Simplifying the Complex to Educate Internal Teams

In the fall of 2021, CMS released a final rule on the QPP that included changes to the Merit-Based Incentive Payment System (MIPS). The QPP rewards high-value, high-quality Medicare clinicians with payment increases while reducing payments to clinicians who do not meet performance standards. MIPS is one track available to clinicians within the QPP that provides performance-based payment adjustments for their services to Medicare patients. 

Given the rule’s complexity, a US-based global biopharmaceutical manufacturer sought to better understand the MIPS changes and their potential impact on its customer base. The client also wanted to help its account executives understand this information to effectively communicate it when working with customers, primarily clinicians subject to the rule’s impacts. 

We guided the client through the rule’s key points and determined the type of informational resource it sought to develop for its account executive team. Through these discussions, we concluded that high-level training on the QPP and MIPS would be most beneficial to staff. The client’s primary goal was for account executives to understand the program so that they could articulate critical points and comprehend exactly how the MIPS track impacts their customers. 

Our content experts began by developing a slide deck outlining the QPP’s history, the scoring of provider performance, and the implications for the client’s business lines. After several iterations of the slide deck, we presented the complex policy in a way that people with minimal exposure to the program could easily understand. We also embedded audio elements into the presentation to enhance the material and provide context. The presentation is now available on the client’s internal training platform and can be used by account executives to familiarize themselves with the policy and program as they prepare to engage their customers.

We then worked with a vendor to produce a short 4-minute animated video that provided a high-level overview of the QPP. It explains how providers can participate in the program and how the program impacts the client’s customer base. We shared the video with client personnel, who presented it internally to account executives. 

Our video helped account executives discuss with their provider customers the complex program and the rule’s updates. Account executives strengthened their knowledge of the healthcare ecosystem and enhanced their negotiating positions. The client was also able to protect its gross–to–net.