On January 12, 2016, at the 34th annual J.P. Morgan Healthcare Conference in San Francisco, Andy Slavitt, the acting administrator of the Centers for Medicare and Medicaid Services (CMS) gave a presentation regarding a wide variety of CMS initiatives including the Meaningful Use (MU) and the Merit-Based Incentive Payment System (MIPS) program created under the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) legislation. Media reports of Slavitt’s presentation and his subsequent tweets largely focused on comments he made that the MU program would effectively end in 2016. The media reports left some people with the impression that Meaningful Use (MU) guidelines would no longer be of significance after 2016. Needless to say, the media’s reporting has created some confusion within the industry, and we wanted to take time to address this topic.
The MU program for Medicare providers as we know it will likely end in 2016 and has been alluded to in numerous industry reports and by CMS over the last nine months. However, the MU program will remain relevant because under MACRA it will be merged into the MIPS program as a means by which to streamline multiple value-based payment programs.
This change to the MU program occurred back in April 2015 when Congress passed and President Obama signed MACRA into law. MACRA will effectively merge the MU program, the Physician Quality Reporting System (PQRS) program, and the Value-Based Payment Modifier (VBM) into a new program called MIPS. Under MIPS, healthcare providers will receive a single annual quality score determined by the following four components: use of technology, quality, cost, and practice improvement. And a provider’s 2017 performance in two of these categories, use of technology (MU) and quality (PQRS and VBM), will represent 75% of their total possible score (two key areas SA Ignite software and services support now). The provider’s annual MIPS score will determine to what extent their Medicare reimbursement will be adjusted up or down by at least 9%. The first MIPS performance year begins on January 1, 2017, and the results will affect providers’ 2019 Medicare reimbursement. In addition, MIPS scores will be publicly reported by the government via the Physician Compare website.
Given this background, it is now important to consider the context of Mr. Slavitt’s remarks. Here’s an excerpt:
The implementation of the bipartisan MACRA legislation is a major item squarely on our punch list that has everyone’s attention. At its most basic level it is a program that brings pay for value into the mainstream through something called the Merit-based incentive program, which compels us to measure physicians on four categories: quality, cost, the use of technology, and practice improvement. … At its core, we need to simplify. We have the opportunity to sunset three old programs and align them together in a single new program. … The Meaningful Use program as it has existed, will now be effectively over and replaced with something better.
In light of Slavitt’s comments, there’s no doubt: SA Ignite customers have a significant advantage in anticipation of MIPS.
So, how is SA Ignite positioned to support these changes?
Since our founding in 2009 and with the release of our first solution in 2010, MU ASSISTANT software, we’ve been focused on empowering healthcare organizations to simplify the management of complex value-based payment programs. In fact, we’ve always taken a proactive approach to these programs, anticipating changes often before they’re even made public.
During 2015, we launched our PQRS ADVISOR services and in the coming weeks we plan to announce an addition to our software platform and strategic advisory services, PQRS ASSISTANT software. From a single login, SA Ignite customers will be able to access predictive analytics for both the MU and PQRS/VBM programs. This undoubtedly will give our customers a significant leg-up when it comes to preparing for MIPS and subsequently will help them to maximize their quality scores.
We have also established ourselves as the industry’s most sought after experts in MIPS. Together with HITECH Answers, we launched a monthly webinar series back in June 2015 titled, “The ABCs of MIPS” which is dedicated solely to MIPS. The series has garnered an attendance of 300 to 400 healthcare professionals and vendors monthly. We also initiated and continue to host a large LinkedIn group focused solely on MIPS where we can further facilitate open conversation on this topic (just begin typing “Merit-Based” into the LinkedIn search bar to find the group). In addition, many months ago we dedicated a portion of our website to MIPS, which includes a comprehensive frequently asked questions section as well as a financial calculator that has been downloaded and utilized numerous times for planning use by the country’s leading healthcare organizations.
We work closely with CMIOs, VP Physician Services, and CIOs to educate other executives and key stakeholders about the practical and financial implications of the MIPS program. We also work daily with MU and PQRS/VBM program directors to assist them in unraveling the nonstop changes in rules and regulations, provide best practices for program management, and support them through data submission.
Helping customers navigate the current value-based program landscape now as well as preparing them for the future is at the core of who we are as a company, and it is who we will continue to be.
We know many of our customers are already busily preparing to submit their 2015 MU and PQRS data. We are grateful to be partnered with such forward thinking organizations.
And for those who aren’t already a customer, we hope to be considered as a future partner.
Thank you for your time and cheers to a happy and healthy new year.