The New Year is often anticipated and celebrated with music and parties. When it comes to the upcoming Year 3 in the Quality Payment Program for 2019, many of us are anxious instead. Your Kentucky Regional Extension Center Team is eager to present an overview of the Year 3 requirements to help you make sense of all the changes. An expert panel will discuss some of the most important aspects of the QPP Year 3 rules and how they will impact your practice.

This webinar will depart from our traditional presentation style, and feature the panel in a more informal conversation about some of the more significant changes to the QPP for the upcoming year. We will share each expert’s perspective on important considerations and pitfalls to be avoided. Some of the topics to be discussed include the new clinician types, the 4 MIPS categories, and Alternative Payment Models.

Our experts will also be answering questions on topics such as hardships, special considerations, facility-based scoring, specialty measure sets, CEHRT requirements, boosting your Promoting Interoperability performance, the new cost measures, and APM Qualified Providers.

Join us January 10th for our first webinar of the New Year!

Webinar: QPP Program Year 3 Requirements
Thursday January 10  12:30 – 1:30 p.m. ET

The New Year is often anticipated and celebrated with music and parties. When it comes to the upcoming Year 3 in the Quality Payment Program for 2019, many of us are anxious instead. Your Kentucky Regional Extension Center Team is eager to present an overview of the Year 3 requirements to help you make sense of all the changes. An expert panel will discuss some of the most important aspects of the QPP Year 3 rules and how they will impact your practice.

This webinar will depart from our traditional presentation style, and feature the panel in a more informal conversation about some of the more significant changes to the QPP for the upcoming year. We will share each expert’s perspective on important considerations and pitfalls to be avoided. Some of the topics to be discussed include the new clinician types, the 4 MIPS categories, and Alternative Payment Models.

Our experts will also be answering questions on topics such as hardships, special considerations, facility-based scoring, specialty measure sets, CEHRT requirements, boosting your Promoting Interoperability performance, the new cost measures, and APM Qualified Providers.

Join us January 10th for our first webinar of the New Year!

Webinar: QPP Program Year 3 Requirements
Thursday January 10  12:30 – 1:30 p.m. ET

Promoting Interoperability (formerly known as Advancing Care Information) takes first place as the category undergoing the most change in Year 3 of the Quality Payment Program. Under the Final Rule released November 1, 2018, CMS updated the Promoting Interoperability category to reflect the goal of a more simplified evaluation and scoring approach.

MEASURES

With the removal, restructuring and addition of new measures, the objectives that eligible clinicians must report on drops from eleven down to four. CMS listened to feedback, and received many comments on provider inability to control what patients do once they leave your office. Therefore, they removed Secure Messaging, View-Download & Transmit, as well as Patient Generated Health Data. All of these objectives require the patient to act in order for the provider to meet the requirements. They’re gone for 2019.

For the second set of measures, CMS removed Patient Education and Medication Reconciliation, since providers have historically performed very well on them. This is in keeping with the goal of streamlining and reducing the reporting burden.

“What’s left?” The required measure set includes:

• Electronic Prescribing
• Health Information Exchange
• Provider to Patient Exchange (Access)
• Public Health/Clinical Data Exchange

Security Risk Assessments are STILL REQUIRED. However, CMS has removed the objective from the list of measures, since it is required for ALL practices regardless of particularization in the program.

SCORING

In addition to the objective changes, CMS also reshaped their approach to scoring for Promoting Interoperability. They moved away from the flexible approach of base, performance and bonus, and it will be a straight scoring approach for 2019. While this reduces the overall complexity, it also makes it MORE CHALLENGING to receive full credit!

Join our upcoming webinar. We will walk you through these changes and discuss how they impact Year 3 in the Promoting Interoperability performance category.

Webinar – QPP Year 3: Promoting Interoperability
Thursday December 13  12-1 p.m. ET

Contact our Quality Experts at Kentucky REC with your questions. Call us at 859-323-3090

Year 3 of the Quality Payment Program begins January 1st, 2019, only a few weeks away. As you focus on Year 2 performance, select the best time frames, and finalize your documentation to prepare for attestation, thinking about Year 3 may seem like too much to handle. We understand the stress of juggling year-end prep, holidays, office hours, and sick days. Here at the Kentucky REC we understand that no one wants to read over 2,000 pages of the final rule and try to decipher what it means to your practice, especially during this hectic time of the year. It may be tempting to put off learning about Year 3 until after Year 2 is put to rest (after attestation).

Leave the heavy lifting to us (yes we really did read all 2,000 plus pages, more than once) and read this summary highlighting the MUST KNOW items before entering 2019. We’ve summed up the Final Rule into the top 5 major changes to get you started. We will be digging into these changes and more during our upcoming webinars on December 6th and 13th. We encourage you to tune in for the repeat if you missed our first Year 3 Overview, and then join the upcoming Promoting Interoperability webinar. The registration links are below.

NEW EC TYPES
In Year 3 of the Quality Payment Program, CMS moved to expand the current five Eligible Clinician (ECs) types to 11. Currently Physicians, PAs, NPs, CNSs and CRNAs who meet the eligibility threshold are required to report to the QPP. Starting in January, this will expand to include PTs, OTs, Qualified Speech-Language Pathologists, Qualified Audiologists, Clinical Psychologists, and Registered Dietitians or Nutrition Professionals. Many of these new clinician types have never had to participate in any quality incentive programs so education on how and where to document key factors will be crucial. For those participating at the individual level, these new clinician types do receive an automatic re-weight on the Promoting Interoperability category. This will move the 25% weighting normally under PI over to the Quality category, making Quality 70% of your final score. For those reporting as a group, unless the group meets the re-weighting requirement, the reporting group should include all clinicians under the tax ID.

EXCLUSION REQUIREMENTS
CMS also expanded the exclusion requirements to include a third criterion so that an EC must meet or exceed $90,000 in Medicare Part B billing, 200 Medicare patients AND have 200 covered Professional Services. With the addition of the third criterion, CMS expects a slight drop in the number of eligible clinicians, as compared to Year 2 ECs. However, paired with the expansion of EC types and other changes, CMS is expecting an overall neutral change in eligibility.

INCREASED THRESHOLDS
In addition to the expanded clinician types and criteria, CMS also increased the performance threshold from 15 points to 30 points for Year 3. The payment adjustment at risk for Year 3 (administered in 2021) also increases from 5% to 7%. This raises the stakes for not meeting that minimum performance threshold of 30 points. CMS also increased the exceptional performer threshold from 70 points up to 75, raising the bar to qualify for an additional incentive outside the budget neutral program.

OPT IN
Brand new for Year 3 is the allowance for clinicians who meet ONE of the three eligibility criteria ($90k, 200 patients, 200 CPS) to Opt-in to the QPP. This means that those clinicians who opt-in can participate in MIPS, and qualify for the payment adjustment in the corresponding payment year. This election must be made on the QPP Portal and is IRREVOCABLE for the program year. This is an additional flexibility given to practices that are just shy of meeting all three requirements, yet have the potential to perform well in the program, and want to participate. In previous years a practice/clinician could submit to the QPP despite eligibility. However, if they were not an EC, they did not qualify for the payment adjustment.

PROMOTING INTEROPERABILITY
Finally, and the largest change in our opinion, is CMS’s restructuring of the Promoting Interoperability Program. CMS reduced the number of objectives that clinicians are required to report on in an effort to cut down on the variables requiring patients to act independently. Therefore, CMS removed the following measures: View Download and Transmit, Secure Messaging, and Patient Generated Health Data. This is in addition to measures that do not require patient activation such as Patient Education and Medication Reconciliation. This leaves a compressed list of objectives including: Security Risk Assessment (non-weighted), Electronic Prescribing, Patient Access to Health Information, Health Information Exchange/Closing the Referral Loop, and Public Health.

In addition to reducing the number of required objectives, CMS updated the scoring process. They moved away from the base, performance, and bonus measures approach, and on to a straight performance-based measurement for simplification. While this new scoring method does simplify the process, it also greatly increases the difficultly to maximize your performance in this category.

While CMS states that overall there are few changes to Year 3, the changes are significant and can deeply impact your performance in Year 3. While highlighting these five major changes to the program, there are many others. A couple examples include an increase to the Cost category, as well as the finalization of the Facility Based Scoring for Quality. We will host webinars each month in the New Year focusing on each performance category, the changes, and how to succeed in the Quality Payment Program.

Join us for these informative hour long FREE events!

Webinar – QPP Year 3: Final Rule Overview – Repeat
Thursday December 6  12-1 p.m. ET

Webinar – QPP Year 3: Promoting Interoperability
Thursday December 13  12-1 p.m. ET

Contact our Quality Experts at Kentucky REC with your questions. Call us at 859-323-3090