Who wants a raise?

Friday, September 01, 2017 12:51 PM
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The Colorado QPP Coalition can help you get a “raise” from Medicare – and other payers, too

by Allyson Gottsman

Practices are encouraged to take advantage of abundant Colorado resources to get a “raise” in Medicare rates through the Quality Payment Program (QPP). There is no need to accept a decrease in your Medicare Part B fees by sitting on the sidelines. The pay cut is not that hard to avoid and there is help to figure out the QPP. Colorado practices of all sizes and specialties have multiple opportunities to get support from local Colorado experts – at no cost to the practices.  Approximately 20 organizations (and growing) have joined forces to support Colorado practices through the complex options available in this first year of the QPP. See the next page for a list of current organizations in the Colorado Quality Payment Coalition.

It’s very simple to avoid a penalty – just submit one measure. It’s that easy, it’s not too late to get started and there is help to figure out what to submit and how. Your action, or lack of action, in 2017 will impact your rate of Medicare reimbursements for all Medicare Part B fees for all of 2019. It is the goal of the Coalition members for no Colorado practice to get a penalty.

But why settle for staying even? Why not get help to benefit from a positive adjustment in your Medicare Part B payments for 2019? This year Medicare is allowing you to “Pick Your Pace” regarding your QPP participation, including minimal effort to stay neutral, some effort and proficiency to get a modest increase, and good effort with good measures and activities to get up to a 4 percent increase for all of 2019. The rate of increase will grow from there, up to a potential 9 percent increase, if you continue to improve your scores, relative to your peers across the country.

The Coalition provides multiple levels of support – all at no cost. They range from material to review for the “do-it-yourself-ers” to onsite practice facilitation and clinical HIT advisor support.

For the independent high-functioning practice, there are websites, videos and podcasts – see the sidebar for some that the CO QPP Coalition has vetted for you – and there are many more than listed here. You can join monthly webinars hosted by Colorado QPP Coalition members or subscribe to the Coalition’s “Fast Facts in Five Minutes,” a monthly e-mail to explain parts of QPP in small bites, for tips and tools to stay current with how QPP is evolving.

For those who want help understanding the program and getting guidance on reporting, Telligen (for larger practices with 16 or more clinicians) and the Texas Medical Foundation Health Quality Institute (for smaller practices with 15 or fewer clinicians) have staff, resources and tools. For Telligen, contact Courtnay Ryan at Courtnay.Ryan@area-d.hcqis.org. For TMF, contact 1-844-317-7609 or QPP-SURS@tmf.org.

If your aspirations are higher than avoiding a penalty and you would like help improving your MIPS score to get a positive adjustment, there is help for that, too. The Transforming Clinical Practice Initiative (TCPi) is available to practices of all specialties of all sizes. TCPi practice support is offered through multiple Colorado organizations, but practices need to register at http://www.practiceinnovationco.org/tcpi/get-engaged/ before Sept. 20, 2017.

In addition to TCPi, any program that works with practices to improve competency in quality improvement, team-based care, care coordination across medical neighborhoods, population management, and a host of other content will be a step toward not only the short-term goal of succeeding in the QPP but also, and more importantly, preparing your practice for future value-based compensation programs by commercial carriers. Go to http://catalog.practiceinnovationco.org to pursue an electronic catalog of options for practice-level support available to practices across Colorado by more than 20 different organizations.

If you have questions about which support option is best for you, contact the organization that suits you best to get guidance. Find a list on the Colorado QPP Coalition webpage, www.cms.org/coqpp/coaching.

Posted in: Colorado Medicine | Practice Evolution | Payment Reform | Interacting With Payers


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