Feedback is Key to Improvement
CMS released the 2017 MACRA performance feedback to the Quality Payment Program (QPP) portal in July 2018. Feedback is the key to improvement and must be reviewed to understand impacts to the clinical care team, clinical infrastructure, cost performance
and Physician incentives. Cost feedback for MIPS track is particularly important as this will be the only opportunity to glean feedback in preparation for the 10% cost category performance in 2018 and 15% in 2019, based on the 2019 proposed rule. For providers in the MIPS APM scoring standard or Qualifying Participants the same 4 areas need analysis which will require reports from the APM Entity.
1. Care Team Focus
Understand beneficiary attribution, high risk beneficiaries, beneficiaries needing primary care providers, beneficiaries with primary care services in a different TIN, inpatient admissions, refine target populations for preventive care interventions and care coordination programs.
2. Clinical Infrastructure
Evaluate quality and cost tracking and/or dashboard performance based on CMS feedback, optimize processes and EHR clinical decision support to close gaps at the point of care, refine target population stratification in alignment with care coordination programs, refine approach on cost management and tracking through claims and clinical data.
3. Financial Analysis
Understand cost measure performance relative to peers based on 2017 performance, inpatient admission beneficiary costs, items and services attributed to your TIN from beneficiaries for services delivered externally to your TIN.
4. Refine Physician Incentive Plan
Review physician performance against the TIN and revise incentive plans based on performance distribution. Evaluate base and bonus measures submitted, ensure reweighting (PCMH, hardships…) was applied correctly, understand highest performing submission method and data completeness performance and determine if a target review with CMS is necessary.
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