AOA MORE can help doctors meet MIPS requirements.

Participating in MIPS? How to avoid a penalty

Medicare granted providers flexibility for tailoring the new Quality Payment Program (QPP) to their advantage this year; however, participants still must report at least once to avoid a penalty.

"Assessed in 2019, the negative 4 percent payment penalty can be avoided this year simply by reporting “some data” to CMS."

The Centers for Medicare & Medicaid Services' (CMS') new Merit-based Incentive Payment System (MIPS) reporting year began Jan. 1, 2017, and though the participation level providers chose determines whether they're eligible for a payment bonus, doctors of optometry still face the possibility of a payment penalty. In 2017, 81 percent of doctors of optometry are receiving a 2 percent payment penalty for failure to meet CMS Physician Quality Reporting System program requirements in 2015. It is critical for doctors to take the necessary steps to avoid the future penalties.

Assessed in 2019, the negative 4 percent payment penalty can be avoided this year simply by reporting "some data" to CMS-an achievable benchmark in MIPS' first year intended to bring providers up to speed for broader participation in 2018 and 2019. By "some data," CMS means providers can avoid a payment penalty by:

For providers seeking to avoid the payment penalty, the AOA's qualified clinical data registry (QCDR), AOA MORE (Measures and Outcomes Registry for Eyecare), will be an important tool, especially considering that registry reporting is emphasized in the scoring of CPIAs. In fact, AOA MORE supports two CPIAs. Here's how to meet the reporting requirement:

  • Participation in a QCDR that promotes use of patient engagement tools. Log in to AOA MORE to obtain and review patient engagement tools. An email will be sent from AOA when new tools are made available. Retain this email for documentation along with the date you accessed materials. CMS Reference Number: IA_BE_7
  • Participation in a QCDR that promotes collaborative learning network opportunities that are interactive. AOA MORE has access to links to online learning opportunities. Access these resources and document your participation in any online learning programs. CMS Reference Number: IA_BE_8

To attest to performance of CPIAs, doctors must use the CMS-developed portal. Here, doctors will be prompted to select the CPIAs performed and will have to attest to performing those activities.

To report one Quality Measure for one patient, this can be achieved by adding one quality data code for a pertinent patient on one claim. For simple claims-based reporting, review the AOA recommended measures list to identify the target population and quality data code that must be reported. AOA MORE is structured to report these specific Quality Measures, however, our ability to report these measures depends on the status of your EHRs integration with AOA MORE.

Questions regarding MIPS participation may be sent to AOA's Associate Director of Coding & Regulatory Policy Kara Webb

Engage with AOA MORE

Nearly 7,000 doctors have enrolled for AOA MORE to leverage its power in becoming a better MIPS clinician, and in June, the AOA released a new resource to underscore this priority. The MIPS Guidebook for Evaluating and Tracking Your Progress provides step-by-step guidance and tips on meeting program requirements for both EHR users and those who don't use EHR.

But, more than just a reporting tool, AOA MORE allows optometry to analyze clinical outcomes for the benefit of improving care over time. This can apply to glaucoma care, contact lens care, pediatric care and more, meaning AOA MORE offers optometry the ability to track outcomes that can be analyzed and improved upon.

Click here for more information about AOA MORE, including FAQs and additional AOA resources.

November 17, 2017

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