The American Medical Association (AMA) has clearly stated that the only way to avoid penalties regarding MIPS 2018 is to report on one of the three significant MIPS quality measures. In this way, physicians can prevent those negative payment adjustments waiting to happen in 2020. Connect with P3Care instantly on LinkedIn – https://www.linkedin.com/company/p3-healthcare-solutions/
The three quality measures are
- Promoting interoperability
- Improvement activities
How Reporting Criteria Changed Over Time?
Eligible clinicians can avoid the penalty by following a reporting strategy as per AMA’s advice. In 2017, it was compulsory for physicians to score at least three MIPS points to avoid a financial penalty at the start of 2019. It means that they only needed to report one quality measure to overcome the penalty risk.
Nevertheless, now the rules are stricter and the focus on value-based services is now more than ever. With this advancement and the modified requirement criteria in the healthcare industry, the new threshold for MIPS 2018 reporting is fifteen points. The clinicians having a score of 15 are able to avoid penalties in 2020. As an EP, if you fail to report the minimum amount of quality measures governed under the Quality Payment Program’s specifications, it results in a definite 5% decrease in reimbursements.
Therefore, scoring equal to 15 is essential for those eligible in this program.
Follow the tips below to avoid a financial penalty in 2020, improve your MIPS performance, and increase your Composite Performance Score (CPS).
Report on Improvement Activities (IAs) to Score Higher
The BEST WAY to meet the required threshold is to report Improvement Activities (IAs) immediately.
The Centers for Medicare & Medicaid Services (CMS) defined 113 measures under this performance category in MIPS 2018. Each performance measure has further subcategories in the form of medium and high-weighted activities. Obviously, the high-weighted activities carry more points and can get you closer to the maximum score.
How Do You Calculate Performance Categories?
The activities for the performance categories function around care coordination, population healthcare, beneficiary engagement, and health equity factors. To score in any category, eligible clinicians are required to collect and submit data for 90 consecutive days in 2018.
How to Submit MIPS to the CMS?
Healthcare providers can submit clinical data for MIPS 2018 via:
- Quality payment program 2018 (QPP) data submission system
- Electronic health record (EHR) system
- MIPS qualified registry
- The qualified clinical data registry (QCDR)
Improvement Activities – A Lucrative Offer for Small Practices
Reporting Improvement Activities (IAs) under MIPS 2018 can elevate the revenue cycle for small medical practices. MIPS reward small healthcare practices with double points as compared to well- established healthcare facilities.
Another advantage to smaller practices is a bonus of five extra points when they score a total of 15 points. It ranks them above the others on the MIPS scorecard with 20 points. Therefore, if you report for one high-weighted improvement activity, you are bound to earn more points.
For the same MIPS score, ECs working for large medical practices must submit data for two or more improvement activities to get up to the threshold limit of 15 points.
MIPS Quality Measures Shield You from Negative Payment Adjustments
Negative payment adjustments can be a big setback for your profit journey. Therefore, use quality measures wisely and in a timely manner. To stay on top of your game, you must fully understand the performance measures to make to turn it into a lucrative opportunity.
There are 275 quality measures and clinicians can select from among them the most suitable measures to meet the MIPS 2018 threshold score. Each Quality measure has further sub-categories as per the following factors:
- Patient engagement
Moreover, CMS has developed a specialized set of quality measures to help physicians identify appropriate quality measures. Clinicians can report data for 12 months on six quality measures. However, it is necessary that one of the quality measures should be outcome measure or a high priority performance measure.
Clinicians participating in the form of virtual groups can use CMS Web interface or Consumer Assessment for Healthcare Providers and Systems (CAHPS) for MIPS survey.
Report for At Least Two Performance Categories
To stay away from negative payment adjustments, report for at least two performance categories. For instance –
- Improvement Activities and Quality
- Or, Promoting Interoperability and Quality
How to Score High and Handsome?
Ordinarily, we see small medical practitioners reporting one medium-weighted improvement activity and one quality measure. This reporting tactic earns you 10 points and with an extra 5 bonus points, you may achieve a total of 15 points.
The Territory of “Promoting Interoperability (PI)”
Another way to earn 50 out of 100 points is by reporting on the Promoting Interoperability performance category. It investigates the patient and physician engagement level and makes the patient information available to other clinicians via EHR technology. EPs are required to submit data for 90 days or more on the base score of four or five measures in this category. The base score measures take their value from the certified EHR edition.
Large medical facilities can achieve high scores by reporting on PI and quality categories. However, they must report on PI performance category to score 50 and two quality measures to get to 70 points and target the bonuses out of a $500 million pool.
EHR Technology – One Step Ahead
Each EHR edition has a different set of performance measures. For instance, the 2014 EHR edition allows reporting on the Promoting Interoperability Transition Objectives and measure set.
Important Tips to Score Higher
- The data submitted on quality measures for at least 20 patients fulfill the data completeness requirement.
- Two medium-weighted improvement activities and four quality measures can get you a score of 16 points in 2018.
It is only possible when the physicians earn 12 out of 70 points in the “Quality” performance category and score 20 out of 40 points in the Improvement Activities.
Vote for Better Healthcare
As 2018 is about to end, the evergreen slogan for the welfare of Americans is to vote for a better healthcare system. That truly goes in favor of the Americans.
If you still haven’t done anything to avoid the penalty in 2020, it is time to connect with a reliable MIPS registry for submissions. America needs you to come out as a winner and reputable practitioner.
Most of the performance categories require data for 90 days. Therefore, reach out to P3Care and report QPP measures efficiently and be free from the worries of non-reporting.