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Course Description

US healthcare is moving away from a pass fail quality and electronic health record usage system to a performance based approach under MACRA. The vast majority of clinicians in US will be directly affected by this initiative and a detailed understanding of how to meet the reporting requirements will be of great benefit to you and your organization.

In addition, clinicians and administrators will need to focus on ensuring there is supporting documentation to meet the specific requirements of each measure or risk potentially negative audits in the future.

Learn about the critical importance of understanding measure specification details not only for data reporting but also from the standpoint of having supporting documentation.

Description of the topic

The Quality Payment Program has two tracks, the Merit – based Incentive Payment System and the Advanced Alternative Payment Models. Both of these initiatives have stringent reporting requirements derive from detailed specification documents. Performance in these programs will depend heavily upon recognition of the nuances of the requirements in a manner that will allow clinicians to determine which patients meet the criteria in which may fall under an exemption or exclusion.

However, awareness alone of the measure specification requirements is not adequate, it must be supported by detailed documentation. Audits will be performed by CMS contractors and if measure requirements are not specifically documented the organization will lose credit for data submitted and may even face penalties.

This program will review specifications for quality and advancing care information measures and the need to have first awareness of their specific details and supportive documentation.

Areas Covered In The Session

  • MACRA Quality reporting and documentation requirements

  • MACRA Advancing Care Information reporting and documentation requirements

  • Audit risk reduction under MACRA

  • Approaches to optimizing success under MACRA through a detailed understanding of the requirements

Learning Objectives

  • Understand the importance of performance under MACRA

  • Learn how an understanding of the detailed specifications for each measure can directly impact performance under MACRA

  • Understand the critical need to fully document information related to measure requirements

Who Should Attend

  • Clinicians

  • Clinical Documentation Integrity (CDI) specialists

  • Healthcare administrators

  • Compliance officers

  • Population health managers

  • Data analytics experts

MEET THE PRESENTER

Michael-Marron Stearns, CPC, CFPC, MD, is a physician informaticist, certified professional coder (CPC), certified family practice coder (CFPC), and health information technology (HIT) and compliance professional.  Dr. Marron-Stearns is the CEO and Founder of Apollo HIT, LLC, a company that provides EHR/HIT best practice and compliance consulting services to healthcare organizations and the HIT industry.   He is a former assistant professor of neurology where he designed a computerized training platform for neurology residents and received several teaching awards.  Over the past twenty years he has been actively involved with the design and implementation of a variety of health information technology software applications.  He has developed thousands of clinical templates and similar content and has provided support for electronic clinical quality measures (eCQMs), clinical decision support (CDS), practice transformations, physician education, compliance programs, and revenue optimization programs.

Dr. Marron-Stearns has provided leadership to informatics and terminology projects at the National Library of Medicine, the National Cancer Institute, the College of American Pathologists, and to several health information technology organizations.  Dr. Marron-Stearns served as the International Director of SNOMED International, where he played a central role in the design and development of SNOMED CT.  He is also a cofounder and lecturer at the University of Texas at Austin Health Information Technology Certificate Program, a nationally recognized model for HIT workforce development.  Dr. Marron-Stearns has been invited to testify in Washington, D.C. before federal sponsored HIT policy and standards organizations on 5 separate occasions.  He is also an accomplished author and lecturer on a range of health care quality, health information technology, coding/compliance and Quality Payment Program topics.  Dr. Marron-Stearns has authored a series of articles on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) for a peer-reviewed publication and provides specialty specific workshops, webinars and guidance for practices on MACRA and related activities.

 

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