MCCI (Medical Care Consortium, Inc.) is a physician owned Medical Group who partners with Humana to engage Primary Care Provider offices successfully transition to a quality or value based model of care by providing practice support around quality related activities such as appropriate documentation and coding, care coordination, Patient Centered Medical Home (PCMH), closing Preventive Health and Quality gaps, etc. and now MACRA.
More info soon!
On this week’s MAG episode, I hosted Dr. Adrienne Mims, Vice President and Chief Medical Officer, Medicare Quality Improvement for Alliant Quality, to talk about the transition to the Merit-based Incentive Payment System (MIPS).
Adrienne Mims, M.D., MPH, is the vice president and chief medical officer for Alliant GMCF. Board certified in family medicine and geriatrics, she has more than 30 years of primary care, consultative and home care geriatric experience. Dr. Mims serves on a number of boards, including the American Health Quality Association (the trade association for Medicare Quality Improvement Organizations), the Georgia Academy of Family Physicians, and the PCPI (the national organization that develops quality measures for all specialties).
In addition, the MAG member serves on the NCQA Geriatric Measurement Advisory Panel and the NCQA Clinical Programs Committee. Dr. Mims was the medical director of the Georgia Medicaid Management Program, and she was the director of prevention health promotion and research with The Southeast Permanente Medical Group in Atlanta.
Dr. Mims completed her undergraduate training at George Washington University, her medical school at Stanford University, her residency at the Martin Luther King Jr./Charles Drew Medical Center, and her geriatric fellowship at the West Los Angeles VA. She also has an MPH in epidemiology from UCLA. It is imperative for medical practices to make a successful transition to Medicare’s new Merit-based Incentive Payment System (MIPS).
Instead of the EHR (Electronic Health Record) or the PQRS (Physician Quality Reporting System) or the Value-based Payment Modifier programs, the government will employ a single payment platform
– which is the result of the Medicare Access and CHIP Reauthorization Act (MACRA) that was signed into law in 2015. The new payment model will be based on a 100-point MIPS Composite Performance Score. That CPS will determine your Medicare payment adjustment – either up or down.
This is scheduled to commence in 2019, and the Centers for Medicare and Medicaid Services will use the 2017 calendar year as the basis for the initial reimbursement – keeping mind this is not an optional process.
Special Guest:
Dr. Adrienne Mims, Vice President and Chief Medical Officer, Medicare Quality Improvement, Alliant Quality
Patrice A. Harris, M.D., M.A., is a psychiatrist from Atlanta. She is the chair of the American Medical Association’s Board of Trustees (BOT), and she is the chair of AMA’s Task Force to Reduce Opioid Abuse. Dr. Harris has been the president of the Georgia Psychiatric Physicians Association, and she has served on the Medical Association of Georgia’s Council on Legislation.
In 2001, Dr. Harris was honored as the Georgia Psychiatric Physicians Association’s
Psychiatrist of the Year. After she earned her medical degree at West Virginia University, she did her residency in psychiatry and fellowships in child psychiatry and forensics at Emory.
She was also a Barton senior policy fellow at the Emory University School of Law. Dr. Harris was the director of Health Services for Fulton County, and she served as the medical director for the Fulton County Department of Behavioral Health and Developmental Disabilities.
Opioid abuse is a crisis in America. More than 40 people in the U.S. die from an opioid overdose every day, while many more are becoming addicted. The American Medical Association (AMA) Task Force to Reduce Opioid Abuse – which is comprised of 27 physician organizations and the American Dental Association – has announced several recommendations to address this epidemic.
It is urging physicians to register for and use state-based prescription drug monitoring programs (PDMPs) as part of the decision-making process when they consider treatment options. When fully-funded and available at the point of care, PDMPs are an effective tool for physicians to identify patients who may be misusing opioids and can be used to implement treatment strategies, including referral for those in need of further care.
AMA will also continue to work with the administration and Congress to develop balanced approaches to end prescription opioid misuse, as well as supporting congressional and state efforts to modernize and fund PDMPs. Finally, AMA has initiated an educational effort and communications campaign to promote safe,
effective and evidence-based prescribing within the medical profession.
Georgia PDMP registration: www.hidesigns.com/gapdmp
MACRA
According to the Centers for Medicare & Medicaid Services (CMS), the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) changed how Medicare health care providers will be paid in several important ways. MACRA
1) eliminated the Sustainable Growth Rate (SGR) formula and 2) created a new framework to “reward health care providers for giving better and not just more care” and 3) combined the existing quality reporting programs (EHR, PQRS) into one new system. According to CMS, this new “Quality Payment Program (QPP)” will replace “a patchwork system of Medicare reporting programs with a flexible system that allows you to choose from two paths that link quality to payments: the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models.”
Special Guest:
Dr. Patrice Harris, Chairman, Board of Trustees, American Medical Association
