MPFS Update for 2018

Description:

MPFS using the RBRVS (Resource Based Relative Value Scale) as the main vehicle for implementing the fee schedule.  Each year CMS proposes changes to MPFS and then at the beginning of the calendar year implements the changes.  The relative value units (RVUs) are almost continuously updated from year-to-year based on special studies.  Additionally, changes to policy issues such as the Global Surgical Package (GSP) are discussed in the Federal Register.  CMS is now in the process of doing away with the Sustainable Growth Rate (SGR) and replacing it with value-based or merit-based payment mechanisms as require through MACRA 2015

• How does CMS go about making changes in the RVUs?
• Are there incorrectly valued RVUs?
• Why is the conversion factor for MPFS so controversial?
• Are changes being made to telehealth services?
• Do ambulance services have anything to do with MPFS?
• What is happening with anesthesia payments?
• What is happening with chronic care management services?
• How can I assess the impact of the MPFS changes in our clinic?
• Will radiation therapy centers and radiation oncology experience decrease in reimbursement?
• How is health information technology is integrated into MPFS?
• What about physician quality reporting?
• Is CMS really going to change the GSP?
• How will MIPS ad APM through MACRA 2015 affect physicians?

 Objectives of the session: 

• To briefly review the main components of MPFS.
• To discuss the broad range of changes being made to MPFS including technical RVU changes as well as policy changes.
• To appreciate the changes being made relative to the Sustainable Growth Rate (SGR), such as MIPS and APM incentives.
• To review proposed changes in the RVUs for selected physician specialties.
• To briefly review changes in CPT and HCPCs coding.
• To discuss the proposed change in the Global Surgical Package (GSP),
• To briefly discuss associated policy areas such as physician quality reporting and the physician compare website.
• To review changes in associated payment systems and services such as telehealth, anesthesia and the ambulance fee schedule (AFS).
• To discuss non-physician practitioners (NPPs) special changes that are being made relative to NPPs.
• To review the possible impact of the proposed changes in different specialty areas.
• To discuss related issues such a provider-based clinics and special services such as observation services.

Agenda for the session: 

1. Review of MPFS and RBRVS
   1. Use of Relative Value Unit
      1. Work Component
      2. Practice Expense Components
      3. Malpractice Component
   2. Conversion Factor and the SGR
   3. Updating of RVUs
   4. Geographic Adjustments for MPFS
   5. Non-Physician Practitioner Involvement
   6. Major Policy Areas for the MPFS
   7. Other Areas Affected by the MPFS
2. Review of Code Set Changes
   1. CPT
   2. HCPCS
3. Changes Being Made to MPFS/RBRVS for CY2017
   1. RVU Changes
   2. Conversion Factor and the SGR
   3. Site-of-Service Considerations
   4. Changes in GPCIs
   5. Facility vs. Non-Facility Practice Expense RVUs
   6. Radiation Oncology
   7. Future Changes and Trends
4. Global Surgical Package (GSP)
   1. GSP Basics
   2. Problem Area for Physicians to Report Correctly
   3. Discontinuing 10-Day and 90-Day Global Periods
   4. Possibly Impacts on Physicians and Clinics
   5. Commenting on the Proposed Changes
5. MACRA 2015
   1. MIPS – Merit-Based Incentive Payment System
   2. APM – Alternative Payment Models
   3. Timing of Changes
   4. Payment Impacts
6. Associated Areas of Concern
   1. Ambulance Fee Schedule
   2. Anesthesia Fee Schedule
   3. Telehealth
   4. Non-Physician Practitioners
   5. Health Information Technology
   6. Physician Quality Reporting
   7. Provider-Based Clinics
7. The Future of MPFS and RBRVS

Who should Attend?

Clinical Staff, Nursing Staff, Physicians, Non-Physician Practitioners, Physician Practice Managers, Clinic Administrators, Financial Analysts, Revenue Cycle Specialists, Chargemaster Coordinators, Provider-Based Clinic Staff, Compliance Personnel, Other Interested Personnel