The following article looks at CMS MIPS quality measures for LPTAC medicine. However, before we go towards the MIPS quality details, we need to look at the underlying purpose and objectives.
CMS (Centers for Medicare and Medicaid Services) is always working on improving the policy to provide better healthcare facilities. Therefore, the new measures are aimed to help improve the overall care delivery and also reward clinicians who are better engaging patients, families, and caregivers.
Here is how CMS looks at MIPS.
“To these ends, and to ensure the Quality Payment Program works for all stakeholders, we further recognize that we must provide ongoing education, support, and technical assistance so that clinicians can understand requirements, use available tools to enhance their practices, and improve quality and progress toward participation in APMs, if that is the best choice for their practice.”
Key Strategic Objectives
Let us have a look at the strategic objectives set by CMS.
- The engagement of patients and the improvement of beneficiary outcomes.
- To further the clinical experiences that offer flexible yet transparent programs.
- Ensure meeting of diverse needs of the physician practices typically those with small practices.
- Further the capabilities of the IT systems that meet various data needs of the end user including reporting and submission.
- Work on improving information and data sharing to ensure its timely availability.
- Enable customized communication while keeping MIPS quality measures specifications into perspective.
Caveats for Individuals and Groups
The new MIPS quality measures take into consideration two LTPAC setting codes. These codes are the basis for the MIPS quality measures specifications. These MIPS quality measures are for application on individuals as well as groups.
Here are some considerations to undertake.
To qualify for the MIPS incentive payments you need to report on the following.
- There are 6 measures with at least one of them as an outcome measure relating to poor diabetes control. The new quality measures mark high specialty and ambulatory practices.
- Each measure’s applicability should be up to 90 days.
- Around 50 percent of your patients have to qualify for one of those 6 measures.
- The minimum number acceptable for the incentive payments stands at 20 patients.
- The health practitioner can only report some measures after a specific diagnosis. Therefore, health clinicians have to be careful when selecting these measures.
Avenues for Submission
You can submit your measures to multiple avenues including EHR, claims, QCDR, and Registry. Registry seems to be the most suitable option for groups that aim to report when using the individual measures.
Why Consider Registry for Submission?
Here are the reasons why you must consider submission via Registry.
- Since you can submit all 2017 QMs via Registry, you do not rely on any other methods.
- Claims Reporting for 2017 QMs only supports a subset. Therefore, be careful to see the claims if the Claims Reporting offers support for it or you need to use Registry instead.
- The group gets a measure of review or control when using Registry before you submit the data. Therefore, it gives a buffer, allowing you to remove any errors that you may find.
Avoiding Penalties is Critical
Make sure to always keep the benchmarks in perspective. By following them you can reduce your chances of getting a penalty. It will also help you satisfy base reporting requirements for MIPS.
Make sure that the data you submit for one patient satisfies that particular measure. If you are able to satisfy all six measures, the data would become a prime example for others to follow. In that case, you may be able to find your data published on CMS’s site for Physician Compare.
How 2017 MIPS Quality Measures Differ?
Previously, there was not much detail available. However, 2017 MIPS by CMS offers detailed benchmarking, relying upon the methodology which involves different performance points.
These individual performance points add to make a total score. Therefore, in 2017, you need to focus on performance as it is a critical year for it. Physicians should know the way they are graded to their performance, comparing it with the past year. It is vital to carefully select QMs which would help you score above average performance.
Here is how CMS elaborates this concept.
“By developing a program that is flexible instead of one-size-fits-all, we’re trying to meet clinicians where they are so that they can make the choice about how to participate in a way that is best for them, their practice, and their patients. Reducing burden, ensuring flexible program design, and improving how we measure cost and quality performance supports clinicians in doing what they do best – making their patients healthy.”