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Aaron Cohen on how to approach the MIPS slowdown, and more

Aaron Cohen, principal and health care co-practice leader at accounting, tax and consulting firm Citrin Cooperman in New York City, talked to Part B News about the merit-based incentive payment system (MIPS) and the "at-your-own-pace" proposal:

On CMS Acting Administrator Andy Slavitt’s proposal: Probably the No. 1 reason to consider reporting under the Medicare Access and CHIP Reauthorization Act (MACRA) for only a part of the year, as opposed to the full year, is it may take time for practices to get acquainted with the final rule, particularly if there are significant changes from the proposed rule.

It would be beneficial for small practices to digest the final rule and start reporting at the point where they are comfortable that they have attained a reasonable grasp of the rule. The experience gained from reporting for part of the year should provide a leg up to the providers in 2018, and negative or positive adjustments can be made to physician reimbursement related to performance for the year.

The delay can provide an opportunity to catch up – but you need to use the time afforded by the delay to catch up as quickly as possible. If you don’t, you’ll have wasted the time and other practices that prepared will gain the advantage.

MIPS and the pay-for-performance future: The writing’s on the wall. As indicated by the promulgation of accountable care organizations (ACOs), bundled payments and myriad other value-based reimbursement programs by CMS, payment based on population health measures is the wave of the future. And it’s clear that to be successful with this reimbursement system, you need to be able to understand the data that underlies the scoring and how your performance compares with that of other physicians because this is a budget-neutral program. You’re competing with them for the money.

Retooling your health IT for MIPS: IT needs include the capability to understand what happens with patients even when they leave the physician office. For example, when you refer to a specialist, how efficiently does that specialist care for the patient? You need to understand the data not just in terms of quality but from a cost perspective as well.

To be successful [under MIPS], the physicians will need data-driven tools that can be used to track and show weaknesses and strengths with respect to adherence to clinical pathways, care coordination and general population health management, above and beyond what is specifically required by CMS. These IT tools will also need to connect to efficient revenue cycle management.

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