QPP Data Submission

Lake Superior QIN Office Hours: Submitting 2017 Performance Year Data to the Quality Payment Program Mona Mathews, MetaStar Candy Hanson, Stratis Health January 18, 2018

Disclaimer Content provided in this presentation is based on the latest information made available by the Centers for Medicare & Medicaid Services (CMS) and is subject to change. CMS policies change, so we encourage you to review specific statutes and regulations that may apply to you for interpretation and updates.

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Lake Superior Quality Innovation Network (QIN) Three quality improvement organizations: • MPRO in Michigan • Stratis Health in Minnesota • MetaStar in Wisconsin

Collaboration to improve health care for Medicare consumers, share best practices, and maximize efficiencies

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Submission Basics

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Reporting for 2017 • Starting January 2, 2018 – Quality Payment Program (QPP) Website opened (https://qpp.cms.gov/) • CMS web interface begin quality reporting and submission January 22, 2018 • Look for new login button at the top of the page

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Reporting for 2017 • Reporting deadline - March 31, 2018 • CMS web interface closes March 16, 2018 (8:00 p.m. EST) • Work with your Alternative Payment Model (APM) Entity to discuss special considerations

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Getting Started with an Enterprise Identity Data Management (EIDM) Account

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EIDM Basics • Your account is same for previous legacy program • Visit CMS Enterprise Portal (https://qpp.cms.gov/) to set up, get account information, reset your password • You will need necessary EIDM accounts and roles • EIDM Guides (or call 866-288-8292 with questions): https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/Enterprise-Identity-DataManagement-EIDM-User-Guide.pdf https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/Enterprise-Identity-DataManagement-EIDM-ACO-User-Guide.pdf

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Verifying your Eligibility • Merit-Based Incentive Payment System (MIPS)/National Provider Identifier (NPI) Look-Up Tool • Qualifying APM Participant (QP) Look-Up Tool • If there is inconsistency between NPI Look-Up Tool and QP Look-Up Tool, the results of the QP LookUp Tool take precedence.

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Group vs. Individual Reporting

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Group vs Individual • Can submit data for group and/or for each individual • CMS will retain all data submitted and use the higher score • No “submit” or “save" button in the data submission system • System automatically updates your record • Can update your data any time during submission window • As you upload your data, you will see your category score (ie: not 25 points for Advancing Care Information (ACI) but how many points you would earn out of the 155 possible)

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Individual vs. Group Reporting Considerations Individual Reporting

Group Reporting

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Score based on individual performance

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Score aggregated for all clinicians

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Solo practice, or did not maintain group status for the whole reporting period

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Large number of clinicians

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If individual MIPS score is higher than group composite score CMS will take the higher of your group vs individual score

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If individual MIPS scores are lower than the group composite score Clinicians with lower performance or measures not applicable to practice may decrease overall group score

Compare scores with all MIPS Eligible Clinicians (EC) and with voluntary reporters

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Every individual needs to meet ACI Base Score and perform the Improvement Activities

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Compare scores with all MIPS ECs and with voluntary reporters Clinicians with higher performance may increase overall group score Only one clinician in the group needs to meet the ACI Base Score, and perform the Improvement Activities

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Data Submission in 2017

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Data Submission in 2017 • Report to Quality, Advancing Care Information, and Improvement Activities in 2017 • Can report using different submission methods for each of the categories • Can only use one submission method per category

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Quality Measure Submission Methods • • • • • •

Claims (individuals only) Electronic health record (EHR) Qualified Registry Qualified Clinical Data Registry (QCDR) CMS Web Interface (groups of 25+) Consumer Assessment of Healthcare Providers and Systems® (CAHPS) for MIPS

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MIPS Scoring

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Pick Your Pace 2017

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NOT RECOMMENDED!

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4.

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Engage as a Qualified Participant (QP) in an Advanced APM …no MIPS requirements! Source: CMS Quality Payment Program – Train-The-Trainer

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MIPS 2017 Transition Year Scoring (0-100 Points) ≥70 points

Eligible for positive payment adjustment and exceptional performance bonus payment

4-69 points

Positive payment adjustment. No exceptional performance bonus payment. No negative payment adjustment

3 points

Neutral payment adjustment

Do nothing – 0 points

-4% payment adjustment

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Modified from: CMS Quality Payment Program – Train-The-Trainer

Stratis Health MIPS Estimator To Help You Choose

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Scoring Results Mockup

Source: www.mipsestimator.org

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Scoring Results Mockup

Source: www.mipsestimator.org

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Resources and Tools

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Education and Technical Assistance Resources 2017 QPP Data Submission Fact Sheet https://www.cms.gov/Medicare/Quality-PaymentProgram/Resource-Library/QPP-2017-Data-SubmissionFactsheet.pdf

Lake Superior QIN https://www.lsqin.org

Stratis Health MIPS Estimator www.mipsestimator.com

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Quality Payment Program Support and Technical Assistance CMS QPP Help Desk ― (866) 288-8292 Email: [email protected]

Lake Superior QIN QPP Help Desk ― Michigan QPP [email protected] ― Minnesota [email protected] ― Wisconsin [email protected]

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https://qpp.cms.gov/sources

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Lake Superior QIN Contacts Michigan - MPRO Holly Standhardt [email protected] Minnesota - Stratis Health Candy Hanson [email protected] Wisconsin - MetaStar Mona Mathews [email protected] 25

Upcoming Events

QPP LSQIN Office Hours Registration LSQIN Events (by date) Date

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Time

February 15, 2018 March 15, 2018

Office Hours Office Hours

12:30 p.m. EST / 11:30 a.m. CST 12:30 p.m. EST / 11:30 a.m. CST

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This material was prepared by Lake Superior Quality Innovation Network, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The materials do not necessarily reflect CMS policy. 11SOW-MI/MN/WI-D1-18-03 010918