MIPS Measures & Scoring Summary

November 20, 2018

Hosted By:

Nick Austin

All right. Good afternoon to everyone in attendance today. I’m Dom with TheraOffice and we’d like to thank you all for joining us for today’s webinar focusing on MIT measures and scoring summaries. Just a few notes before we get started here. If you do have any questions throughout the presentation, please feel free to type them into the Q&A field at the bottom of your screen now since we received an extremely high volume of questions during our last MIPS webinar, we won’t be answering any questions live at the end of this presentation as we did previously instead.

We’re going to take all of your submitted questions and answer them in an official FAQ document post-webinar and that will be distributed to all attendees here at a later date. Also all attendees will be receiving an electronic version of this PowerPoint in an email we will be sending out post-webinar and a recording of this webinar will also be posted to our training center by this Friday for future viewing. Now without further adieu…

I’m going to turn this over to our director of product management here at TheraOffice they cost:

Thanks Dom and welcome everyone to today’s webinar on mips measures and scoring summary. This is the second webinar in a series that we’re doing with regards to mips. And we’re all very happy that you’re here today.

The focus of today’s webinar is really to take a. A deeper dive into the specific measures and you can understand exactly how they’re formulated how they’re scored and how TheraOffice is going to be helping you perform those measures through the 2019 reporting year. So let’s go ahead and get started.

So first off we’re making the Assumption today that you have already viewed the previous webinar entitled mips Made Easy with TheraOffice. If you have not seen this webinar, it is available to the TheraOffice Training Center. So make sure that you do go back and watch that one. Um, each webinar is not all inclusive of everything you need to know with regards to Maps.

Unfortunately. It’s a very complicated program with lots of information related to it. So I’ve had to split this up. So it is important that you view every one of them from that webinar. We did receive a few very common questions as follow-ups the first of which was when reporting through the registry.

Do you have to report on every patient or just Medicare patients? And the reason this question kept coming up was because pts have been so used to just submitting permits as part of pqrs are sorry just submitting for Medicare patients as part of pqrs that it sounded strange to them that they would have to report for all patients.

This is true. You do have to report if you’re Port reporting through the registry on a hundred percent of your patients regardless of their insurance. Yes, that is true will be kind of covering some some areas of that that make that look not so bad or help you understand a little bit about why that that is a requirement.

It’s throughout this webinar. So the other question that we received up on John was some confusion between the individual versus group reporting. And this is really just your choice based on whether or not you want certain providers to participate in the program or your entire company submitting as a group is enrolling every single provider every single NPI attached to your 10 submitting individually is you choosing which providers you want to participate in.

So those are two big questions that we received from the previous webinar. Thought we’d answer me again in this one. And then the other thing that we received a lot of questions on was with regards to the registry pricing and we’re happy that we are able to give you guys some additional information with regards to pricing with the therapist registry.

If you are submitting individually the price will be 299 dollars per provider per year. Under that rate You’re simply choosing which providers you want to enroll in the program and it’s $2.99 per provider per year. If you choose to submit as a group then we’re going to be doing custom pricing and the goal of the cars custom pricing is to get you to a reasonable rate given your number of providers.

If you think of it this way, if we if you were to submit individually for every single provider in your database and submitting as individuals. It would be $2.99 per provider if you were submitting that entire list of providers as a group. The and rate would come under that $2.99 per provider per year.

It’s going to depend on a few different variables, but we’re trying to make it a little more affordable on the the group rate for you guys instead of just the flat 299.

So what do you get for your registry for you? Peace? What is the advantages of submitting as a registry? Well, their apis registry will collect analyze and report your mips data to the qpp program. We will also be providing quarterly updates to you on your mips progress. So we will actually be letting you know specifically how you’re doing.

Data will also be submitted all at once in q1 of 2020 and before that data gets submitted. We will do a final consultation with you with each registry customer to confirm who you want that data submitted for. So let’s say you choose to submit individually and at the end of the year or at the beginning of next year 2020 we have that consultation with you and we noticed that there’s a few providers that have been performed so well and that might actually end up.

Getting under that 30-point threshold that might end up getting hit with a penalty if you’re choosing to submit individually and you’ve got those providers you can choose just to not participate in the program for that provider if they were not required to participate. So if you’re opting them in and then they fell under your expectations, you can choose not to submit.

So that’s another advantage of registry. And then also throughout the year if we notice anybody falling behind we will be reaching out or doing our best to do so to assist in understanding the maps requirements. So if you’ve got providers that are consistently missing where to let you know about that as we’re analyzing that data throughout the year.

Okay, so now we’re going to jump into the specific quality measures and exactly how they work. And before we do that, I want to give one warning to everybody. This webinar is based on information released in the final rule. We are still waiting on information to come out in the form of measure specification documents.

Unfortunately Medicare has not released these yet and it’s looking like it might be a few weeks into December before we get these final specification documents. These documents can impact what measures you report on how these measures are reported and what frequency they are required to be reported at so these do these can have a very big impact.

We did not want to wait all the way until the end of the year to do this webinar because we wanted to get you information as soon as possible so that you could make your decisions as to whether or not you want to roll most program. But know that things can still change with this and if they do know that we will be alerting you to that through newsletters through additional webinars.

We’ve got another webinar lined up. Next week that will be covering the update itself. So if something changes between now and then we’ll be learning you to there. So yeah, just always keep your eyes open on this one as things are still fluid. All right. So the quality category breaks down into 11 different measures therefore process measures for pts and OTS and their seven outcome measures before process measures are BMI current medications pain assessment outcome assessment.

And for the seven outcome measures, we have the photo measures based on the body part.

Okay. The first measure is BMI, and this is one that everyone should be used to because you did it already in in the pqrs program. If you never participate in that program some of this will be new to you. That’s fine. We’re going to go through the details of what it really means to report on this measure.

So BMI is required for evals only. This is the only one of the process measures that’s evals only the others are evals Andre Valles. So BMI is defined as percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous 12 months and with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous 12 months of the current encounter.

So let’s talk a little bit more about BMI and what some of these definitions are how CMS is defining them through those specification documents. So height and weight and eligible professional or their staff is required to measure both height and weight height and weight must be measured within 12 months self-reported values cannot be used.

Okay, so you just can’t take the patient’s word on what their height and weight is you have to actually measure it. And then a follow-up plan if the most recent documented BMI is outside normal parameters and a follow-up plan is documented during the encounter or during the previous 12 months the documented follow-up plan must be based on the most recent document it BMI outside of normal parameters.

So these are definitions coming specifically from CMS and how BMI should be treated. Let’s now take a look at what TheraOffice is going to be doing for you with regards to that BMI measurement.

So here you’ll see a screenshot of what the new BMI section within documentation. Looks like we’ve added it as a new section into all of your notes and within it you’re going to see basically we have specced out this entire measure for you directly within your documentation. So first there’s a checkbox for patient not eligible.

So when is the patient not eligible for? For the BMI assessment. Well a good example of that would be the patient is pregnant if they’re pregnant BMI doesn’t really have any relevance to the to it so you don’t need to take it at that point. So you would check that box for patient not eligible as long as they are eligible.

You would enter in the height and the weight and then we would automatically calculate the BMI for you. From there if the BMI is within or outside of the normal parameters, then you would have to indicate a follow-up plan, which we have given you the specified follow-up plans options directly from CMS in the form of a check box list.

You can always select other and then put the actual follow plan the notes should you want to or if the patient is not eligible for a follow-up plan? You can select that option as well. And then the BMI assessment that appears below automatically gets calculated based off of what you’re entering into this BMI section.

So all you have to worry about is doing the BMI part and doing a follow-up article. I’m in will actually make the assessment for you within MEPS based off of that information that’s been provided.

Alright, so the next one is current medications and this one again is familiar from the picaresque system. This is on evals Andre Val’s and one thing real quick just to make sure to clarify re valves is defined as submitting a nine seven one six four four one six eight. If you’re up OT it’s not the use of a progress note.

Okay, so when we’re talking re Val’s that is always in reference to the CPT code not if being a progress note. So current medications how they’re defining. This measure is the percentage of visits for patients aged 18 years and older for which an eligible professional or eligible clinician attest to documenting a list of current medications using all immediate resources available on the date of the.

This list must include all known prescriptions over the counters herbals and vitamin mineral dietary supplements and must contain the medications name dosage frequency and route of administration. So that last part is the part that. It’s potentially a little bit of a difference than what you’ve seen in the past.

This is specifically requiring that you indicate the name the dosage the frequency and the route of administration that’s got to be included in your note. So in addition to that part one of the questions that we always receive questions on our is an image note good enough for the current medications.

The usual process that a lot of clinics e is the provider treats the patient and that Medicare patients coming in with a handwritten note of all of the medications that they’re taking because they’ve been down this path before they know the they know the routine. They know they’ve got to come with that list.

So you just take a scan copy of it and that is their current medications list. Is that enough well, Let’s look a little bit at how Medicare is defining this. So they say the eligible clinician must document in the medical record the obtained updated review the medication list. So what is the medical record and this is often debated, you know, is it the data?

Is that the report? What’s the official Medical? The truthful answer on this is that the medical record is everything the medical record is the patient profile the case information the notes the reports the flex notes. And yes, it’s the image notes. That’s all part of the patient’s medical record.

Everything is a part of it. So is it okay to use an image note as part of the current medications as long as it includes those four fields of dosage frequency and route of administration. And yes.

So let’s take a look at how their apis has adapted to this current medications requirement. So we have in the update updated your existing medication History Section to be reformatted to include those for specific columns. In addition to that. We’ve also added some check boxes below for no current medications or for attesting to the current medications being documented in an image node.

And then same thing as to be a my we’ve got our current medications assessment that automatically is going to determine your mips mips core your mips result from that grade or from those check boxes. So if you go into that that section and simply check the box for a test current medications being an image note.

It’s automatically going to update to current medications documented.

Alright, the next to quality measures are a little bit tied. So we’re going to go through these a little bit of a different way. The first one is pain assessment. And this is again evals entry valves patients a teenager’s age and older require a pain assessment using a standardized tool and documented a follow-up plan with painted when pain is present.

So the main thing. To talk about with regards to the pain assessment has to do with this standardized tool. So they’re saying pain assessment requires a multi-dimensional clinical assessment of paying using a standardized tool may include characteristics of pain such as location intensity description.

And I’m Federation. So they Define standardized tool as an assessment tool that has been appropriately normed invalidated for the population which is used so visual analog scale rolling Morris oswestry numeric rating scale. Basically any of these kind of standardized tools would be good for pain assessment, but it does have to be linked to some tool that you’re using to assess that pain.

Alright, so the next one is outcome assessment, which is somewhat similar to the pain assessment but based off of function and this is percentage of visits for patients aged 18 years and older with documentation of a current functional outcome assessment using a standardized functional outcome assessment tool on the date of service encountered.

And documentation of a care plan based on identified functional outcome deficiencies the date of the identified deficiencies. So very similar to pain assessment. But this one is focusing more on function. Again. This is for evals and re valve. Okay. So again, how are they defining the outcome assessment?

They’re defining it as a standardized tool and they give some examples but don’t limit it to these examples oswestry rolling Morris that disability Basically any tool that measures function is one that qualifies for this the main thing that they note is that a functional outcome assessment is a multi-dimensional and quantifies pain and musculoskeletal and neuromusculoskeletal capacity.

Therefore the use of a standardized tool assessing pain alone such as the visual analog scale does not meet the criteria of a functional outcome assessment standardized tool. So that means that there are some tests that. Quantify both pain and function. There are some tests that do it for only pain and some that do it for only function.

So you need to make sure that you’re covering both bases. You need to cover function and pain through your standardized testing. So given these definitions of these two measures going to the next slide. We’ll see exactly how TheraOffice has handled this so we’ve decided to. Factor this into the functional testing section within the functional testing section.

We have added two drop downs one for pain assessment one for functional. And these dropdowns will automatically score your mips measures based off of what you’re filling out in the functional testing section which tests you’re using and the score in the impairment part actually doesn’t even matter.

All they’re looking for is that you’re actually measuring these so as long as you are including tests within this section, it’s automatically going to be scored accordingly. So let’s the way that we’re splitting between the pain assessment and the functional assessment is based off of each individual test and whether those tests cover pain or function, so you’ll see a list here.

This is the list that we loaded in by default by standard for every. Therapist database I know a bunch of you have added in some additional ones. That’s completely okay, you’re going to need to update these your additional ones to indicate whether or not their pain or function and we’ll talk a little bit more about.

That exact process in the update webinar that we’re doing next week, but this is how we split the existing ones the default ones that were in TheraOffice and you’ll notice there’s three tests specifically oswestry role in Morris and Beatty that are all all covered both pain and function. So by doing one of those tests, it would cover both your pain assessment measure and your functional assessments measure.

So in addition to it automatically scoring from those sections, it will also include a override button next to each of those dropdowns and the use of that override button is for certain rare circumstances that we’re going to go through now. So why would you override pain assessment and we’re making some assumptions as we’re going through and scoring that pain assessment.

We’re making the assumption that by testing pain for patient that’s coming for physical therapy that test has. The result is positive and you’re doing a follow-up document because that’s why they’re coming in for PT. That’s why you’re treating that patient. You’re always going to do a pain assessment follow up that that’s what your plan of care is for.

So we’re making that assumption that both is positive and plan of care gets documented. Now, there are some instances where that is not the case you might be. Treating a patient who has required maintenance. They’re not having any pain but they have required maintenance that you still need to keep treating them for and maybe you need to do a re-evaluation for them.

Okay, that would be an instance of pain assessment document documented as negative. No follow-up plan required. So you would actually need to use the override. In that instance another example of maybe they tested as positive, but you were just doing a one-time evaluation for them. So you didn’t actually do a follow-up in that case you would need to do the the override.

There’s also an indication here of patient not eligible. You’ll see that pop up in a few of these measures. I want to be careful about when you actually use this Medicare specifically defines patient not eligible as being severe mental and/or physical incapacity or the person is unable to express himself herself in a manner understood by others.

Or the patient is in an urgent or emergent situation or time is of the essence and it is and to delay treatment would jeopardize patient’s health status at second one probably is never going to apply to pts or OT use the first one there are some instances where it could so it kind of depends on your patient population.

Who’s your true you’re treating if you have special circumstances for these I would check those over eyes and see if those are instances where you would need to change it. And same thing for outcome assessment we’re making the assumption that it’s positive and that you are documenting a plan of care if there are no functional deficiencies identified, but you’re still going to be treating them.

I would indicate that or I would look again into the override for this one patient not eligible. Is defined as patient refuses to participate so there is another option here. It’s a patient just doesn’t want to take that functional assessment. That is an option to just simply indicate that they’re not eligible for it patient is unable to complete the questionnaire similar to the the pain assessment one that we had talked about before and again patient isn’t an urgent or emergent medical situation.

Okay, so that’s it for the process measures and the next set of measures available in mips are the outcome measures and these are the photo measures so it’s functional status change for patients with and we’ve got knee hip foot or ankle lumbar shoulder elbow wrist or hand or just other General Orthopedic impairments.

These measures are. Basically the same thing as functional the functional outcome measures except they are risk-adjusted and they’re qualified as outcome measures by the by the mips program. So this is measured at discharged by taking a risk adjusted difference between the expected score and the actual score.

Okay, so details with regards to the outcome measures how they should be reported how they should be handled within TheraOffice. Unfortunately, we could not get all of this wrapped up before today’s webinar. So we are still to be determined with regard to these outcome measures. We are very much hoping that we can get all of the details for you available by the next webinar.

Still working out some finalize details on this between us and photo and we should have all of this available for you in the next webinar. We do apologize. We’re really really hoping to get in for today’s webinar. But unfortunately this one is going to have to get pushed off to. The next one I mentioned it earlier about the warning with these specification documents coming in late.

Unfortunately CMS kind of just put salt on a timeline where things are very very limited in how much time we have to complete all this stuff. So I apologize again on this one. We’re hoping to get you guys better answers with regards to how to handle these in a shorter time span that we possibly can so stay patient with us on that.

Alright, so the next thing to cover with regards to the mips program and how we’re going to set you up for Success within this program is the additional check that we’re making when locking a note within TheraOffice, so. When you go to lock a note with interoffice, there’s going to be an additional check that is going to validate your mitts results.

When a corresponding e Valerie Val code is used to use an eval coder eval code on any patient. You’re going to see receive this pop-up that. Tells you how you scored on each of these measures with each of those measures. It’s not about just reporting you have to actually meet the performance and we’re going to go into a lot more detail on that when we get to the scoring section of this webinar, but during that mips setup wizard on the update you will be able to set whether or not.

Performance met is required for every measure again. We’re going to be going over this I will say you should. Enable that option during the mid Setup Wizard. We definitely recommend it and you’re going to see why when we get that scoring. The the other part of this is is that this engine the the way that this works is based off of the eval or eval code being in there and we’ve been trying to think through scenarios in which somebody could accidentally use the wrong CPT codes or forget their eval ER eval code when it’s supposed to be in there.

And it’s hard to come up with those scenarios. I would say from you guys perspective. It is extremely important that eval codes and revalue codes are never forgotten when you’re doing the documentation will really need to aim for a hundred percent here and the only way we can get there. Is it you’re making sure to use those correct codes during the actual documenting of the note.

So super important that if you guys ever have a problem with eval codes being forgotten when they should have been used or eval codes not being used when they should have and then adding them in late that’s going to be something that you’re going to need to figure out on your side to ensure that doesn’t happen.

It’s too important for the success of this program. All right. So before we get into scoring summary, we’re going to quickly talk about Improvement activities and the other side of mips. This is a brand new category that was introduced specifically form its inclusion. It consists of various activities that can be formed by clinics with hopes of making improvements to their process through ways such as ongoing care.

Patient in clinic shared decision-making safety practices and expanding access depending upon a clinics location as well as the number of patients being treated is expected that two to four of the available activities are completed with the only requirement for submission of this category being an attestation that the activities themselves were performed.

Okay, so there’s a little bit of a different category, but let’s start diving in some of the details that you guys understand how this works.

So first off we need to talk a little bit about which measures you need to or how many measures you actually need to report on and this is based off of something called a special designation. They’re different special designations that can be assigned to practices. And it is based off you could have the sorry you could have this small practice designation.

You could have the non Faith non patient facing designation or the health professional store shortage area or World designation and by having one of these it is going to lessen the requirement of the Improvement activities. The only way of tracking this is by going to that qpp website and doing that participation look up the link is listed right there again down is going to be sending out a copy of this webinar.

So don’t worry too much about writing down that URL at this exact moment. You’re going to be getting a copy of it where you can just click on that link. But by going there you’ll actually see if your MPI has any of those special designations. Okay, if you do have one of those special designations than you can.

Sorry, if you have one of those special designations, your requirement will be one high waited activity or two medium hot waited activities for everyone else not with one of those special designations. You have a requirement of two high weighted or one high to be diem or form medium waited activities.

Okay. So those are the requirements it is based off of that designation. Alright, so now let’s talk about the APT a recommended Improvement activities. This is the list a PTA put out of what are some good options for you promote use of patient reported outcome measures regular training and care coordination improve practices that disseminate appropriate self-management materials.

There’s lots of different measures that. Are available to you. These are the ones that they’ve specifically pointed out that they think would match your clinics as well as possible. The one that we really want to highlight here is the collection and follow up on patient experience and satisfaction data on beneficiary engagement.

It’s a high weighted measure. So you it does count more towards that requirement. And the reason we well here let’s go to the next slide when cock talk about some of the details of this. So looking at this the description that they offer for this Improvement activity is collection and follow up on patient experience and satisfaction data on beneficiary engagement including development of improvement plan.

And that’s it. There are no other requirements that this is the Improvement activities category is very straightforward. Very simple, very. Just leaves you to kind of make your own interpretation of it and simply a test towards you completing this to the best of your abilities. So you simply attest to doing this so collection follow up on patient experience and satisfaction data and beneficiary engagement as long as you are collecting patient satisfaction data and using it to.

Develop improvements within your practice you are doing this Improvement activity. You can attest towards it. The reason we are bringing up this one in particular is because TheraOffice does have plans in q1 of 2019 of releasing a. Platform by which you can reach out your patience and collect that that survey data and actually do something with it with regards to Patient satisfaction.

So the other part about Improvement activities is you actually only need to do them for a 90-day period so this isn’t something that you need to worry about starting January 1st. You actually have a little later in the year before you have to start really focusing on your improvement activities doing those attestation through.

You want to do them through your registry if you’re using a qualified registry, if you’re reporting through claims, you would make the at a stations through the qpp website.

Okay, so there are a hundred and thirteen total Improvement activities to choose from and a PTA picked out a handful of them. But there’s a bunch of other ones and some of those could apply to you. So one of the information tivities that we saw was. Medicaid patients. You know, there was there’s one in particular that said the engagement of new Medicaid patients and follow-up Improvement activity.

So if you treat a lot of Medicaid patients and you’re treating them in a very timely manner that might be one that you want to consider utilizing. So I would recommend for anybody participating in the program to view all hundred and thirteen of those Improvement activities and see which one’s potentially could.

Match the best for you and then make the determination about which one’s your clinic is going to be pursuing for the 2019 reporting year.

Okay, so now let’s talk about mid scoring. Hopefully we can clear this up a little bit for everybody. So mid scoring is based on a hundred point scale the higher the score the better and Improvement activities are scored based on whether or not you did them and their specific waiting and quality measures are score based on how often you met.

The performance thresholds versus previously established. Benchmarks so back when you did the picaresque system. It was all about reporting mips is about performing. You actually have to perform on the measures.

Okay, so I know there’s a lot of information within this PowerPoint and a lot of it was probably pretty redundant for a lot of you if you participated in the picaresque program, you probably knew a lot of us already this next slide here should. Be new information for you, and it should be very important to the way that you participate in this program and focus on this program.

So scoring for the quality measures is based on a curve and it is a very steep curve is based off of Benchmark data from previous years and because. PT’s were enrolled in this program almost as an afterthought the measures that they were given are pretty generic and apply and are used by most of the healthcare industry.

So what that means is that the benchmarks are really really high are ready for these measures you need to perform at an excellent level in order to. Score well on these measures and it really does require no mrs. So let’s to illustrate this. Let’s take a look at one of the measures in particular the functional outcome assessment measure.

So this measure Awards three to ten points towards your quality score, which is roughly 14 percent of your final mips. Let’s assume you’re reporting this measure on 50 patients. If you report 50 out of 50 patients with a performance met you score 10 points, if you have 49 of 50 patients, so you miss one patient.

You didn’t do a functional outcome assessment on one of your 50 patients that score drops from 10 points to 5.3. If you miss another patient that score drops again to 3.5 and if you miss a third patient. You are all the way at the bottom at three points the difference between performing on one patient compared to 47 patients is the same.

So it is a very steep curve. I mentioned this to our CFO. Bro Ballantine. He said that’s not a curve. That’s Cliff. That’s correct. This is a cliff. You cannot miss on any patients and to really illustrate this. It applies to even the largest of clinics. So. Let’s let’s talk about it in a larger setting you have 5,000 patients and 4999 of those patients.

You gave a functional outcome assessment to but you missed on one single patient. You would score a 5.9. Out of 10 that’s for missing only out on a single patient. You cannot miss on anybody with regard to these four process measures. There are two generic. The benchmarks are too high. This needs to be performed by everybody.

So what does that tell us? How does that help guide us in terms of how we approach this program? Well, the first thing I would say is. This needs to become part of your standard procedure. So those four process measures that we mentioned before taking a patient’s BMI taking the are getting their current medications having them do a standardized test that covers both pain and function that needs to be required as part of your process for an evaluation for every patient and there should be no exceptions.

That that has to be part of your workflow. If you put this on providers to remember to do it, you’re leaving open the potential of of missing even a single patient that can mess up your hips for so let’s talk a little bit about some scoring tips some some things that that we think will help you in the process of MEPS and scoring as best as you can first hit that we’ve got.

When you’re going through that mips wizard when you receive the update require a performance met on all of your patients. So when they go to lock a note, there’s any Valerie Val code in there. We’re not going to let them lock it unless they performed those for process measures. I would a hundred percent recommend this for all.

I’ll clinics willing to participate MEPS. I would even extend this out to clinics that are reporting on claims. Now. The reason that I say this is because if you’re reporting on claims, you technically only need to report for the patients that are Medicare. But if you follow that philosophy then there’s the potential chance of maybe you didn’t know that this patient was Medicare when you were doing the evaluation and therefore you didn’t take their BMI.

Well, it turns out you needed to take their BMI and you missed that single patient. And now you’re Mick scores ruined because you missed it out on a single patient make it part of your standard procedure procedure for every patient and it won’t be a problem. So I would also make partner stand procedure and require that performance met through that and that’s wizard.

Quality measures also require a minimum of 20 cases in order for them to be counted. So you will not get scored on that measure. If you didn’t have a minimum of 20 cases. There is a plus five point onus available to any small practice that participates. So anybody that’s doing claim submissions know that you do get an extra five points as long as you’re under 15 providers.

There’s also a bonus for complex patient population. And this is done entirely by CMS. You can’t apply for it. I know everybody thinks their patients are complex. That’s the joke. I’ve always heard from Petey’s but the. Medicare will determine this but know that if that is the case, you do get an extra bonus score for it.

The other thing to keep in mind as quality represents 85% of your mips course, it’s very important. But Improvement activities is also 15 percent. So make sure to do those Improvement activities as an extra 15% that you can get by doing them and then I mentioned this before but require compliance with Miss measures as part of your standard procedure all patients even if reporting claims.

Okay, so I know with regards to the scoring I will say this part the scoring is extremely complicated. We tried to simplify it down as much as we could. But if you are really ambitious, here’s a really handy guide from Medicare on how they go about scoring for MEPS. Again, it’s pretty complicated and this guide is specific 2018.

They could technically change something for 2019, but they probably won’t release that scoring guide until the middle of 2019. So for the ambitious, feel free to click that link. You guys can take a deeper dive into how they will be scoring it.

All right. Thank you everyone today for attending today’s webinar. I hope you found this informative and helpful. We are doing questions and a little bit of a different way. I know some of you really really like asking questions and getting answers directly within the webinar, but we want to try it this different way because we know some questions that get.

Gotten lost in the past. We want to cover everybody’s and make sure that it those those questions sometimes can be very very valuable get answered for everybody. Even those that are watching this at a later date. So get those questions submitted. We’re going to leave this webinar open. It won’t kick you out on a medically get those questions you submitted that you have and we’re going to be following up with everybody.

On those questions in a group kind of setting so that you’ll see the answers to all of them. We want to try it this way and hopes that we can cover more bases and have kind of better documentation of those questions for future use. So again, thank you everyone for attending today’s webinar and we look forward to going through this process with you.

We know it’s a big one, but we’re confident and that will find success together. And have a happy holidays, and we will see you guys next week during the update webinar. Thanks again.

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