This Week – June 4, 2016

This Week in Washington, D.C.

  • ACG’s MACRA Tidbit for the Week
  • AJG Series on Patient Experience Measures


Is Quality Reporting King?

The answer seems to be “yes,” at least for the beginning years of MIPS and APMs.  Why?

ACG members participating in the modified fee for service option (MIPS) will find that the “Quality” score represents 50% of the total MIPS score in 2019 and 45% in 2020.  From there, it decreases to 30%, but CMS can increase this percentage if ACG members are for some reason ineligible to meet other components (for example, not enough patients in “Resource Use”).   Additionally, as proposed, approved alternative payment models (APMs) scores are also based on MIPS quality measures or quality measures comparable to MIPS.  For ACOs, for example, the performance weight for “Quality” is 50% in 2019.  Thus, your quality reporting activities will have a significant influence on your success in the new payment systems under MACRA, regardless of which payment model you choose.

We say “quality reporting” is king for MACRA…..  not so much “quality”…. as ACG members are all too familiar with the fact that mandated quality reporting does not necessarily translate into improved quality of patient care.  The good news is that Congress and CMS do recognize the value that registries such as GIQuIC have on quality improvement.  Further, participation in quality improvement registries will help increase scores of other MIPS’ components, including “Advancing Care Information” (25% of total score) as well as the “Clinical Practice Improvement Activities” (15% of total score).  Click here to learn more about signing your practice up for GIQuIC.

Please note that ACG does not endorse simply linking reimbursement to quality reporting.  However, when policymakers mandate quality reporting as a condition to payment, it is ACG’s goal to minimize practice management burdens and protect GI reimbursement as much as possible.  Participation in GIQuIC helps to meet this goal. Many ACG members are already participating in GIQuIC to help improve patient care as well as benchmark performance of individuals within the GI practice.

More on MACRA: ACG Hopes to Keep This Simple.   We compiled a detailed overview for you, hopefully in a simplified fashion and in plain English.  Read the summary and potential impact to GI: Making $ense of MACRA

Speaking of Quality Reporting: Have you checked out the AJG Series on Patient Experience Measures?  

The ACG Practice Management Committee developed a paper on measuring satisfaction authored by Louis J. Wilson, MD, FACG (pictured to the left), Jay N. Yepuri, MD, and Richard E. Moses, MD.  “The Advantages and Challenges of Measuring Patient Experience in Outpatient Clinical Practice,” is being published as a four-part series in the American Journal of Gastroenterology Red Section.

What’s the Connection to Quality Reporting in MACRA?

As currently proposed, MIPS will not require CAHPS surveys for individuals choosing to report MIPS quality measures collectively as a practice, or via the “group reporting” option.  However, CMS proposes scoring incentives in the MIPS “Quality” component for those groups that do participate.   CMS proposes to allow registered groups of two or more MIPS eligible clinicians to voluntarily elect to participate in CAHPS.  This would fulfill one of the required “cross-cutting” or “patient experience” measure requirements, and additionally, CMS’ proposed scoring methodology would give bonus points for reporting CAHPS data.  For more information, please read the summary and potential impact to GI.