OOA Secretary-Treasurer Dr. Dave Anderson of Miamisburg provides answers to possible questions about MORE.
Have you signed up for MORE?
I signed up for MORE in June 2015 after attending Optometry’s Meeting in Seattle.
Why did you register for MORE?
After seeing the changes enacted by the U.S. Congress regarding CMS payment, it was clear that following any effort to unify healthcare was necessary. After learning the details of MIPS (Merit-based Incentive Payment System) scoring, I knew that Registry membership was a key component of the new payment structure in the coming years.
How easy was it to sign up?
It was really simple to sign up, although it is important to understand that each doctor in a practice needs to sign up individually. The first doctor of a practice signs up the practice with the EHR vendor details, but each doctor much assign their identification number to the system. In total, it took five minutes.
Is your EHR is endorsed?
My EHR was one of the first to be endorsed by MORE, and I was aware of the registry from my vendor before the AOA announced the process for signing up.
Why should I sign up if my EHR is not endorsed?
Additional EHRs are being endorsed by MORE and, in time, all the major EHRs will be included. The goal of MORE is to be inclusive of all EHRs and to fully represent all practicing ODs. Even if your EHR vendor is not listed currently, the more people who sign up for MORE with an EHR that is not endorsed, the quicker MORE will work to integrate with that EHR system.
What is the cost?
Nothing. MORE is fully a FREE benefit of AOA membership. This is the first time ever that membership directly impacts your future payments for the services you provide. AOA created MORE to not only engage in the Electronic Health Initiative of CMS, but also to be a valuable member benefit. If you are not a member of the AOA, the cost for MORE is $1,800 per year.
What diseases/diagnoses/codes are reported?
The registry is able to measure and compare outcomes of all areas of practice. This includes diabetes, glaucoma, pediatric care, amblyopia treatment and contact lens complications. Regardless of the way an optometrist practices, the registry is able to measure and compare all the key areas of eye care.
What if my practice only sees kids?
This is a perfect opportunity to showcase the benefits of primary eye care. From amblyopia treatment outcomes, to learning and reading, a pediatric practice will be measured against outcomes of similar patients. The payment model may appear to be only related to the Medicare population, but very quickly this model will be seen in private insurance plans and Medicaid plans as well.
What if I am in ophthalmology practice?
All the more reason to sign up. In an ophthalmology practice, an Optometrist is seeing patients for post-op care and major systemic and eye diseases. These are being watched very closely to help define better practice and clinical guidelines for overall better population health and outcomes within a specific population or disease. What better way to show that an OD seeing patients alongside an ophthalmologist is at or above the top clinical care measures.
Does each Doctor in practice have to sign up?
In short, yes. Although only those that wish to be measured and included in the registry to help determine the MIPS scoring. Much like meaningful use and PQRS, this is optional and results shown are based on the specific provider. Much like these other programs, our payments will be compared to others using this system and those who are highly performing will be paid significant bonuses while those who do not use this and other programs will see significant penalties.
Does MORE involve staff?
It can, but after signing up for MORE, the setup is finished and the doctor continues to see patients. The real area where staff may be involved is related to the measured outcomes. If a doctor sees he/she is falling short in a specific area, for example follow up care for diabetic patients, the staff may be charged to improve the recall system. Otherwise, all the information collection is done based on the services done daily in your EHR.
Is anything about prices reported?
No, everything about fees is specific to the doctor. There are no published results for an individual doctor. Everything is accessible only to the doctor who signs up. In fact, each doctor in a practice only sees their own measures and not the measures of the whole practice.
Is anything about dispensary reported?
No. The only information that will be pushed from each doctor’s EHR is the information related to billed procedures and the correlating ICD-10 codes and a demographic relationship as well as the medication information related to the provider, not specific patients. For example, the information available would include the percentage of glaucoma suspects in the past 12 months and what medications are prescribed most frequently.
Will MORE save me money?
Ideally, this will not only save money by helping a doctor better understand practice norms, this will also help a provider earn more money based upon participation in a program that measures outcomes and will apply to the MIPS scoring and therefore future payment models.
What if I sign up and competitors in my town don’t?
This is a national database registry, so there is no concern about other doctors and the data that is gained from their practice. The data is used only as an aggregate and to compare the individual doctor to others nationally.
Here is a link to the AOA’s MORE site with more information and signup:
The deadline for enrollment for EHR Incentive Program Participants is February 29, 2016.