REQUEST YOUR 2016 PQRS FEEDBACK REPORT

If you haven’t so already, now is the time to request your PQRS feedback report for 2016, and see if you can apply for an informal review performed by P3Care.

Did you know a Medicare penalty is put in place for those who do not apply for an informal review, which will take effect in 2018! The absolute deadline to request your feedback report is December 1st, 2017. The feedback report will illustrate your 2016 PQRS reporting results and indicate if you are subjected to a positive, neutral, or negative payment adjustment for 2018. Based on the 2016 quality reporting results, you will also receive information on how individual and group providers have performed on quality and cost measures through the Annual Quality and Resource and Use Reports (QRURs). The objective of the PQRS feedback report is to ensure you have the necessary information for a positive outcome on future Quality Payment Programs (MIPS). The feedback report also consists of comprehensive information regarding the overall quality of healthcare provided to Medicare patients and cost performance. You are also given the opportunity to have your results reviewed if you believe there has been a miscalculation in the value modifier adjustment; you must make this request by December 1st, 2017.

Apply Today!

Don’t worry if you’re subjected to a negative payment adjustment for 2016; it’s never too late to get back on the right track with P3Care! The primary reason to replace the previous PQRS, and introduce the new and more effective MIPS was so providers can submit data by picking a pace that is best suited for their practice and focus on providing quality care at the same time. There is still enough time to take part in this year’s QPP and avoid a negative payment adjustment for 2019. P3Care is dedicated to improve your quality reporting and help you take full advantage of the remaining MIPS year. Our consultants will assist you every step of the way, and make sure you submit at least one quality measure for 2017 to help avoid further negative payment adjustments. The deadline is fast approaching, contact P3Care today for assistance in requesting your 2016 PQRS feedback report and to avoid a Medicare penalty.

909-245-8350 (P3 Client Service).

MIPS QUALIFIED REGISTRY & VENDORS

Criteria 

In order to be included in the MIPS qualified registry vendors, you must self-nominate your organization each year (even if you have previously qualified) and gain approval by CMS. As a clinician, individual or group, you’ll see yourself directly interacting with your selected vendor on a regular basis.

Therefore, it’s absolutely necessary there’s a mutual understanding in regards to expectations and outcome goals. Essentially, the objective of any qualified vendor is to ease all billing and QPP reporting tasks. Which leaves you with valuable time to focus on patients.

To give you a brief understanding of the procedure, here are a few of the necessary requirements to be completed by a vendor in order to be approved by CMS for the 2018 MIPS Qualified Registry Vendors.

  • Provide information about previous registry status (new or existing registry)
  • Each vendor should have at least 25 participants by January 1st, 2018.
  • Provide an attestation statement, verifying that all data in relation to measures, activities, and objectives are accurate and complete.
  • You must submit data using one of the CMS provided secure data submission methods.
  • Provide information on how we (the vendor) will process data validation and MIPS eligibility.
  • Include our supported MIPS quality measures and performance categories.
  • How the vendor will collect information and determine the provider’s performance rates.
  • Process for verifying providers TINs and NPIs.
  • Provide random audit process.

Disclaimer 

Accuracy is absolutely vital in all aspects of data collection, reporting, and submission. CMS has determined a penalty in regards to inaccurate data submissions. Therefore, this results in possible probation and disqualification for the following year.

Side Note-  Registry updates would show which vendor is on probation.

In addition, CMS has provided us with a checklist consisting of data submission tasks. You must complete all the tasks to be approved for a qualified registry. The categories a vendor must complete (with a brief description) include:

Indicate– Certified EHR technology, start and end dates for performance periods. Whether or not vendors are reporting on quality measures, objectives, and improvement activities.

Submit– Submit and report data for all supported MIPS categories, provide eligible clinicians with performance feedback at least 4 times a year, quality measure ID numbers.

Report (on the number of) – Performance and reporting instances, inadequate submission criteria.

MIPS Qualified Registry Vendors 2018

Verify (clinician information)–  Details about services provided to clinicians along with contact information and charges. This should be a signed consent by the provider to allow the vendor to provide CMS with MIPS data on their behalf. Also provide HIPAA compliance (patient-focused) agreement between both vendor and clinician, verify all data submitted is accurate and complete.

Comply- Submit data using one of the secure options provided by CMS, fulfill requests by CMS to review data at any time, take part in annual registry meeting and monthly support calls.

We at P3Care are proud to be 2017 CMS certified! P3Care’s objective has always been to reduce workload burdens off of providers and staff to enable them to look after patients in a better way.

If you’re on the hunt for a medical billing provider or MIPS support, we can ensure you will be satisfied with our committed service!

Our CMS registry approval will ensure you that we have successfully demonstrated our capabilities on reporting data for the MIPS transition year 2017 in the following categories: Quality, Advancing Care Information, and Improvement Activities.

Furthermore, the CMS registry will provide you with the necessary information needed when selecting an appropriate vendor for your practice. Therefore, you can find detailed information about each vendor under the following headings: Contact Information, Cost, Reporting Options (individual or group, Services Offered, Performance Categories, Quality Measures Supported, and eCQMs Supported.

P3 Healthcare Solutions and Medical Billing

To decide which professional medical billing company suits their practice best is one of the most important decisions a provider will make. The financial outcome of your practice heavily relies on the efficiency and accuracy of the medical billing vendor you select. Whether you practice individually or in a group,

CMS qualified registries are a collection of vendors that are certified to report on quality measures and data for the Quality Payment Program / MIPS. CMS registry vendors have all necessary tools, knowledge, and software up their sleeves. This is important to submit data on behalf of providers directly to CMS.

Furthermore,  qualified registries are self-nominated. And they have proved to meet requirements set out by CMS and the QPP. P3 Healthcare specializes in supporting MIPS eligible clinicians through Benchmark Quality Reporting. While also functioning as a proficient and client-centered Medical Billing firm.

Therefore, MIPS qualified registry is open to the public anytime. You can view P3 HealthCare Solutions in the MIPS qualified registry vendors by visiting the CMS Resource Library.

MACRA & MIPS: A CLOSER LOOK

MACRA

Talking about MACRA & MIPS, it is important to learn that in 2016, MACRA (Medicare Access and CHIP Reauthorization Act of 2015) was officially introduced, ruling out the existing and outdated Sustainable Growth Rate method. Previously, providers received payments based on the number of Medicare patients they provided care to; rather than being paid for the quality of care they provided. Not only was this method proven to be ineffective for the patients, but drastic effects were observed when it came to receiving financial support for Medicare expenses. Treating a high volume of patients (quality or no quality) basically meant higher payments for providers. MACRA established a Quality Payment Program (QPP), a method that will motivate providers to deliver well thought out quality care to patients by rewarding them with payment adjustments. Eligible providers are able to choose one of two pathways in the QPP, MIPS (Merit-based Incentive Payment System) or APMs (Alternative Payment Models).  An estimated 500,000 providers will be eligible to participate in the first year of MIPS. The amount MACRA will provide for positive payment adjustments is quite overwhelming, up to 3 billion dollars in the next six years! Let’s take a closer look at MIPS, and how P3Care can provide you with consulting services to ensure you understand how to take full advantage of this new and improved payment process.

MIPS

In order to take part in MIPS, you must meet the requirements associated with Medicare billing (Part B). Selecting this route of the QPP focuses on receiving payment adjustments based on the specific data you have submitted. For the 2017 transition year, there are three different categories. To help better understand how you’ll be scored under MIPS, specific weights are given to each category. This will allow you to divide your attention accordingly. You will also need to determine if you are participating in MIPS individual or as a group. Here’s a closer look at the MIPS performance categories for 2017.

·         Quality

60% of the data submitted will pertain to this category; signifying the main purpose of eliminating the previous method, and implementing MIPS. In this category, providers which practice solely are required to report up to 6 quality measures (out of 271), which are the most associated with their specialty. Clinicians will be scored based on the number of days they have submitted data for (read more below), along with accuracy and completion of all the required specifications for each measure. Closely assessing each measure helps determine if high-quality healthcare goals are achieved. The total number of points earned on 6 quality measures + any bonus points will determine your final score of the Quality category.

·         Advancing Care Information

Taking up 25% of the total MIPS score, this category replaces the previous Meaningful Use program. You’ll need to select one of two reporting measure sets, depending on your EHR edition. Each option is composed of different measures; therefore it’s essential you only report on which option relates to you. There are three subcategories that will determine you’re the total score for this category, they include Base Score, Performance Score, and Bonus Score. Failing to complete all of the requirements in the Base Score category will result in a 0 in the overall Advancing Care Information category.

·         Improvement Activities

The remainder of the score (for 2017) will come from the Improvement Activities category, weighing at 15%. This category allows CMS to determine if clinicians are improving clinical practice to its highest potential. A few key aspects include providing quality care by involving the patients in decisions,  continuous coordination between provider and patient, providing self-management techniques, patient/family education, providing follow-ups, using safe technology, and being reasonably accessible. You’ll have the opportunity to choose from a variety of activities, that best suit your practice, to report data on. Each activity is categorized as either has High or Medium; high weighted activities are worth more points. Individual Medicare providers will need to submit data on up to 4 activities for a minimum of 90 days, in order to earn full potential points.

Cost

In the last but not least, Cost is the fourth category, upon which physicians’ MIPS score is based upon.

Physicians don’t have to report separate data for cost category. However, CMS calculates this MIPS quality measure by analyzing the submitted administrative data.

For the year MIPS 2017, the cost category had a value of 0% in the final scorecard. MIPS 2018 was the first performance year in which, the cost was set for 10%. This score accounts for the lower cost expenditure while physicians provide high-quality healthcare services to patients.

Right now, we are passing through MIPS 2019, which is the 3rd year of this value-based program.  The cost-quality measure is a significant part this year as well and accounts for 15% of the final MIPS score.

MIPS is running quite successfully with more and more clinicians taking part in it every year. Its impact on the healthcare industry is progressive and physicians upon realizing its importance for revenue cycle management are subject to adopt modern and cost-effective healthcare ways.

MIPS 2017 – THE P3CARE WAY

MIPS Consulting Services

At P3Care, we understand the importance of participating in MIPS and achieving positive outcome goals. We go the extra mile, to ensure we are there to assist you every step of the way, no matter how big or small your practice is! From determining eligibility to explaining MIPS core requirements, to providing progress reports, we are committed to eliminate the stress associated with performance data and allow you to focus on providing high-quality care to patients. P3Care’s analysts and consultants are trained and have comprehensive experience with Medicare Quality Care Programs. Our professional team of consultants will closely work with you to determine which quality measures are best suited for your practice. In addition, we will apply all applicable codes to claims, provide you with monthly analysis and feedback reports, submit your performance data to Medicare by appropriate deadlines, and provide you with the best solutions to gain a positive or neutral payment adjustment.  There is still time to avoid a negative payment adjustment for the transition year 2017. Contact P3 today to find out how!

P3Care Tips on MIPS

  • Selecting measures that are the most applicable to your practice plays a key role in earning positive or neutral payment adjustments.
  • P3Care will go out if its way to make sure you earn full potential points in all the categories, along with bonus points!
  • Submit at least one quality measure or improvement activity, to avoid a potential -4% payment adjustment.
  • P3Care helps you in the distribution of work connected with the demonstration, making sure you have maximum time for patients. If you ignored quality reporting in the past due to workload, P3 is the place for you!