“If you’re already doing Meaningful Use, or doing some kind of practice awareness, care coordination or patient engagement activities in your practice, you may be able to achieve 70 in that first year and gain access to that money,” he said.
Quality measures will make up 60% of the score the first year and include screening for tuberculosis within six months of starting a biologic; documenting functional status, disease activity and prognosis in RA patients; and glucocorticoid management in RA patients, among other measures.
“These are things you probably do all the time. Now, you just have to choose measures, document and report them,” said Dr. Harvey.
Providers may choose from more than 90 practice improvement activities to report, such as patient engagement activities or care coordination among a patient’s various healthcare providers.
“We’ve never been able to get paid for care coordination. But now, if you do this and do it well, you can get paid for it. Extended office hours are another measure. That’s a patient engagement activity. Think about things you already do in your practice,” he said.
In MACRA’s first performance year, resource use, or cost, is set at zero, which benefits rheumatologists because they often prescribe expensive drugs, said Dr. Harvey.
“The ACR will prioritize our advocacy efforts to make sure they appropriately take drug costs into account in the future. We want to ensure that we influence this in a way that’s beneficial to rheumatologists,” he said.
Use RISE for Points
Rheumatologists who use RISE automatically earn practice improvement points, said Dr. Harvey. RISE submits data directly to the CMS, with no need for additional data entry.
In the Advancing Care Information category, physicians will report on five different measures:
- Doing an EHR security risk analysis;
- E-prescribing;
- Providing patient access to their EHR records;
- Sending a summary of care report from one electronic record to another; and
- Acceptance of that report.
Those who do Meaningful Use will score well in this category, said Dr. Harvey.
To predict how well your practice will fare through MIPS, examine your current adjustments through Meaningful Use, and look at your Quality Research Utilization Reports to see how your practice compares with your peers’ scores, he said.
“If you are an employed physician or part of a large group that’s already doing these activities, you are at an advantage already,” he said.
APMs
In MACRA, Congress encouraged physicians to participate in APMs by exempting them from MIPS, and giving them 5% lump-sum bonuses for five years and higher annual updates, said Harold D. Miller, president and CEO of the Center for Healthcare Quality and Payment Reform.
