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MACRA Patient Engagement Cheat Sheet #2

Patient Engagement Strategies for MIPS Success
The first major impact of the Medicare Access and CHIP Reauthorization Act (MACRA) that most providers will feel comes from the Merit-based Incentive Payment System (MIPS) program. MIPS rolls up and replaces the Meaningful Use, Physician Value-Based Payment Modifier, and Physician Quality Reporting System programs. The only providers who won’t be affected by MIPS are those who are part of an Advanced Alternative Payment Model (APM) or those who have extremely low Medicare patient volume. As a result, for the vast majority of providers, MIPS will be the most significant mandatory value-based program they have been subjected to thus far.
The MACRA final rule contained a number of changes to MIPS that eased the first-year burden on providers by giving them 3 different approaches from which to choose:

The 2017 financial impact of MIPS is minimal. Therefore, providers shouldn’t focus too much of their MIPS strategy on 2017 performance. However, delaying planning would be a mistake. Starting in 2018, MIPS requirements grow while the anticipated penalties and bonuses also scale up quickly. Therefore, wise providers will use 2017 to develop winning MIPS strategies for the year 2018 and beyond.
Providers will be scored under MIPS in 4 categories:
  1. Quality
  2. Cost/Resource Use
  3. Clinical Practice Improvement Activities
  4. Advancing Care Information
An effective patient engagement strategy can help providers improve and report their scores across all these categories.

Quality Category

Under MIPS, providers can choose which measures (from a list of 200)  they want to report based on their specialty and patient mix. Therefore, it would be impossible to address all of them in one article. However, the following examples should illustrate how engaging patients helps meet quality goals.
Meaningful patient engagement has been shown to improve a number of outcome measures that map to specific MIPS quality metrics. Engaged patients have better medication compliance which, in turn, affects outcomes. For example, if you are tracking the “Hemoglobin A1c Poor Control” metric, you will certainly want your patients to take their medication consistently. 
Patient engagement can also improve data collection. For example, if you are tracking the “Pain brought under control within 48 Hours” metric, your patients could receive  automatic reminders and use a smartphone app to report pain levels without the need for you to contact them. 
Once individual providers and provider organizations have narrowed down the list of metrics they are targeting, they should consult with patient engagement experts to determine how best to leverage appropriate technologies to manage toward these metrics.

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