Simplifying the Complex to Educate Internal Teams

In the fall of 2021, the CMS released a final rule for 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 1 of the tracks available to clinicians within the QPP that provides performance-based payment adjustments for their services to Medicare patients. 

With 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. Additionally, the client wanted to develop a way to help their account executives understand this information to effectively communicate it when working with customers, primarily clinicians who would be most impacted. 

Once the training was developed, Avalere worked with a vendor to produce a short 4-minute animated video that provided a high-level overview of the program. It explains how providers can participate in the QPP and what it means for the client’s customer base. This video was shared with the client and presented internally during 1 of their informational account executive meetings. Avalere will remain in contact with the client to ensure any future updates to the QPP or MIPS are shared with this team. 

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

Avalere content experts began by developing a slide deck outlining the QPP program’s history, the scoring of provider performance, and the implications for the client’s business lines. After several iterations of the slide deck, Avalere successfully presented the complex policy in a way that individuals with minimal exposure to the program could easily understand. Avalere also embedded audio into the presentation to enhance the material and provide context. This presentation is now housed on the client’s internal training platform and can be used by account executives for familiarization with the policy and program and to reinforce the customer impact.  

Avalere’s video helped the account executives successfully discuss the complex program and the rule’s updates with providers. Account executives were able to strengthen their healthcare ecosystem knowledge and increase negotiating abilities. The client was also able to further protect their gross–to–net.