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How do the quality measures that ACOs Report to CMS correlate with the APP quality measures?
For TINs who are part of ACO, starting in 2021, Measures reported to the APM have no bearing on MIPS quality performance category score, and vice versa. However, if APM measures happen to overlap with your MIPS measures, such as is the case for the Shared Savings Program, then you may be able to use the same data for both programs.
Source: 2021 CMS APP Fact Sheet (from CMS QPP Website)
Implications for Registry
ACO Members have been sheltered from CQM submission since the beginning of the program. Starting in 2021, this is no longer the case, and every member TIN will have to submit CQM to MIPS for the first time.
Some of those TINs will have their own EHR, but we have found that even those will value your advisory services. But others - particularly hospital based provider TINs - do not have EHR certified to generate MIPS CQMs, and will need your Certified Services.
In addition, ACOs themselves will have to report on new Quality Measures against all payers, all patients and all TINs. This is a significant new requirement, for which ACOs have neither the tools, data pathways, nor expertise.
Let our team help you in these pursuits with our expertise, tools and qualifications
New revenue from existing customers
AI Based Coding
Coding for MIPS is a nice revenue add-on for Registries and QCDRs. Our AI engine reads clinical and billing information to identify "G" codes that your systems need for measure calculation.
Whether your clients do their MIPS coding internally, or with a billing company, AI does the job so cost-effectively, that you can make new revenue, while saving clients money.
And AI based coding for MIPS can easily happen all year long to smooth out your workload, while enabling meaningful feedback cycles quarterly, or even monthly.
Qualify for End-to-End Electronic Bonus
Because AI interfaces to your CEHRT and eliminates manual abstraction, our solution qualifies for End-to-End CEHRT bonus, with no requirement for Manual Abstraction. Simply using our system will increase your MIPS CQM score by 10%! Longer term, CMS is phasing out CQM submission methods that are not based on real-time CQM creation and analysis. Take advantage of the End-to-End Bonus while credit still applies.
Improve Compliance diligence and Reduce compliance effort
Quarterly Feed back cycle management and documentation
Some Registreis think sending an e-mail with a link to a dashboard is great customer service. We give you a more actionable approach, tailored to each client, and designed to make you competitive with the most sophisticated advisory firms, all bundled into your registry offering. Better customer interaction equals more loyal customers, and big competitive edge.
Basic Level: MACRA Monitor's simple Action Item database ties to every single TIN in your portfolio. You have at-a-glance verification of where each TIN stands. When CMS calls to audit your compliance, you'll have detail history with notes and attachments.
Active Feedback Level: Let our Concierge team develop detailed analytics, customized to each TIN's up-to-the-minute status. We can even conduct the client briefings, if you like.
Provider Eligibility Reconciliation
Basic Level: Our Three-way matching between PECOS, QPP and provider systems makes sure you have a permanent record of exactly which providers contribute to group scores (and how). We maintain eligibility / filing status at for each TIN, and for each provider within each TIN. MACRA Monitor simplifies the process of query against the QPP database, and integrates each status into scoring, submission and financial projections.
Active Feedback Level: We reconcile, and record provider QPP status as of each CMS Snapshot date, on your behalf. It's a big job, and no one wants to do it - but CMS states that your records are incomplete without it!
Prevent Submission when documentation is missing
Basic Level: Our database will manage submissions for you. Only when your compliance checklist is complete, will the tools allow submission. Some documentation (like Consents) create a "hard stop", preventing submission altogether. Other documentation provides a warning you can bypass. At a minimum, we validate for:
- Signed Consent forms
- Improvement Activities Documentation
- Scoring thresholds by category
- Documentation proving Quarterly (or more) Feedback Sessions
Active Feedback Level: Our concierge team will engage with your TINs throughout the year to obtain needed documentation. Since all work is done in our MACRA Monitor database, you have constant visibility into our (and your clients') progress.
CMS Submission Validation
At submission, we automatically accept CMS acknowledgements incorporated into our database, just so you can be certain it all went as planned.
Then we go one step further. CMS will echo back their "preliminary" scoring, which we display in our dashboard, right next to the scores we expected. This process really helps make certain the submission went correctly, in a timely enough fashion to reach when something goes wrong.
QCDR Submission Support
A lot of specialties don't have good options under standard MIPS measures. QCDR provides good choices for many, but can be expensive. And around 83% of all QCDR Measures lack advance benchmarks. Our service will help pick the right entity, manage data and evaluate the ROI before spending any extra money.
optional in our monthly macra program
You can't optimize by passively publishing a dashboard.
Improving MACRA Metrics comes from an active program, throughout the year. We get started as soon as a full month's data is available, and follow a regimen of extract, report, analyze and plan and act for every month thereafter.