Dr Kate Goodrich on CMS Efforts to Prepare Providers for MIPS

CMS has a number of mechanisms in place to help physicians successfully adapt to the Merit-based Incentive Payment System (MIPS) under the Medicare Access and CHIP Reauthorization Act (MACRA), according to Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS. These efforts include funding practice transformation and quality improvement networks as well as building partnerships with medical societies.
Published Online: November 05, 2016


CMS has a number of mechanisms in place to help physicians successfully adapt to the Merit-based Incentive Payment System (MIPS) under the Medicare Access and CHIP Reauthorization Act (MACRA), according to Kate Goodrich, MD, director of the Quality Measurement and Value-Based Incentives Group in CMS. These efforts include funding practice transformation and quality improvement networks as well as building partnerships with medical societies.

Transcript (slightly modified)
How do you expect physicians will adapt to MIPS being the default Medicare payment program?
Well, for some providers out there, for some clinicians out there, that are not in an ACO [accountable care organization] or are not in some other alternative payment model [APM], certainly if there is an alternative payment model eligible for them, we would encourage them to join that model, but we understand that that’s in some instances a little bit easier said than done. You have to prepare your practice to be ready to take on financial risk and so forth, so that’s not where everybody is.

So for everybody else, they will be subject to MIPS, again, unless they fall below the low-volume threshold. And so we’ve tried to design the program again by significantly reducing the burden, to make it easy for people to participate, by implementing the transition year that we just talked about to help them ramp up for full participation later on. And so we’re doing a few things to help people get ready for that.

Number 1, we have already put out about almost $700 million in awards to what are called practice transformation networks, and these are organizations that have very deep expertise in helping physicians to change their practices, to focus on health of their population, to begin the transition into alternative payment models. They may not be ready yet, but it’s helping them redesign their practice. So we call that frontline technical assistance. That work is happening now. We’re already, these organizations, these practice transformation networks, are already recruiting physician practices from solo practices to large group practices across the country to really start providing them that 1 on 1, daily assistance to help them be successful in MIPS and ultimately transform to APMs.

Our quality improvement networks, which traditionally have worked with hospitals and nursing homes, now are able to work with practices to help them understand what they need to do to be successful in MIPS. To help them select quality measures, understand what the registries are that they can sign up with for reporting quality measures. Understanding how to get the most out of their electronic health record system, for example. Understand how what different tools are out there for improvement activities.

And then finally, we will be making contract awards soon to organizations that will be dedicated to helping the solo and small practices, rural practices, and practices in health professional shortage areas, to sign up for and be successful in the MIPS program. Or in an APM, if there’s one available to them, certainly. So this is $100 million that is being focused directly on those types of practices that we know are the most concerned about being successful in this program and may not even know about the program. So we’re directing a lot of money towards those practices as well.

The other thing that is I think very important is for us to partner with the specialty societies, the state and local medical societies, certainly registries and EHR vendors who are often the entities and partners that practices actually have the most interaction with, so that they understand what the rules of the road are for the MIPS program, for the transition year. So they can help practices directly to, again, be successful in the MIPS program.

So it’s a lot of partnership, it takes a lot of work, but we really are undertaking what I would say is a pretty unprecedented effort to really try to reach out to every clinician in America if we can get to them, but we know it can’t all be done from CMS. We really have to rely on our partners to get to these practices so that they can start reporting, and more importantly start improving. 


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