February 22, 2017
Deborah H. Tracy, MD, MBA
- Board Certified Anesthesiologist
- Subspecialty Certified Pain Management, ABA
- Fellow of the Interventional Pain Practice, WIP
- Board Certified Pain Management, ABIPP
Dr. Tracy was appointed to serve on the Medicare Carrier Advisory Committee, First Coast Service Options, representing the Florida Society of Interventional Pain Physicians in 2006. Since that time she has been involved in the evolution of Medicare's local coverage determinations for physicians in the State of Florida and has engaged in the many challenges facing physicians including: initiatives from the OIG, CERT and RAC audits, CMS Value Based Modifier Program and most recently the MACRA/MIPS, APM, Medicare Quality Payment Program. She served as Past President of the Florida Society of Interventional Pain Physicians and remains on the Board of Directors, as well as President of the Hernando County Medical Society for 9 years; additionally, she is the Editor-in Chief of the FSIPP Newsletter. Dr. Tracy now serves on the Board of Directors of HCA Oak Hill Hospital, a 350 bed hospital in Hernando County.
Practicing in Hernando County Florida where the ratio of Medicare per capital is one of the highest in the United States, gives her the opportunity to engage in the fore front of Medicare initiatives. Dr. Tracy lectures to physicians and healthcare providers across the Country and the State regarding healthcare reform and the business of medicine. She has authored a Level II Office Surgery Compliance Manual and a Compliance Manual for Prescribing Controlled Substances.
PART 2. LAST OPPORTUNITY!
CMS QUALITY PAYMENT PROGRAM REVIEW
Emphasizing Pain Management
SCORING & QRUR
The Final Rule of the CMS Merit-Based Incentive Payment System, MIPS, and Alternative Payment Models, APMs, was published on 10/14/16, and is ~ 2,300 pages. Now identified as the Quality Payment Program, QPP, it is extensive in scope to reward or penalize providers for performing certain activities in four performance categories. The four categories are: (1) Quality, which will replaces PQRS, (2) Cost, attributed to Medicare providers by a complex set of statistical formulas replacing the Value Modifier (3) Improvement Activities, a new category of 90+ undertakings and (4) Advancing Care Information, which replaces Meaningful Use. The four categories result in a final score of between 0 to 100 points.
Depending on the provider's final score, a penalty/reward is assessed, or the provider remains neutral. For 2017 the penalty is 4%, but the bonus could be 3 to 4 times that amount. Physicians must educate themselves and their practice managers on how to understand and potentially achieve high scores in the new Quality Payment Program and avoid costly penalties in their Medicare Part B claims. Although Cost will have a weight of 0% for 2017 the Quality Resource Use Report, QRUR, will continue to be calculated for providers. This report emphasizes the cost of a providers care compared to his peers. An understanding of this report will enhance a provider's ability to understand how he can potentially improve decision making to increase quality and decrease cost.
This webinar will explain and review:
- QUALITY PAYMENT PROGRAM (QPP) and clarify questions generated from ASIPP Members
- Scoring Components of MIP
- QUALITY, ACI (Advancing Care Information), IA (Improvement Activity), RU (Resource Use)
- Patient population and effects on coverage
- THE QUALITY RESOURCE USE REPORT, QRUR
*This program has been approved by the American Academy of Professional Coders (AAPC) for
1.5 continuing education hours
. Granting of prior approval in no way constitutes endorsement by the AAPC of the program content or the program sponsor.