webinar

MACRAWhat’s In Store for Independent PracticesPresented by John Lynn July 13, 2016

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Agenda

2

Agenda

2

• Welcome & Introductions• MACRA• How Kareo Can Help• Your Questions

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Speaker

John Lynn Editor & Founder

HealthcareScene.com, a network of 10 EHR and HIT blogs

Co-founder of InfluentialNetworks.com & Physia.com

Blogs have published over 10,000 healthcare IT posts with more than 18 million views

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Agenda

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Agenda

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• Welcome & Introductions• MACRA• How Kareo Can Help• Your Questions

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Move to Value and Quality

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What is MACRA?

Medicare Access and CHIP Reauthorization Act of 2015

• Replaces Sustainable Growth Rate (SGR) and the annual "Doc Fix"

• Single Framework - Quality Payment ProgramStreamlines Multiple Quality Reporting Programs Into

• APMs (Advanced Alternative Payment Models)• MIPS (Merit-based Incentive Payment System)

Currently a Proposed Rule

• Public Comment Period Ended June 27th

• Final Rule – October 2016?

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Most Small Practices Will Do MIPS!

CMS Expects Most Will Move from MIPS to APM Over Time

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Are You Part of an APM?

Who's Considered an Advanced APM in 2017?

• Shared Savings Program (Tracks 2 and 3)

• Next Generation ACO Model• Comprehensive ESRD Care (CEC) (large

dialysis organization agreement)• Comprehensive Primary Care Plus

(CPC+)• Oncology Care Model (OCM) (two-sided

risk track available in 2018)

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What’s the Benefit of Being an Advanced APM?

•Up to 5% Bonus Starting in 2019 through 2024•Higher Fee Schedule Update in 2026

The MACRA APM Creates Extra Incentives, It Doesn't Change Current APM Functions or

Rewards Value

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Most Small Practices Won’t be Advanced APMs

Advice for Those Who Might Be in an APM:

• Consult Your ACO or other APM OrganizationAsk:

• Are You a Qualified APM Participant (QP)?

Only Advanced APMs (QPs) Are Excluded from MIPS

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MIPS Details

Replaces 3 Programs:

• PQRS• Medicare EHR Incentive Program (Meaningful Use)• Value-Based Payment Modifier (VBM)

These Programs Go Through 2018

New Program:

• Clinical Practice Improvement Activities (CPIA)

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MIPS Details

Worth Noting:

• Medicaid EHR Incentive Program will Continue• Medicare EHR Incentive Program for Hospitals Will

ContinueImmediate Timeline:

• First Performance Period is 2017• MIPS Adjustments Happening in 2019

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Who's Eligible for MIPS?

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Who's Not Eligible for MIPS?

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What's the MIPS Incentive or Penalty?

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MIPS - 4 Performance Categories

Note: “Resource Use” is sometimes called “Cost”

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Performance Category Weighting

MIPS 100 Point Scale

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MIPS Composite Performance Score

• MIPS Performance Score Compared to Threshold - Determines Adjustment You Receive

• CMS Intends to Publish the Benchmarks and Thresholds Prior to 2017

• Gives Credit for Partial Performance• Scaling Factor to Keep Program Budget Neutral• Exceptional Performance Incentive ($500 Million

Available)

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Quality Performance Category

PQRS Replacement

• Reduction from 9 to 6 measures• No Domain Requirement

Changes

• Close to 300 Measures Available• Specialty Specific Measure Sets• Year 1 Weight - 50%

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Resource Use (Cost) Category

Value Modifier ReplacementNo Data Submission Required

• Calculated Based on ClaimsChanges:

• Added 40+ Episodic Specific Measures• Year 1 Weight - 10%

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Clinical Practice Improvement Activities Category

New Category (CPIA)

• 90+ Activities to Choose From• Minimum of One Activity• Small practices (15 or fewer professionals)

- Two Activities = Full Credit

• Patient Centered Medical Home = Full Credit• APM Participation = 50% Credit• Year 1 Weight - 15%

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Advancing Care Information Category

EHR Incentive Program (Meaningful Use) ReplacementChanges:

• May Participate as Individual or Group• Year 1 Weight - 25%

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Advancing Care Information Scoring

Score within a Score (25% of Total MACRA Score)

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Advancing Care Information Still Includes

Base Score (Reporting)

• Protecting PHI• ePrescribing• Patient Access• Patient Engagement• HIE• Public Health and Clinical Data Registry Reporting

Performance Score

• Patient Electronic Access• Coordination of Care through Patient Engagement• HIE

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Advancing Care Information Changes

• Removed "All or Nothing" Approach from EHR (Meaningful Use) Program

• Removed Redundant Measures• Eliminated CPOE and CDS Objectives• Reduced the Number of Required Public Health

Registries

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Small Practice Support for MACRA

$20 million/year from 2016-2020 to Small Practices

• Provides Technical Assistance with MIPS or Transition to an APM

Concept of a "Virtual Group"

• Not Available Until 2nd Year of ProgramAccommodations for Small Practice Reporting for:

• Quality Category• Cost Category• Clinical Practice Improvement Category

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MACRA Comment Period

134 Physician Events – 60,000 Participants3,710 Formal Comments ReceivedGeneral Feedback

• Delay the January 1, 2017 Start Date• 90 Day Reporting Period for 1st Year of Advancing Care

Information• MU Stage 3 Requirements Should Be Delayed Until

2018• More Simplification• APMs Aren’t Accessible to Most (Which is Bad)• Data Blocking Attestation Requirement is Controversial

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Medicare Fee Schedule Changes

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How Do You Fit Into MACRA?

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Agenda

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Agenda

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• Welcome & Introductions• MACRA• How Kareo Can Help• Your Questions

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Awards and Rankings

Growth awards The speed at which

medical practices are moving to Kareo and referring it to other

providers.

Best places to work Happy, engaged

employees stay longer, have more experience and

offer better customer service

Analyst reviews 3rd party recognition,

driven by direct customer feedback,

equals trust and credibility

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Kareo Platform

Kareo Billing

• Centralized A/R Management

• Intuitive Billing Analytics • Easy & accurate charge

capture• ICD-10 Ready• Smarter billing/patient

collections• Secure messaging• Powerful scheduler/appt.

reminders

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Kareo Platform

Kareo Clinical

• Comprehensive dashboard

• Simple charting• Easy ePrescribing• Convenient eLabs• Specialty templates• Electronic Superbill• Integrated Patient

Portal • Secure messaging

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Kareo Platform

Kareo Managed Billing• Dedicated team of specialists • Simple scheduling/calendar• Charge Capture (web/mobile)• Nationwide Billing Rules Engine• Claims tracking• Billing Tasks• Billing Analytics

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Kareo Platform

Kareo Marketing• Marketing and front

office automation• Online visibility and SEO • Online appt. scheduling • Email, text & voice

recording appt. reminders

• Post visit patient reviews• Practice analytics for ROI• Patient communications

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Agenda

37

Agenda

37

• Welcome & Introductions• MACRA• How Kareo Can Help• Your Questions

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