Speakers

Jas GrewalCEO and Co-Founder

Aditya MangalVP of Customer Success

• MACRA impacts both physicians and hospitals

• Most providers will fall under the MIPS category

• Performance in 2017 will determine payment in

2019

MACRA Recap

1. Have you prepared a MACRA plan for 2016 through

2018?

Poll

• I have a plan in place (67%)• I somewhat have details of a plan

(17%)• I have yet to begin preparing a plan

(16%)

Action Plan for 2016 through 2018 to

Prepare for MACRA

Agenda

Risks and Milestones to Consider Through

This Journey

Tools and Resources Required for a

Successful Plan

2016: Know Yourself

• Understand your PQRS reports

• Benchmark your performance

Action Plan

• Get certified EHR• Evaluate solutions for

patient engagement

• Plan and schedule your 90-day reporting period for 2017

• Review CPIA list

• Analyze population by cost/patient

• Identify workflow changes for plans

Quality (50%) Advancing Care Information (25%)

Clinical Practice Improvement

(15%)

Resource Use andCost (10%)

2016 (August) 2017

Certified EHR a Must Have

Evaluate cost analyticstools

Enable quality team to review PQRS & CPIA

Milestone: MACRA ruling in November

Milestones, Resources, and Tools

2017: CMS Performance

Benchmark Year

• Report 6 domains; 1 cross-cut, 1 outcome

• Watch for NPRM (July) to address changes

Action Plan

• Ensure efficacy of EHR• Complete security risk

assessment

• Execute 90-day reporting period. Decide on CPIA

• Enable patient reach out for health status checks

• Monitor high-risk patients for specialized care

Quality (50%) Advancing Care Information (25%)

Clinical Practice Improvement

(15%)

Resource Use andCost (10%)

2017 2018Complete SRA inEarly 2017

Complete the 90 day reporting for the period you decided

Quality teams review & adjust measures based on feedback

Milestone: First Feedback report in July

Milestone: CMS collects data starting January

Get a clear picture of yourPopulation; Enable structured outreach programs.

Milestones, Resources, and Tools

2018: Continue to Optimize

You will get penalized in 2019 based on 2018 performance.

Review your quality performance based on CMS feedback reports and put in place improvement action plans; focus on high risk patients

Focus on payment maximizing initiatives. Think of achieving high patient engagement through automation

Optimize Your Performance

2018 2019Improve quality based on your first feedback report

Enable tools & processes to focus on high risk and high utilization patients

Quality teams review & adjust measures based on feedback

Milestone: Second Feedback report in July

Get a clear picture of yourPopulation; Enable structured outreach programs.

Milestones, Resources, and Tools