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How’s CMS Helping Eligible Clinicians Prepare for MIPS?

CMS has enlisted help from practice transformation networks and other organizations to help eligible clinicians prepare for MIPS.

By Sara Heath

CMS has funneled millions of dollars into providing clinician support during the transition to the Merit-based Incentive Payment System (MIPS), according to the CMS Director of Quality Measurements and Value-Based Incentives Group Kate Goodrich, MD.

With reporting slated to begin in January, 2017, MIPS, one component under MACRA’s Quality Payment Program, could serve as a challenge for many healthcare professionals, Goodrich explained. In an interview with the American Journal of Managed Care, she noted the different overtures CMS is making to assist clinicians in the program.

According to Goodrich, it would be ideal for clinicians to participate in the Quality Payment Program through an advanced alternative payment model (advanced APM), but that may not be feasible for all clinicians.

“Certainly if there is an alternative payment model eligible for them, we would encourage them to join that model, but we understand that that’s in some instances a little bit easier said than done,” Goodrich explained. “You have to prepare your practice to be ready to take on financial risk and so forth, so that’s not where everybody is.”

Instead, CMS has enlisted the help of many expert groups poised to assist eligible clinicians.

First, CMS has established practice transformation networks. These organizations reportedly have expertise in practice transformation, helping clinicians to focus on population health and begin transitions to advanced APMs. With $700 million in funding, these groups will reportedly be instrumental in the transition to MIPS.

“We call that frontline technical assistance. That work is happening now,” Goodrich explained.

“These organizations, these practice transformation networks, are already recruiting physician practices from solo practices to large group practices across the country to really start providing them that one-on-one, daily assistance to help them be successful in MIPS and ultimately transform to APMs.”

Specifically, practice transformation networks help hospitals select quality measures and understand the registries for which to sign up for quality measure reporting. They are also helping transitioning practices use EHRs effectively and efficiently.

Second, CMS has established organizations to assist solo, small, and rural practices. With $100 million in funding, these organizations help practices that are “the most concerned about being successful in this program and may not even know about the program,” Goodrich noted. “So we’re directing a lot of money towards those practices as well.”

Third, Goodrich noted that CMS is reaching out to national and regional healthcare professional organizations and technology vendors. The agency hopes to educate these stakeholders in the “rules of the road” for MIPS and highlight the primary goals for the program. This will ideally result in several resources for eligible clinicians.

“It’s a lot of partnership, it takes a lot of work, but we really are undertaking what I would say is a pretty unprecedented effort to really try to reach out to every clinician in America if we can get to them, but we know it can’t all be done from CMS,” Goodrich said. “We really have to rely on our partners to get to these practices so that they can start reporting, and more importantly start improving.”

Goodrich also acknowledged some of the flexibilities CMS built right into the law, including a one-year transition period for struggling clinicians. Additionally, the agency worked to streamline reporting measures and implemented a pick your pace policy.

Pick your pace allows eligible clinicians to report to MIPS on their own timeline. By reporting any data pertaining to MIPS, for example, eligible clinicians can avoid negative payment adjustments in 2019. As eligible clinicians meet more program benchmarks, the more positive payment adjustments they may receive.

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