The American Academy of Neurology (AAN) has developed neuro-specific measures that you can use in your practice to get a higher score for the MIPS payment program because neurology measures are not “topped out” and they may be more relevant to your practice.
Jose Rocha is the director of Central Business Office, Performance Medical Management, and is practice manager for AAN Board Member James N. Goldenberg, MD, FAAN, at FirstChoice Neurology. In this practice, there are 68 neurologists among the 88 providers in the group. The group―which is spread across Miami, Ft. Lauderdale, Palm Beach Gardens, Tampa, and the Florida Keys―has physical medicine and rehabilitation, pain management, sleep specialists, and ancillary providers.
Develop a MIPS Strategy
For Rocha, the work on preparing for the new payment program has evolved over the last three years. He said they have been trying to figure out “What do we need to do to meet CMS’s requirements? And what do we need to do in the system to make it less intrusive to the physician’s day-to-day?”
The first step was to figure out the best way to report. The group considered reporting via EHR or third-party registry. Using an EHR was the easiest way to do it since data was already in their system. And there was no guarantee that it would take less work if they did it any other way. They decided not to use the Axon Registry because they have been using different measures and they would have to “push” data up to the registry rather than having it “pulled” by the service. But he is anxiously waiting for the interface between the EHR and Axon. The group is fully committed to supporting the AAN and the Axon Registry.
Then, Rocha and his team identified measures and mapped these to their EHR system. They chose mostly primary care measures in the first year (e.g., BMI, documenting current meds, and tobacco screening) because it was easy to do. They also selected measures around depression screening and controlling high blood pressure. Because of the preponderance of stroke management work at the clinics, these were relevant to practice. All of this, Rocha noted, would have been impossible to do without an EHR.
The team also selected several Improvement Activities. They encouraged providers to use a patient portal and rolled out more providers using telemedicine for snowbirds (patients who are only in Florida during winter months) more for 24/7 access.
“Part of our rollout was education on the patient side. Many were excited about the telecommunication aspects,” said Rocha. Rocha expects to achieve more than 90 points in MIPS for 2017 reporting.
Rocha shared some tips he gleaned from his experiences:
Get physicians involved: It’s important to get all the physicians involved early, according to Rocha. “This is not a top-down approach. Physicians were involved at every level. First, I asked what measures would be easy. I asked them which measures were relevant to them. Then, it was interesting. You must communicate to physicians the importance of this: this is how they’ll rate you. This is how plans will determine how valuable the physicians are to them. So, it’s important to get the physicians engaged to come out with a better product.”
Make sure physicians are aware of their performance: “Every month, give physicians a ‘report card’ letting them know how they’re doing on their quality measures. This keeps them engaged throughout the year. At quarterly meetings, share how the group is doing.”
Make it easy for clinicians: “Find alignment between quality measures and improvement activities,” said Rocha. The AAN provides a table of suggested high-impact Improvement Activities at AAN.com/view/TipSheet. The document can help providers understand how to implement measures and complete Improvement Activities.