACO) Model 7. Oncology Care Model (OCM) two- 4. Comprehensive Primary Care Plus (CPC+) sided risk arrangement Source: Public Law 114-10 (April 16, 2015), CMS, Medicare Program; Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model (CJR), July 2016
Adventist ’ s Response to MACRA H OW A DVENTIST IS R ESPONDING TO MACRA - Task Force: AHS has established a MACRA task force to manage the organization ’ s response to MACRA for both employed and CIN providers. - MIPS in 2017: The vast majority of AHS providers will be subject to MIPS in 2017) - Deloitte Engagement: Deloitte was engaged to support AHS in MACRA preparation by assisting in developing an education plan for providers and executives as well as assessing potential MIPS performance H OW A DVENTIST WILL S UPPORT Y OU - Education: AHS will continue to provide relevant training and education to keep you up to date on everything you need to know about MACRA and MIPS - Communication: AHS will release communication via emails, newsletters, and webinars to inform you of any important new rules or changes to the law - MACRA Helpline: AHS will establish a MACRA help desk rule to answer your questions and help you manage MIPS reporting - Long-Term Commitment: AHS is committed to supporting both employed and CIN providers using Athena, Cerner and eCW in 2017 and beyond
MIPS Reporting at Adventist AHS is leveraging Athena and Cerner to report on the following for MIPS Existing Available for 2017 Quality Improvement Activities Report 6 measures Report up to 4 activities (From a possible 83 (With 11 expected to be met measures) through use of Athena) Cost Advancing Care Information No reporting required Report up to 11 measures (This category has no weight (Measures are the same as 2016 in 2017) Meaningful Use) The goal of MIPS reporting is to maximize payment adjustments for the most providers *90 day reporting period necessary
Considerations When Deciding How To Report for MIPS • TIN Revenue – TINs with small revenue may be excluded from MIPS and/or the revenue at stake is not sufficient to warrant action in certain performance categories • Number of Providers – In some instances it may make sense to do individual reporting to avoid having to report for providers who are excluded • Reporting Period – Minimum is any continuous 90 day period, maximum is the entire calendar year. The reporting period can be different across performance categories (i.e. Q1 for Quality, Q4 for ACI) • Minimum Reporting Requirements – Submitting any one of the following will prevent a negative adjustment: – 1 Quality Measure, – 1 Improvement Activity, OR – 4 ACI Measures (Risk Assessment, eRx, Timely Access, Summary of Care) • Reporting Process – We currently do not know how easy/difficult it will be to actually submit data
Experience at an Academic Institution Steve Rose University of Wisconsin
Quality Payment Program Begins in 2019: First Performance Year is 2017 Establishes Two Payment Tracks The Merit-based Incentive Advanced Alternative Payment System (MIPS) Payment Models (APMs) • • Combines Multiple CMS Programs Advanced APM Criteria: – – Physician Quality Reporting Participants must use certified EHR technology – Meaningful Use* – Payment must be based on quality – Value Based Payment Modifier – Must bear more than nominal • Provides for Incentives/Penalties financial risk (two-sided risk) • Budget Neutral • • Four Scoring Categories Additional Incentive for significant – participation in Advanced APMs Quality – Cost – Advancing Care Information • Groups participating in Advanced – Clinical Process Improvement APM are exempt from MIPS *Does not impact Medicaid or Hospital Meaningful Use Programs
UW Health • Shared savings program, but track 1 – Not eligible for Advanced APM • Participating in MIPS in 2017
MIPS Scoring Models 2019 MIPS Scoring 2019 APM Scoring Standard Category Definition Quality Quality Measures Cost Calculated by CMS based on Claims CPIA Clinical Process Improvement Activities ACI Advancing Care Information (Meaningful Use) • Preferential Scoring for APM participation (APM Standard Scoring) • Not scored on Cost • Automatic Bonus Points in CPIA category • Quality benchmarks for MIPS & APM Standard same as MSSP
UW Health Preparation Moving forward on both tracks • Advanced APM – Applied for Next Generation ACO. If accepted, 1 st performance year will be 2018 – • MIPS Standard Scoring – Continue to prepare for MIPS group reporting in 2017 • ACO data submission for 2017 performance year • Continue preparation for Meaningful Use Stage 3 and ACI – Hospital and Medicaid – Stage 3 : Target 2018 – ACI – Target 2017 – Prepare to submit CPIA activities for 2017 performance year
MIPS Scoring Categories Category Description Maximum Example % Overall Possible MIPS Points Score Quality If ACO, use ACO 80-90 ACO Data submission points will be 50% Quality Measures points assigned to all UW Health clinicians who are eligible for MIPS • Base Score – 50 points Advancing Care 25% • Performance Score for ‘Sending Information Meaningful Use 100 points (ACI) Measures secure message to patients =50% converts to 5 points • 1 – 10 points for each measure • Participation in UW Health ACO Clinical Practice 15% Improvement Groups can 60 points (MSSP-ACO) = 50 points • UW Health Anti-coagulation program Activities choose from 90 Activities = 20 points • Medicare Spending Per Beneficiary Cost Claims based Average 10% • Hospital Readmission Measures measures Score
Recommend
More recommend
