麻豆传媒

SAN DIEGO -- Rheumatologists can use the so-called developed by the American College of Rheumatology to manage the data reporting needed to comply with new requirements under MACRA, a researcher said here.

Through participating in RISE, physicians can match the patient data recorded in electronic health record (EHR) systems with the reporting domains established in Medicare's new Merit-Based Incentive Payment System (MIPS), said Jinoos Yazdany, MD, of the University of California San Francisco, speaking at the American College of Rheumatology (ACR) annual meeting.

RISE is available at no charge to members of ACR and its Association of Rheumatology Health Professionals affiliate. When EHR data are linked to RISE, relevant data are automatically uploaded to the registry. And because RISE has been designated by the Centers for Medicare and Medicaid Services (CMS) as a "Qualified Clinical Data Registry," physicians can easily fulfill their MIPS reporting requirements, the on its website.

Yazdany reported on a preliminary analysis of MIPS-related data stored in RISE for January to September 2017. The goal was two-fold: directly, to determine how well participants were doing in meeting quality standards set by CMS; and indirectly, as a means to show off the RISE platform and its capabilities.

Yazdany began her talk with an overview of MIPS, pointing out that not only does it provide a structure for performance-based payment, but also that the data will be used for public quality ratings for individual physicians. It covers four domains:

• Care quality
• Improvement activities
• "Advancing care information" (the new incarnation of Meaningful Use)
• Cost

She noted that cost is not currently part of the required data collection but it will become so next year. Data collected this year will determine payment adjustments made in 2019, Yazdany said, with a 4% penalty for submitting no data and additions of up to 4% for meeting or exceeding certain benchmarks.

All three of the currently collected domains can be handled through RISE, Yazdany said, and a "dashboard" allows physicians to track their progress toward meeting the standards in each domain (A video demonstration of the dashboard can be seen).

For the study, quality measure data for the first three quarters of 2017 covering rheumatoid arthritis, gout, and preventive care as well as drug safety were analyzed. Percentages of patients receiving recommended care was the outcome measure.

These data came from 225 practices and 750 rheumatologists. Yazdany noted that about 3,800 rheumatologists are required to participate in MIPS based on Medicare billings and numbers of patients seen under Part B. Data covering more than a million patients treated in these practices were included.

The upshot, she said, was that most practices were doing a good job of meeting the benchmarks needed to receive incentive bonuses in 2019, but also that there was "wide variation" among practices.

But she also strove to show that, when properly reporting their data, it's not difficult for physicians to earn high scores. Of the 15 rheumatologists registered in RISE who have completed reporting for all three of the current MIPS domains (cost being excluded this year), all 15 met criteria for "high performance" that would earn them a bonus payment.

"This is great news," Yazdany said. "It suggests that people are going to do very well in this program, they're going to be positioned to succeed."

She acknowledged that MIPS is something of a moving target, "likely to evolve" as full implementation gets underway. She told 麻豆传媒 that the RISE platform is adaptable, with adjustments to reflect new or altered requirements capable of being made "in a matter of days."

Yazdany also noted the "continued tension" between the goal of improving care quality and the reality of the burden imposed on physicians through regulation. "It's important that we all stay engaged and advocate for meaningful reform of this program that makes sense for our specialties," she said.