Guiding You on Your MACRA Journey.

You've charted your course for MACRA. But with each update to the ruling, the map is being redrawn. Do you stay the course or rethink your route? Do you stay on the MIPS path, or are you ready to give Advanced APMs a try? The answer is not always simple. We're here to help.

Choosing Your Route.

You begin your journey faced with two options, each with its own set of rules. Choose your adventure:

Merit-based Incentive Payment System (MIPS) Path

Proceed if:

You are not a qualified participant in an APM
You bill for Medicare B
Your billed charges > $90,000
Your beneficiaries > 200
You hold an eligible role

If you haven’t determined your eligibility yet, use the QPP Lookup Tool.

Advanced Payment Models (APM) Options

Bundled Payments for Care Improvement Advanced Model
Medicare Shared Savings Program Track 2 & 3
Next Generation ACO Model
Oncology Care Model Two-Sided Risk Arrangement
Comprehensive ESRD Care Model
Comprehensive Primary Care Plus (CPC+)
Comprehensive Care for Joint Replacement
APM Performance Pathway (APP)
All Payer Option

It's important to make sure you qualify before you take those first steps.

Your MIPS Compass.

Quality

Submit collected data for at least 6 measures, or a complete specialty measure set, with bonus points available.

Promoting Interoperability

Points for attesting to performance category measures organized under 4 objectives (2015 CEHRT), with bonuses available.

Improvement Activities

Choose from high or medium value activities that promote care coordination, beneficiary engagement, and patient safety.

Cost

Cost is calculated on Medicare Spending Per Beneficiary (MSPB) and total per capita cost measures.

MEDITECH Supplies for a Successful Trip

Every traveler needs supplies along the way; we've got you covered. From embedded predictive analytics and quality reports to seamless connectivity with patients and outside providers, you'll be equipped with the tools you need to make the transition to value-based care models.

Improvement Activities

Telehealth: integration of remote monitors and activity trackers

Population Health/Patient Registries

Behavioral Health

Patient Portal, including direct booking (beneficiary empowerment)

Virtual visits (expanded practice access)

Management of social determinants of health (achieving health equity)

Quality

Surveillance (predictive analytics)

Quality Vantage dashboards

Business and Clinical Analytics

Promoting Interoperability

Immunization registry

Robust security*

e-Prescribing* and medication reconciliation

Interoperability with HIEs* and member of Commonwell Health Alliance®

Transmission of patient summary

Patient and family access to records* and education

Secure patient messaging

* indicates a requirement

Cost

Clinically driven charge capture

Integrated supply chain

Automated claims processing

Measuring Your Progress: How MIPS Calculates Scores.

2021

40% Quality
25% Promoting Interoperability (PI)
20% Cost
15% Improvement Activities (IA)

It IS a Competition: Tracking Penalties and Percentages.

No matter how well you perform, you are always being measured against your peers — which means the bar is always being raised. How do you stay positive?

Stay ahead of the competition by keeping a close eye on your measures. MEDITECH's Quality Vantage dashboards can help. Quality Vantage dashboards provide an interactive view of regulatory measure performance, giving you a "point-in-time" view of measures well before the reporting period and attestation. Color coding indicates where performance is not meeting thresholds, so you can easily see the areas that need extra attention. View by practice, group, hospital, or down to the clinician level — even drill down into a patient list to view patients, encounters, medications, and orders that are counted on the provider/measures.

"Quality Vantage is a powerful tool for providers and organizations to view quality metrics in near-real time. Its simple and sleek design makes it easy to navigate for all staff. Having quality metrics within MEDITECH is an integral part of identifying and improving patients’ health easily."

Scott Stone, Application Specialist, CAPM

Kalispell Regional Healthcare

Recalculating Your Route: A Guidebook To MACRA Changes.

Detours, roadblocks, change en route. Most travelers change direction from time to time. Your journey with MACRA is no exception; our dedicated team will stay on top of the latest government changes and give you the tools to either switch things up or stay the course. Check out the MACRA section of our Regulatory page for the latest best practices, FAQs, and update bulletins; or review our blog.