MACRA Quality Payment Program Improvement Activities Patrick V

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MACRA Quality Payment Program Improvement Activities Patrick V. Bailey, MD, MLS, FACS| Medical Director,

MACRA Quality Payment Program Improvement Activities Patrick V. Bailey, MD, MLS, FACS| Medical Director, Advocacy DIVISION OF ADVOCACY AND HEALTH POLICY

Improvement Activities Component • NEW requirement • Select from a list of 93 activities

Improvement Activities Component • NEW requirement • Select from a list of 93 activities - Point system: Activities with assigned point values • 10 points or 20 points - 40 points for FULL CREDIT • Two to four activities • 20 points for some rural and small practices • Attestation Quality Payment. Program Improvement Activities

MIPS: Final Score Year 1 – Weight by Category Advancing Care Information 25% Quality

MIPS: Final Score Year 1 – Weight by Category Advancing Care Information 25% Quality 60% Cost 0% Quality Payment. Program Improvemen t Activities 15% Improvement Activities

Improvement Activities Component • List of 93 activities - Point system: Activities with assigned

Improvement Activities Component • List of 93 activities - Point system: Activities with assigned point values • 10 points – medium value • 20 points – high value - 40 points for FULL CREDIT • Two to four activities - 20 points for some rural and small practices • One to two activities - 50 percent reduction in the requirement for FULL CREDIT • As compared with that in the Proposed Rule Quality Payment. Program Improvement Activities

Improvement Activities Component • REPORTING of Improvement Activities for Year 1 of MIPS -

Improvement Activities Component • REPORTING of Improvement Activities for Year 1 of MIPS - Attestation • Traditional registries (registry reporting option) • Qualified Clinical Data Registries • Portal on CMS website Quality Payment. Program Improvement Activities

Improvement Activities Component • High-Value (20 point) Activities - Use of a qualified clinical

Improvement Activities Component • High-Value (20 point) Activities - Use of a qualified clinical data registry(QCDR) to generate regular performance feedback - Consultation of a prescription drug monitoring programprior to issuance of a Controlled Substance Schedule II opioid prescription that lasts for longer than three days - Seeing new and follow-up Medicaid patients in a timely manner , including individuals dually eligible for Medicaid and Medicare Quality Payment. Program Improvement Activities

Improvement Activities Component • Medium-Value (10 point) Activities - Participation in a QCDR, clinical

Improvement Activities Component • Medium-Value (10 point) Activities - Participation in a QCDR, clinical data registry, or other registryrun by a government agency or private entity, such as a hospital or a medical or surgical society - Provision of specialist reportsback to referring providers to close the referral loop - Bilateral exchange of necessary patient informationto guide patient care that could include participation in a health information exchange or use of structured referral notes Quality Payment. Program Improvement Activities

Improvement Activities Component • Medium-Value (10 point) Activities - Participation in Maintenance of Certification

Improvement Activities Component • Medium-Value (10 point) Activities - Participation in Maintenance of Certification Part IV - Annual registrationby eligible clinician or group in the PDMP of state where they practice - Use of evidence-based decision aidsto support shared decisionmaking - Use of tools that assist specialty practicesin tracking specific measures that are meaningful to practice, such as the Surgical Risk Calculator Quality Payment. Program Improvement Activities

Improvement Activities Component • NEW requirement • Select from a list of 93 activities

Improvement Activities Component • NEW requirement • Select from a list of 93 activities - Activities with assigned point values - 40 points for FULL CREDIT • Two to four activities • Attestation • 15 percent of final score Quality Payment. Program Improvement Activities