1. Quality Reporting: Difficult to Live With It; Even More Difficult to Survive Without It! The Wisconsin Experience

2. Introductions George M. Lange, MD, FACP, OSMAP Rick Abrams CEO at Wisconsin Medical Society Chris Kleine Product Director at Physician Compass

3. Medicine’s Challenge What will our future state look like? “The best way, the only way, to predict the future is to create it!” - Peter Drucker

4. Important Fact Health Information Technology and Quality Reporting are here to stay – Whether we like it or not

5. The Badger State’s Response to this Challenge and Future Reality? We will embrace it and proactively create a successful future; We will not resist it

6. Quality Reporting in Wisconsin History MD/DO Executive’s 2002 Assessment of the future – Future success will be driven by: Transparency of information to the patient Evidence-based, data driven medical outcomes

7. Wisconsin’s Proactive Response Wisconsin Collaborative for Healthcare Quality – WCHQ was founded in 2003 – Voluntary multi-stakeholder consortium of physicians, healthcare organizations, payers and business groups – Committed to publicly reporting performance measures to help improve healthcare – Currently claims 40 healthcare organizations as members

8. Taking Quality Reporting to the Next Level Necessity of having to do so – April 2015: Enactment of Medicare Access and CHIP Reauthorization Act (MACRA) The Good News: SGR is repealed! The Challenging News: Medicare payment will transition from a volume-driven to a value-driven payment model The Challenging News: The majority of physicians across the nation are woefully unprepared for this future state

9. Options to Deal with this Future State Drop out of Medicare? Retire? – Not much of an option for many physicians Accept a reduction in payment that starts at 4% in 2019 and accelerates to 9% in 2022 and beyond? – Again, not much of an option Acquire the tools to get out ahead of the transition so that the future will by marked by growth and prosperity; not by anguish and financial ruin

10. Wisconsin’s Choice? We have chosen to “tame the beast” In concert with our county and specialty medical society colleagues, the Wisconsin Hospital Association, the Collaborative and others, we have chosen to arm our physicians for future success; Here’s how:

11. Qualified Clinical Data Registry (QCDR) The Collaborative sought and received from CMS the QCDR designation in 2014 – Significance: Enabled Wisconsin physicians, individually or as part of their group, to successfully report quality measures to comply with the Physician Quality Reporting Program (PQRS) – Significance: The Collaborative is one of the few QCDR’s that is not specialty specific

12. Taking Quality Reporting to the Next Level With the enactment of MACRA, we have created a tool that will enable all physicians regardless of specialty, geography or practice environment to successfully comply with current quality reporting requirements and to position physicians to successfully participate in the new world of the Merit-based incentive payment system (MIPS) and Alternate Payment Mechanisms (APM)

13. Taking Quality Reporting to the Next Level That tool is: Physician Compass!

14. Physician Compass Founded in 2015 to utilize the experience and workflows created by WCHQ Expand the success realized in Wisconsin to physician groups at the national level Enable physician groups to satisfy current compliance initiatives and align for future quality reporting programs

15. Physician Compass Overview Qualified Clinical Data Repository (QCDR) Rich history of clinical integration, quality measure development and reporting Created by physicians, for physicians – to improve the health of our patients

16. Physician Compass Solutions Physician Quality Reporting System (PQRS) Custom Quality Reporting and Measure Creation

17. Physician Compass Solutions PQRS Overview Physician Quality Reporting System (PQRS) – PQRS is a reporting program managed by the Center of Medicare and Medicaid Services (CMS) – Promotes physicians and other health professionals to submit quality information – Quality metrics are submitted annually to CMS

18. Physician Compass Solutions PQRS Incentives and Penalties on Medicare Payments (Groups of 10+ EPs) Service Dates Year of Impact PQRS Penalty Value Based Modifier Adjustment EHR Penalty Total Penalty for not reporting PQRS (PQRS Penalty + VBM) NegativeNeutralUpward 20152017-2.00%-4.00%0.00%+4.00%-3.00%-6.00% 20162018-2.00%-4.00%0.00%+4.00%-4.00%-6.00%

19. Physician Compass Solutions PQRS Service Dates 2017 - 2020 Service Dates Year of Impact MIPS (Merit Based Incentive Payment System) NegativePositiveHigh Performers 20172019-4.00%+4.00%+10.00% 20182020-5.00%+5.00%+10.00% 20192021-7.00%+7.00%+10.00% 20202022-9.00%+9.00%+10.00%

20. GPS Group Processing System Group & Individual Measure Reporting – Group Reporting (Tax ID level) - GPRO Data Submission Vendor (DSV) Registry – Individual Reporting (Provider level) Registry Qualified Clinical Data Registry (QCDR) Target market is practices with >25 providers

21. MAPS Manual Abstraction and Processing System Individual Measure Reporting using Measure Groups – Manual entry of 20+ patients (>50% must be Medicare) – Currently available Measure Groups Preventative Care Diabetes Additional groups to be added for 2016 Target market is small practices (1 – 25 providers)

22. Custom Navigator Custom Quality Reporting Flexible application to create custom quality measurements Target quality measurements to better understand a specialty area or patient population Measurements are facility/health system specific Fully configurable numerator/denominator criteria

23. Convenient File Formats Comma Separated Values (.csv) format Standardize data via data mapping Files available to be extracted from customer Provider Master ListBlood Pressure File Clinic Master ListTobacco File Patient FileMedication File Patient Header FileProcedure (CPT) File Encounter FileProblem List File Clinical Data FileInpatient File

24. Product Pricing Provider CountAnnual FeePer Provider Fee Annual Minimum GPS ALL$4,000$150$6,000 MAPS 0-25$0$275None 26-50$0$250None 51+$0$225None Custom Navigator Based on project specifications.

25. Physician Compass Aligning for the Future Physician Compass’ products and its ability to measure clinical data will enable physicians to comply with future quality reporting programs Nimble, flexible platform can quickly enhance and adapt to complex government quality reporting initiatives such MIPS and APM

26. Summary and Key Points Experienced, successful clinical data registry – Reported PQRS for 4,000+ providers in 2014 – Estimated 5,000+ providers in 2015 Reputable clinical quality measurement reporting Simple, affordable PQRS and MU solution for all sizes of physician groups and practice environments

27. Questions? Thank you!