MACRA MIPPS – Can Care Delivered at Home Help?

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html

Hello Doctor, are you ready for MACRA, MIPS and APMs? You may want to consider how home health and hospice can help you meet your PQRS Preferred Specialty Measure Sets. Now that was a lot of acronyms! To learn more, click on the link above to CMS.gov

MACRA – Medicare Access and Children’s Health Insurance Program
MIPS – Medicare Merit Based Incentive Payment Systems
APMs – Advanced Alternative Payment Models
PQRS – Physician Quality Reporting System

How can home health and hospice help? The PQRS measures include measures in various domains including: Effective Clinical Care, Patient Safety, Communication and Care Coordination, Person and Caregiver Centered Experience and Outcomes, Efficiency and Cost Reduction, Community/Population Health. Home Health and Hospice can be leveraged to meet many of the requirements of the various domains.

Example (Patient Safety): PQRS 286 Dementia: Counseling Regarding Safety Concerns. Home Health can support a Physician by making sure all home health plans of care related to Dementia include counseling regarding safety concerns. In turn, when the Physician reviews and signs off on the home health plan of care they are confirming that, indeed, home health, as an extension of the Physician, counseled the patient on safety.

Example (Communication and Care Coordination): PQRS 155: Falls: Plan of Care. Home Health can support a Physician by making sure all fall risk patients have a plan of care for falls documented.

The more Physicians take seriously the oversight they provide for patients on home health and hospice the more they can leverage home health and hospice as a natural extension of their Physician practice which leads to better coordination of care, better outcomes, lower costs and Higher MIPS scores and better reimbursement.