Eyeworld Daily News

EW SHOW DAILY 24 ASOA News Today Monday, May 8, 2017 by Ellen Stodola EyeWorld Senior Staff Writer existing penalties sunset at the end of 2018 (based on 2016 reporting). Eligible professionals will receive a final performance score of 0-100 based on their performance in these four categories. The final score will be compared to a performance threshold and the mean or median of all composite performance scores for all MIPS eligible professionals during the prior period. These are not just ophthalmology but for every specialty, Ms. McCann said, which is another issue that could be problematic. In some cases, CMS may determine a provider is excluded from one or more of the other MIPS categories and will reweigh the other categories to make up the difference, she added. There will be a positive, nega- tive, or neutral adjustment based on the composite score, she said, and the negative adjustment is capped at 4% in 2019, 5% in 2020, 7% in 2021, and 9% in 2022. If the eligible professional's composite score is at the threshold, they will not receive a MIPS pay- ment adjustment. However, higher performance scores will receive proportionally larger incentive pay- ments up to three times the annual cap for negative payment adjust- ments. Ms. McCann highlighted the implementation of MACRA and went into detail on performance pe- riod options for physicians to avoid a penalty. She discussed the specific performance categories in MIPS: quality, cost, ACI, and improve- ments activities. She also discussed options for APMs. For a more in- depth analysis of these topics, see the article in tomorrow's edition of EyeWorld Daily News on the Legisla- tive and Regulatory Update, which took place on Sunday evening. Ms. McCann will be giving her ASOA MACRA presentation again today from 10:30 to 11:30 a.m. in the 411 Theatre. EW Editors' note: Ms. McCann has no financial interests related to her comments. Nancey McCann gave an update on MACRA at the ASOA program N ancey McCann, ASCRS• ASOA director of govern- ment relations, Fairfax, Virginia, gave an update on the Medicare Access and CHIP Reauthorization Act (MACRA) at the ASOA program on Sunday morning. She started by discussing "how we got here." It's important for peo- ple to understand what's going on in Washington, D.C. and Congress, she said. There is a bipartisan effort to move Medicare payment into a system based on outcomes, quality, and efficiencies. MACRA was developed in a bipartisan, bicameral process over 2 plus years, Ms. McCann said. It was supported by more than 750 national and state-based physician organizations. It passed in the House of Representatives in March 2015 and in the Senate in April 2015. MA- CRA, Ms. McCann said, permanent- ly eliminates the SGR, which had been producing Medicare physician payment cuts annually since 2002, and it provides for 5 years of a 0.5% update. It also implements a new payment system that ties reimburse- ment to performance and offers two payment pathways: a modified fee-for-service model (MIPS) and advanced alternative payment mod- els (APMs). For ophthalmology, the best path is MIPS for the foreseeable future, she said. MIPS, or the Merit-Based Incen- tive Payment System, consolidates the current quality reporting pro- grams (PQRS, VBPM, and Meaning- ful Use) and adds clinical practice improvement activities into a new program beginning in 2019, based on 2017 reporting. Several other important issues for ophthalmology were included in MACRA. First, Ms. McCann said the global surgical codes were protected. CMS policy would have transitioned all 10- and 90-day global codes to 0-day, she said, adding that analysis showed that ophthalmology would have been the hardest hit special- ty. MACRA also incorporates the Standard of Care Protection Act, indefinite opt-out for private con- tracting, and EHRs are required to be "interoperable" by 2017. Ms. McCann went on to explain the MIPS program, which consists of giving a composite score of quality (60% for the first year); cost (0% for the first year); advancing care information, or ACI, (25%); and improvement activities (15%). MIPS streamlines PQRS, VPBM, and EHR Meaningful Use, she said, and the MACRA update Ms. McCann gives an update on MACRA.

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