The snowy winter season has approached, and the MIPS 2023 reporting process is now at its peak. Clinicians participating in MIPS 2023 have completed segment 2 of their reporting successfully. Yes, you got it right. Now it’s time for the final eligibility determination before the submission window opens. Alongside, we have virtual group Elections for MIPS 2024, starting on October 2, 2023. So, those who want to take part in MIPS 2024 must act now. Whether you’re a solo practitioner or a group, you have an equal opportunity to elect the virtual group election.
In today’s blog, we will be addressing the three key perks associated with virtual group reporting. But before that, we will give a little introduction to virtual groups for our learners in a while.
Virtual Group Reporting: A Way to Appear in the MIPS Program
The framework of QPP MIPS allows eligible clinicians to select one of the four reporting options.
- Virtual groups
- Individual group
- APM entity
So, it’s totally up to the clinician to choose how they want to perform in MIPS 2024. Each participating type gives specific perks and sometimes special status to them in MIPS. Well, for now, let’s just confine our discussion to the formation of virtual groups.
A virtual group allows two or more TINs to combine with eligible solo practitioners or groups. In a virtual group, two or more TINs are assigned to:
- One or more eligible solo practitioners
- One or more groups (comprising 10 or fewer clinicians with at least one MIPS-eligible clinician)
- A combination of both—solo practitioners and groups
As they participate in combination, they also get a combined MIPS final score. Remember that solo practitioners or groups elect to make their virtual groups. During this phase, they also select their official representatives. Likewise, they keep the CMS informed about any changes. Throughout the performance year, a solo practitioner or group can participate in one virtual group.
Virtual Group Participation Benefits: Why Become a Part of a Virtual Group?
A virtual group participation in MIPS 2024 seems attractive due to the benefits it offers. Anyhow, there is one limitation applied to this participation. The virtual group participation option is only valid for MIPS reporting. So, they cannot report via the APM Performance Pathway (APP) or MVPs for MIPS 2024. That’s why one must make a clear decision when deciding to be a part of a virtual group.
Here, let’s see what benefits virtual group participation gives MIPS 2024.
Expansion in the MIPS Performance Volume
We all know that “unity is strength,” and this perfectly describes the situation in virtual groups. MIPS-eligible participants may face a shortage of cases to report. However, when they assign their TINs to MIPS 2024, this combination will benefit them. Their MIPS performance volume automatically increases.
Convenient Collaboration and Resource Sharing
One such benefit of virtual group participation is increased resources. They can work together and share the resources. Thus, overall, they are adding to their potential performance in MIPS.
Unparalleled Flexibility in MIPS 2024
To some extent, virtual groups have flexibility in choosing their structure freely. In other words, when it comes to virtual groups, the possibilities are endless. These groups have the unique advantage of determining their composition. So, they are unrestricted by factors such as location or specialty. What’s more, there’s no cap on size. Thus, whether you’re a solo practitioner or part of a small group with at least one MIPS-eligible clinician, you have the freedom to shape your virtual group as you see fit.
Am I eligible for Virtual Group in MIPS 2024?
To be eligible to participate in a Group, one must necessarily fulfill the eligibility criteria. For both solo practitioners and groups, MIPS has certain criteria:
Necessities for Being an Eligible Solo Practitioner
- Must belong to an MIPS-eligible clinician type
- At least exceeds one low-volume threshold element
- Has Medicare enrollment as a clinician been done before the beginning of FY 2024?
- will neither a QP nor a partial QP choose not to participate in MIPS
Necessities for Being an Eligible Group
- NPIs under the Tax Identification Number TIN collectively surpass at least one of the low-volume threshold elements.
- The group consists of 10 or fewer clinicians, including at least one clinician eligible for MIPS, who have reassigned their billing rights to the TIN.
A virtual group encompassing both MIPS-eligible and non-eligible clinicians So, the total number of NPIs billing under the TIN determines the group’s size. If a group opts to join a virtual group, all clinicians within that group automatically become part of the virtual group.
A virtual group can have clinicians who are also participating in APMs. Thereby, clinicians in advanced APMs may attain Qualifying APM Participant (QP) status. And if that happens, they will be exempt from MIPS.
MIPS 2024 is coming up with new challenges for all eligible clinicians. Although there is time to start PY 2024, the preparatory phase has begun. Along with reporting in FY 2023, clinicians have to prepare for the coming year as well. The first and foremost step in preparing for PY 2024 reporting is selecting the participation type. For all the solo practitioners and groups ready to assign their TINs to virtual groups, it’s high time. The virtual group election period has commenced. Secure your spot in MIPS 2024. We hope this blog will help you choose why you should be in a virtual group for the coming year.