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Case Study - Achieving MIPS Exceptional Performance in an Epic Environment

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SPH Population Care ™ Summary: The University of South Florida's academic medical center, USF Health, Tampa, FL chose SPH Analytics' Population Care™ | Quality Measures solution to monitor, manage, and improve quality measures for the Merit- Based Incentive Payment System (MIPS), a program under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The USF Health MIPS program was so successful that they achieved "Exceptional Performance," making them eligible for bonus payments, despite coding gaps in their Epic EHR. The Exceptional Performance bonus in MIPS is a pool of $500 million reserved for top MIPS performers. To be an exceptional performer in MIPS, providers must earn 70 out of 100 points for their Composite Performance Score. "We are so pleased with our performance in the first year of MIPS reporting," stated Dr. Terri Ashmeade, Chief Quality Officer at USF Health Morsani College of Medicine, University of South Florida. "Our organization had not widely deployed Quality Data Codes in our EHR, so we had to work with the SPH team throughout the year to optimize our data using other codified data and structured text fields." Background: USF Health is an academic medical center and a multispecialty clinical information network (CIN) with 585 physicians, practicing in more than 30 specialties, with 484,000 outpatient visits per year. It uses Epic as its Certified Electronic Health Record Technology (CEHRT) solution with integration of historical data from AllScripts. USF Health set the goal of achieving exceptional MIPS Quality reporting scores as a win-win for patient care and the best possible payment adjustments. The management team felt that reaching this standard during the first reporting year would help ensure long-term success. Challenge: Implementing the MIPS program posed several challenges to USF Health. The MIPS Quality category is worth 60% of the total MIPS Composite Score for 2017, so the center was focusing on quality measures to maximize MIPS bonus payments. USF Health's network is composed of more than 30 medical specialties, thus requiring thought and insight to select and track the optimal mix of MIPS reporting measures. A consultative partnership with a reporting solution vendor would be critical for success. Achieving MIPS "Exceptional Performance" in an Epic Environment Case Study

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