[Group Name]

Monthly Meeting Plan Meeting Agenda: Share and evaluate observations MACRA Manager: Is our EHR generating all the data we need in a timely and accurate manner? Are we gathering our non-EHR MACRA data? Which MACRA decisions have not yet been finalized Financial Management:  What should we plan (in the aggregate) for MACRA financial adjustments? How do MACRA financial adjustments apply at practice levels? Have we set appropriate operational and financial targets, and how are we tracking against those targets? Should we modify our targets, and if so, what would be the impact? Provider Management Which providers (and which practices) need help with which dimensions of MACRA? Which providers (and which practices) need help with which specific measures How will MACRA impact compensation and reimbursement for each provider? Quality Staff How are individuals and practices performing (based on MACRA benchmarks) on the measures they currently track? Which new measures would offer the best opportunity for improved MACRA scores? For which measures / providers should we focus detail population health activities? Marketing or Credentialing How will our competitors use public MACRA information to gain marketing advantage? How can our providers become individually and collectively more competitive, regarding public MACRA data? Discussion: Identify shortfalls and actions Action Items: Assign and communicate for progress reporting at next session Pre-Meeting Concierge Activities Integrate CQM and PI data - No later than 3 days prior to meeting date, the MACRA database should be refreshed with the most current data from EHR, Registry and any other systems. Manage non-integrated data - On an ongoing basis, each TIN should be evaluated for Security Risk Assessment, Immunization Registry, Public Health Registry and CPIA measure identification. Each meeting will have as an agenda item validation that these components are in process, scheduled or have been met. Analyze data and summarize observations - The MACRA Concierge will analyze current data and prepare observations for team discussion.

Data Completeness and Accuracy: MACRA Manager Is our EHR generating all the data we need in a timely and accurate manner? Are we gathering our non-EHR MACRA data? Which MACRA decisions have not yet been finalized Example: We don’t yet have PI or CQM reporting from EHR for some of our clinics; or in some clinics, some providers are missing data. Meeting Action: Identify responsible person, and assign Action Item for follow up in next discussion

Financial Expectations: Revenue Cycle Manager What should we plan (in the aggregate) for MACRA financial adjustments? How do MACRA financial adjustments apply at practice levels? Example: Analysis 1 – Overall we are still under our targets, but in reasonably close range. Analysis 2 – For most of our practices, submitting as MIPS Group appears the most profitable, except for Jones Island which makes more under Individual Rules Meeting Action: Identify whether any follow up is required, either for setting targets, or resolving shortfalls.

Financial Expectations: Revenue Cycle Manager Have we set appropriate operational and financial targets, and how are we tracking against those targets? Should we modify our targets, and if so, what would be the impact? Example: Are our target scores still appropriate for each category of providers? Do our target scores achieve desired financial outcomes? Meeting Action: Validate and move on … or update with new values for next reporting cycle.

Provider Billing Projections: Revenue Cycle Manager How will MACRA impact compensation and reimbursement for each provider? Example: Focus on our top three Medicare billers in this clinic would result in higher reimbursement than all others combined, since their aggregate billing represents a high percent of overall revenue, and their personal MIPS scores are on average lower than everyone else. Meeting Action: Assign individual to drill into each of the highlighted providers, and figure out where their scores would benefit from the most attention.

Provider Management: Clinical Leadership Which providers (and which practices) need help with which dimensions of MACRA? Example: This clinic is performing well on Quality, but struggling with PI. Further analysis needed to see why so many providers failing PI altogether. Meeting Action: Identify responsible person, and assign Action Item for follow up in next discussion

Provider Management: Clinical Leadership Which providers (and which practices) need help with which dimensions of MACRA? Example: In most cases, providers falling below our target for PI are simply not set up to generate measures. Providers below targets on CQM tend to be in a limited set of Specialties Meeting Action: Identify responsible person, and assign Action Item for follow up in next discussion

Provider Management: Clinical Leadership Which providers (and which practices) need help with which specific measures? Example: Jones Island Doctors having difficulty with Secure Messaging, and Immunization Registry. Meeting Action: Identify responsible person, and assign Action Item for follow up in next discussion

Provider Management: Clinical Leadership How are individuals and practices performing (based on MACRA benchmarks) on the measures they currently track? Which new measures would offer the best opportunity for improved MACRA scores? For which measures / providers should we focus detail population health activities? Example: Our required Outcome measures are not delivering MIPS Decile scores and require physician training, and EHR configuration. Across the board, we seem to perform lower than expected on Controlling High blood pressure and we need to further analyze physician / patient activity. Meeting Action: Identify responsible person, and assign Action Item for follow up in next discussion

Meeting Action: No further action at this time Action Items Who has agreed to what actions, tied to which observations and which providers? What is the ongoing status of our action Items? Example: So far, all action items are on track, and have been assigned and e-mailed to each responsible individual Meeting Action: No further action at this time