MIPS 2019 reporting, Healthcare Solutions, MIPS QPP, MIPS 2020 reporting, MIPS quality measures, Medicare and Medicaid Services, MIPS qualified registry, MIPS consulting services

3 Points to Consider Before MIPS 2019 Reporting

Physicians! It’s time to prepare for the MIPS 2019 reporting period. There’s only a little time left.

This time may be hectic and stressful, even for MIPS qualified registries. But don’t worry, P3 Healthcare Solutions has come up with effective tips to target high MIPS scores.

Let’s be honest, MIPS QPP can be a daunting approach to earn incentives for those who are not careful.

On the other hand, it can be rewarding and tends to appreciate clinicians’ efforts for showing remarkable performance.

Now, the bad performance can’t be blamed over a misunderstanding. It’s been three years since MIPS if you still can’t perform well, you should expect financial setback.

Financial Risk Is Increasing!

  • This year, the performance threshold is thirty points.
  • Financial risk is up to 7%.

You can imagine that the reporting complexities will be higher than the years before. Some people will win this game while others will lose. The only way forward is to strategize beforehand and report according to the specified guidelines.

So, just let’s dig into three important points to consider before MIPS 2019 reporting.

Understand the Criteria for the Minimum Performance

Did you know that only by correctly reporting for Improvement Activities (IA) and Promoting Interoperability (PI) categories can give points up to 40? It is at least 10 points more than the minimum threshold that can save from the penalty.

Speaking about the reporting strategy, keep in mind that this year, PI category data submission has especially been strict. Now, it’s not enough to just say that yes! I did it. You have to provide substantial evidence for the performance.

Pay Attention to MIPS Quality Measure

You might be thinking that if reporting for just IA and PI is enough to save your face, why not just stop there.

But we suggest, NO! You should not only be considering penalties but the goal should be incentives and bonuses.

Striving for better opportunities give margin to stay ahead of game from those physicians, who might only have taken measures to prevent themselves from penalties.

So, working not only to save yourself but to earn incentives and bonuses should be included in strategies, and reporting for MIPS quality measure is an efficient way to do that.

Don’t Wait Until the Very End for Data Submission

CMS – The Centers for Medicare and Medicaid require data for 90 days of PI and IA performance categories. The same is not the case with Quality and Cost measures.

CMS also has a specified timeline in which eligible clinicians can report data to them. However, if you consult a MIPS qualified registry, you are able to save data and make relevant changes from time to time.

March 31, 2020, until 8 p.m. EDT is the last date for QPP MIPS 2019 data submission. During this period, eligible clinicians can also update their data if required. So, until the submission window stays open, you have time to make changes to comply with the CMS requirements to score high in the end.

This strategy reduces the chances of errors and data redundancy. MIPS is a bit complex, but the key to success is comprehending the reporting criteria, which is an easy process when collaborated with MIPS consulting services as P3 Healthcare Solutions.

Small medical practices or hospitals need their time to plan, but a smart strategy can go a long way to maximize returns, optimize time, and efforts.

So, start planning today.

Learn about MIPS quality measures specifications 2019 in a nutshell.

How Can MIPS Consulting Services Help Increase Your CPS?

MIPS has been an amazing initiative in the healthcare industry. This quality payment program instantly got attention from clinicians in terms of providing value-based services to patients. Therefore, the physicians’ participation rate has been outstanding since the very first year. This trend has also put pressure on the MIPS consulting services to use improved methods to better report clinical data.

Another reason for high participation is the fortification from the penalty that is imposed on non-participation or poor performance. This has to do a lot in changing physicians’ thinking to strive for being the top-scorer, especially, when there is so much to gain as incentives and bonuses.

Reporting MIPS quality measures with data completeness constraint requires accuracy and dedication from MIPS consulting services. The thing to consider is that healthcare organizations already have data and then consult MIPS qualified registries to report data.

Then, how can MIPS consulting services improve performance based on the present data? This question demands thorough analysis and this article gives insight into four MIPS score-increasing tactics.

  • Document Data for a Large Set of Quality Measures & Look for High Performers

This is the simplest way to ensure that the data you have is best for reporting MIPS quality measures. When healthcare organizations consult MIPS consulting services, most of them already know about the best-suited quality measures. However, there are some that at the start of the MIPS reporting period, run hundreds of tests to determine the most scoring MIPS quality measures.

The advantage of running this strategy besides the obvious one is to check if you can get extra points from the available data while submitting it to CMS. Moreover, the search for high-priority measures becomes easy for MIPS consulting services via this method.

Some professionally qualified registries or even healthcare organizations tend to chase a larger set of performance measures throughout the year. This way, they get the flexibility to report for the best performing measures at the end of the year.

  • Switch to Electronic Methods for Reporting

The end-to-end electronic reporting method is the best way to earn bonus points, and thus requires data submission through Certified Electronic Health Record Technology (CEHRT) to CMS. It automates the data submission process with efficient data extraction and measures calculation.

This method helps MIPS consulting agencies to earn additional points per measure or even increase 10% of the total MIPS score.

  • MIPS Consulting Services Should Report Free Text DataMIPS Consulting and quality measures

Qualified services should invest additional efforts in collecting free-text data. It surely involves the extra time and a bit of investment but can result in improving the MIPS scorecard.

Going through patients’ reviews and medical codes can help taking out important points. A dedicated team is required to abstract data for this purpose. Otherwise, outsourcing companies can also do this favor for MIPS consulting services.

  • Review the MIPS Score for Individual & Group Performance

Getting incentives and eligibility for the bonus pool gear up physicians’ performance and it is only possible when MIPS data is optimized. Before data submission, reporting services should check performance rates both as individuals and even as a group.

It is possible that clinicians get more points while submitting data as a group for treating a similar set of patients. It also helps to add low-performing physicians in the group that may be excluded from the MIPS race as individual healthcare providers.

Thus, physicians can earn a high score when MIPS consulting services uses a few simple tricks. Indeed, these tricks require efforts and but continuous monitoring of score throughout the year, provide opportunities to increase revenue cycle.

As a MIPS consulting service, would you try these tactics or have any other ideas for high MIPS score, share with us at https://www.linkedin.com/company/p3-healthcare-solutions

Healthcare IT, MIPS Quality Measures, MIPS 2018, MIPS 2019, MIPS Quality Measures, MIPS consulting service

Bill Gates Selects Six Healthcare Technologies For 2019

The article lists technologies to look out for in 2019, according to Bill Gates. After analysis of the MIT Technology Review’s yearly content around emerging technologies, he was able to select 7 of them with the most impact. These special applications have a future in healthcare because they come from none other than the maestro himself.

Bill Gates besides the selected bunch of applications wrote:

“We’re still far from a world where everyone everywhere lives to old age in perfect health, and it’s going to take a lot of innovation to get us there.”

“For now, though, the innovations driving change are a mix of things that extend the life and things that make it better.”

Healthcare IT makes the use of technology for better outcomes. Such applications will facilitate the reimbursement process and providers in general. P3, as an MIPS consulting service, assimilates with technology to report on behalf of the providers and value-based care will only benefit from these technological marvels. Please follow us on LinkedIn for a vitalized experience and find the latest information on the Merit-based Incentive Payment System (MIPS).

https://www.linkedin.com/company/p3-healthcare-solutions

The revolution is in their essence, and, nobody will be able to deny their absolute magnificence once the rollout of the benefit in public.

  1. The $10 Blood Test

Healthcare IT, MIPS Quality Measures, MIPS 2018, MIPS 2019, MIPS Quality Measures, MIPS consulting service

We attribute this invention to the bioengineer, Stephen Quake of Stanford University.

What does it do?

Physicians will be able to identify women who are set to deliver before time.

Extraordinary, as it sounds, it will ease the pain of the parents, especially the mothers. Children born prematurely have a less chance of survival, but, due to this test, the survival rate is going to increase, big time!

When we talk in terms of MIPS Quality measures, such creations can improve, the mortality rates and reveal better population health outcomes. Patient satisfaction levels will go up while keeping healthcare quality-driven.

  1. Screen Environment Enteric Dysfunction (EED) Disease

The probe developed by Guillermo Tearney, MD, Ph.D., and a professor at Harvard Medical School, physicist and pathologist at Massachusetts General Hospital in Boston is going to show you evidence of this degenerate disease.

What does EED do?

It slows down or stops the absorption of nutrients.

Furthermore, the probe will replace the expensive endoscopy used in gastrointestinal cases.

Amazing, isn’t it?

The third world or poor countries have a reminiscent amount of EED patients. Therefore, this goes out to you – time to heal is soon, very soon.

  1. German Cancer Vaccine

The next invention comes from Germany, and, it is against cancer that has spun the world over its head. In 2019, BioNTech and biotech giant Genentech are having clinical trials for the first cancer prevention vaccine. It is going to destroy cells with cancerous elements attached to them.

A tremendous achievement, as it is, we are one up against the illness, and, now cancerous growth will find a legitimate challenger to stop things from going south.

  1. Reduce Greenhouse Gases

Healthcare IT, MIPS Quality Measures, MIPS 2018, MIPS 2019, MIPS Quality Measures, MIPS consulting service

The next invention is going to reduce greenhouse gases and slow down the process of climate change. Intense weather conditions, too much heat or too much cold are weather conditions attributed to climate change.

David Keith, Ph.D., a climate scientist at Harvard University in Cambridge, Massachusetts implements ways to store carbon dioxide from the environment and convert it to synthetic fuels. Public health has only one way to go, and that is up!

  1. Toilets with Cleaner Outputs

Time has come for toilet wastes to stay away from disposal into water resources. Energy-efficient toilets are in focus as an effort to stop contamination of the environment. One of these models comes from Tampa, University of South Florida and the other from sanitation enterprise Biomass Controls.

The two toilets are self-sufficient and don’t need water to move fecal waste to the disposal site.

Water contamination causes the disease to spread from one population to another.

Nevertheless, with the help of these innovative waste stations, we will be able to process waste without using water and put an end to water-borne illnesses.

  1. Alexa  The Amazon’s Marvel

Despite intense marketing campaigns for the device, Alexa proves to be a helpful companion for real. The voice-enabled assistant has features that benefit hospitals and practices to understand speech in both emergency and normal situations.

The artificially intelligent gadget can be the difference between sickness and wellness, expanding its role in patient care.

We would love to see you come up with healthcare inventions we’ve missed in the comments below.

MIPS data submission, MIPS quality measures, MIPS submission method, MIPS qualified registry, quality measures

Right MIPS Submission Methods Lead To Successful MIPS Reporting!

MIPS – a quality payment program for physicians is one of a kind and progressive step that benefits both, physicians and even the patients. The prior tangled and twisted reimbursement method failed to contribute to the healthcare industry via any advancement. Thus, MIPS came as light at the end of the tunnel for physicians to direct their financial matters in the right direction.

Reporting accurate data, according to the medical practice and with the appropriate submission method is inevitable to score high in the MIPS scorecard. The period for submitting MIPS qualified measures is already short so there is no time to waste.

This article discusses all the queries regarding MIPS submission methods so that physicians successfully report clinical data to CMS.

First, Do Your Research Well!

The first step in MIPS reporting is to recognize what submission method will suit your practice, the best. The right decision will have a huge impact on your submission. Otherwise, you’ll end up scratching your head for unnecessary delays caused by poor research, as many factors are important for a professional MIPS submission.
In addition, MIPS data submission seems easy. However, it is not as simple as one may estimate. Let us briefly explain the MIPS reporting process.

How to Report MIPS?

Physicians work day and night treating patients to deliver quality-based medical services. MIPS eligible clinicians report their performance data on a yearly basis to CMS. There are four performance categories for MIPS:
• Quality holds 50% of the total MIPS score
• Promoting Interoperability (PI) holds 25% of the total MIPS score
• Improvement Activities (IA) holds 15% of the MIPS score
• Cost holds 10% of the total MIPS score

As per the CMS submission requirements, physicians report against three categories. However, the CMS authorities themselves measure the cost category. They calculate performance for this category by administrative claims data.

Now, Choose Between MIPS Submission Methods!

Clinicians can choose from a number of submission methods as per their requirement,
• CMS Web Interface
• Administrative Claims
• Electronic Healthcare Records (EHRs)
• Qualified Clinical Data Registries (QCDR)
• Qualified Registry
• CAHPS for MIPS Reporting Survey Vendor
• Attestation

Another factor that plays an important role in the successful MIPS data submission is finding the right and specialty-specific MIPS quality measures to report.

Physicians can consult MIPS qualified registries, which help them choose the measures relevant to their practice. Reporting data against the relevant measures gives the chance to score high.

How to Report MIPS Data?

Physicians have the freedom to report either as an individual or in a group.

As an individual identified by individual National Provider Identifier (NPI) with a single Taxpayer Identification Number (TIN)

In a group of two or clinicians with a single TIN, identified by NPI

There is also another option to report via a virtual group.

Consider the Following Points When Choose a Submission Method!

  • While considering what submission methods will result in your favor cost-effectively, you also need to ponder upon their limitations.
  • Clinicians are only allowed to report data via a single submission method for a single performance category.

Look out for all possible scenarios that can occur with the submission method. As each MIPS submission method has its benefits and limits as per the medical practice. Therefore, carefully check all the logistics and your organizational structure before submitting data. It may leverage your performance score for positive or negative payment adjustment.

Not only deciding the right submission method is time-consuming, but it also requires thoughtful planning, resourceful implementation, and the ability to incorporate progressive steps of your organization.

All this Process is Hectic but you can Stay Stress-Free with P3Care!

Physicians may be worried about how they’ll manage to choose the right MIPS submission method along with their responsibilities. Don’t worry and let us share your MIPS reporting burden. P3Care has been MIPS qualified registry for two years. Our specialized methods, resources, and experience in this field speak for itself. Moreover, we as an H I.T consultants help to choose you the right quality measures and the submission method.

For further information, visit https://www.linkedin.com/company/p3-healthcare-solutions

Laying Down The Numeral Facts Of MACRA-MIPS

MIPS a value-based reimbursement model activates under MACRA by the Centers for Medicare & Medicaid Services (CMS) to promote quality and cut down the cost of healthcare. It is an opportunity for medical professionals to choose quality over quantity, effectively deliver, and in return, earn some incentives. The positive payment adjustments await only those with scores higher than 15 out of a total of 100 points.

To stay updated on the QPP, follow us on our LinkedIn page – https://www.linkedin.com/company/p3-healthcare-solutions/

For scores above 70, bonuses are likely to happen from the $500 million pool of money reserved only for the top performers. If you look closely, the program benefits all, the doctors, the insurance companies and most of all, the patients who are at the receiving end.

The Composite Performance Score (CPS) determines the overall performance of each practitioner when they report measures for four performance categories under the Quality Payment Program 2018.

Minimum Requirements of MIPS 2017

We saw the practical implementation of MIPS in 2017! The year 2017 was also the transition period to settle things down slowly and gradually. In 2018, the eligible practitioners are quite aware and implement the procedures to qualify for incentives, bonuses or simply to avoid penalties at the start of 2020.

There is a change in the set of rules for 2018. Each of the categories influencing the MIPS final score undergoes an increase in the number of measures. QPP 2018 is a chance for you to show brilliance in terms of quality of care and earn incentives along with a solid reputation in the healthcare industry.

Quality covers 60%, Improvement Activities (IAs) 25%, and ACI or meaningful use carries 15% of the total score. A MIPS Final Score of 3 or above would save them from negative adjustments in 2019.  It included reporting on 1 Quality measure, 1 Improvement Activity or all the Advancing Care Information (ACI) measures.

It was only recently that CMS published the scores of 2017 on their QPP portal.

Basic Requirements in 2018

In MIPS 2018, the Quality covers 50%, Improvement Activities (IAs) 15%, Promoting Interoperability (ACI or meaningful use) 25%, and Cost, the new category, makes up to 10% of the final score.

In 2018, the rules are changed and the stakes are higher now. The EPs need 15 points to make it to the safe zone and avoid a higher penalty (up to 5% of the Medicare Part B payments) in 2020. To achieve this score, you must successfully attempt 2-3 Quality measures, 4 Improved Activities or perform all the ACI base measures.

MIPS Qualified Registry like P3Care only takes a few of your minutes to shortlist those measures.

Mathematical Side of MIPS

Quality holds significance as a performance parameter for MIPS 2018. It adds to the total score by assessing how well the practitioners perform measures in terms of their practice or their field of expertise. The practitioners review the list of measures and select only those best suited to their practice.

For specialists, there are specialty-specific measure sets. In 2017, there were 30 specialty measure sets. Some sets have fewer measures and some have more, but you have to complete only those related to your specialty. For sets containing more than 6 measures, you must cater to those 6 and complete an outcome measure or a high-priority measure, additionally.

Topped Out Objectives

There are 6 topped out Quality measures identified by CMS in 2018. The measures identified as ‘topped out’ means that the eligible physicians are no longer able to score more than 7 in them. Performance for these measures is usually high and completing them does not mean improvement in the quality of service.

Multiple Measure Options for Eligible Clinicians in 2018

Quality – CMS website displays 271 measures from which you can select six of your choice with one outcome measure or a high-priority measure.

Improvement Activities (IA) – Report up to 4 measures to achieve a score of 40 points in this category.

Promoting Interoperability (PI) – The category was Advancing Care Information (ACI) or meaningful use the year before. ECs must report all 4 base measures to achieve a maximum score. Select from among the seven measures.

Cost – Medicare Spending per Beneficiary (MSPB) is at stake here and it has zero measures for you to report. CMS will deduce the score itself by analyzing the claims data of the practitioner.

Hard Work Pays Off

Successful execution of all these performance categories can earn you 15 points and save you from the penalty in 2020. However, when you complete more than 6 or 7 measures along with a few outcome measures or high-priority measures, you make yourself eligible to bonuses from the $500 million pool. The bonus payments keep on increasing with each passing MIPS evaluation period.

The 70 points will earn you a place in the elite class of doctors and practitioners who give maximum attention to their patients. They care for them to the best of their ability, and in return reap the profits. In doing so, they take the US healthcare system one-step closer to glory.

Everybody is a Winner                      

QPP 2018 has something for everyone. The clinicians reap the rewards in terms of positive payment adjustments, the patients go home feeling well, and the government feels the pride in its policy structure.

MIPS 2019 – A Brief Overview

We have gone one step ahead. Now in the 3rd performance year of MIPS, the percentage of all performance measures has changed as follows.

MIPS penalty level has gone to -7% and the minimum score to avoid a penalty is 30 points.

The scores for each performance category are:

  • Quality 45%
  • Promoting Interoperability 25%
  • Improvement Activities 15%
  • Cost 15%

Every eligible clinician who reports for Medicare Part 2 or Critical Access Hospital (CAH) Method II payments can participate in MIPS 2019.  Moreover, every clinician can report as a group or as an individual but it applies across all categories.

It means, if a clinician chooses to report individually, he can report solely with this submission method for all categories.

Eligible clinicians have lots of chances to earn incentives and bonuses in this year by performing well for interoperability and maintaining quality.

The resulting situation brings down healthcare expenses and improves efficiency. Everybody gets to be a winner.

We are an approved MIPS registry to report data on your behalf. Dial 1-844-557-3227 (1-844-55-P3CARE) or email at info@p3care.com to talk to a trained HIT consultant.

MIPS 2018 Updates For Clinicians And Healthcare Providers

The MIPS 2018 will help the healthcare providers realign themselves to ensure compliance, enabling them to keep taking advantage of the incentive payments.

CMS gave an update on 2nd November 2017, sharing MIPS 2018 updates applicable to the QPP (Quality Payment Program).

A Background to the MIPS 2018 Updates

We all know that there is a shift in the US healthcare industry towards quality healthcare. These new updates reflect the refinement of the policies for QPP while taking into consideration the US healthcare industry’s transformation concerning infrastructure, technology, clinical practices, and physician support practices.

MIPS 2018 Updates & QPP Strategic Payment Program Objectives

CMS aims to accomplish 7 strategic QPP objectives with the introduction of MIPS 2018 Updates.

  1. To assist in the overall improvement of beneficiary outcomes. It also means engaging patients by deploying relevant MIPS and Advanced APM policies.
  2. The improvement in the clinician experience through the introduction of a transparent and flexible program. This approach will help provide clinicians with easy to use program tools.
  3. Increase adoption and availability of the robust Advanced APMs.
  4. Maximize participation and understanding of the program by deploying customized communication that focuses on support, education, and outreach. The underlying theme is to ensure the program fulfills the needs of diverse types of practices, patients, physicians, and small healthcare providers.
  5. To promote the increased sharing of data and information relating to the program’s performance. Thus, the underlying concept is ensuring timely yet accurate availability of actionable feedback to clinicians and other relevant stakeholders.
  6. Help deliver IT systems with improved capabilities relating to reporting, data submission, and an overall improvement in its front and backend, delivering greater efficiency and value.
  7. Lastly, one of the core strategic QQP objectives is to improve program implementation and foster ongoing development that keeps the requirements of the US healthcare industry into context. Furthermore, it also helps small and rural healthcare providers successfully take part in the program.

What are the MIPS 2018 Updates?

MIPS 2018 Updates and quality measures

Let’s look at the highlights of MIPS 2018 updates.

  • Performance Period
  • The performance period is changed from 90 days to the 12-month calendar year.
  • The cost will be applicable based on the 12-month calendar year.
  • A minimum of 90 days period will be under review for Advancing Care Information.
  • A minimum of 90 days period will be under consideration for evaluating Improvement Activities.

Performance Threshold or Payment Adjustment

  • Minimum Performance Threshold will consider 15 instead of 3 points.

Road to accomplishing 15 points for performance threshold

Here is how you can attempt to accomplish the 15 points. You can fulfill any one of these criteria to reach the goal of 15 points.

  • To submit 6 Quality Measures that meet data completeness criteria.
  • To meet the base score for Advancing Care Information. To accomplish it, you will have to submit 5 base measures and also submit a medium-weighted Improvement Activity.
  • To meet the base score for Advancing Care Information. Also, submit 1 Quality Measure which meets data completeness requirements.
  • Lastly, you can also reach the 15-points performance threshold goal by reporting all Improvement Activities.
  • For achieving exceptional performance, the providers must reach the threshold of 70 points.
  • The law requires the payment adjustment for the 2020 payment year to range between -5% to +5X% (where +5% means = 5% X scaling factor). The scaling factor is achieved to ensure the accomplishment of budget neutrality.
  • Under the revised MIPS 2018 updates, the adjustment factor applies to items and services under Medicare Part B (It includes Part B drugs too).

Quality

  • The 2018 Quality Measures Specifications will become applicable.
  • Weight to the final score is 50% instead of 60%.
  • For Data Completeness, CMS wants providers and clinicians to meet a minimum threshold of 60% instead of 50%. Therefore, measures not meeting this data completeness criterion will only get 1 instead of 3 points. However, small healthcare practices will still get 3 points.
  • The scoring has a 3-point floor for measures against the benchmark. There are 3 points for measures that either do not have a benchmark or they do not meet the case minimum requirement. Measures which fail to meet data completeness requirements will only get 1 point and not 3 points, except small practices getting 3 points. There is no change introduced for the bonuses. One of the MIPS 2018 updates is that CMS proposes the introduction of a cap of 6 points for a particular set of 6 topped out measures.
  • The improvement scoring will be given by measuring the rate of improvement. The increase in improvement will mean more points, particularly for the providers that have a lower performance during the transition year. The improvement will be measured in the Quality Performance Category Level, with ten percentage points available for Quality Performance Category.
  • One of the MIPS 2018 updates is about the topped out measures scored with a maximum of 7-points and not the standard 10-points.

6 topped out measures for 2018

  • #21. To either select the Prophylactic Antibiotic-First or Second Generation Cephalosporin.
  • #23. Venous Thromboembolism Prophylaxis, when they are indicated in all the patients.
  • #52. COPD (Chronic Obstructive Pulmonary Disease), Inhaled Bronchodilator Therapy.
  • #224. The overutilization of the Imaging Studies in Melanoma.
  • #262. Confirmation via image, of successful excision of Image Localized Breast Lesion.
  • #359. To optimize patient exposure by utilizing Standardized Nomenclature for CT (Computerized Tomography), imaging description.

Improvement Activities

  • The providers must be aware of the specifications of the 2018 Improvement Activities.
  • The weight to the final score will be 15%.
  • There isn’t any change in the number of activities that MIPS eligible clinicians need to report for reaching 40 points. CMS wants to propose more activities to select from and also wants changes to existing activities for Inventory. The clinicians practicing in rural areas and small practices would only be needed to report no more than 1 high-weighted or 2 medium-weighted activities for reaching the highest score.
  • For the TIN to get credit for group participation, only one MIPS eligible clinician would have to perform the Improvement Activity.

Advancing Care Information

  • The providers and clinicians must be aware of the specifications for the 2018 Advancing Care Information Measures.
  • The weight to the final score is 25%.
  • To allow the MIPS eligible clinicians to use either the 2014 or 2015 Edition of CEHRT in 2018. And also to grant them a bonus if they only use the 2015 Edition of CEHRT.
  • To add exclusions for the Health Exchange Measures and E-Prescribing.
  • To add more Improvement Activities which would show the use of CEHRT to the list eligible for a bonus of Advancing Scare Information.
  • One can earn 10% in performance scores if they report about any of the criteria to clinical data registry or single public health agency.
  • An additional 5% is allocated for submitting to one additional clinical data registry or public health agency (not reported underperformance score).
  • To add decertification exception for those eligible clinicians who’s EHR has been decertified, retro effectively for 2017 performance periods.
  • The deadline for exception application submission for the year 2017 and for future years, is set on December 31st for measuring the whole year’s performance.
  • Small practices which have 15 or fewer clinicians, the addition of a new category for hardship exceptions to re-weight the category of Advancing Care Information to 0. To reallocate the 25% of the category weight of Advancing Care Information to the category of Quality Performance.
  • CMS will reweight the category of Advancing Care Information to 0 and reallocate its 25% performance category weight to the category of Quality Performance for these reasons.
  • Automatic Re-weighting
  • Certified registered nurse anesthetists, clinical nurse specialists, physician assistants, and nurse practitioners.
  • The non-patient facing clinicians including pathologists and radiologists.
  • The hospital-based MIPS eligible clinicians.
  • The ASC (Ambulatory Surgical Center) – based MIPS eligible clinicians and the certified registered nurse anesthetists.
  • To reweight through an approved application.
  • There are significant hardship exceptions, and CMS will not be applying a five years limit for these exceptions.
  • A new hardship exception to the clinicians practicing in small practices has 15 or fewer clinicians.
  • There is a new decertification exception added for the eligible clinicians whose EHR has been decertified and becomes effective retroactively for the performance period of 2017.

Cost

  • There will be a weight of 10% added to the final score.
  • CMS will include the total per capita cost measures and MSPB (Medicare Spending per Beneficiary) for calculating the Cost performance category score for the MIPS performance period of 2018. These two measures will be carried over from the Value Modifier Program. These two programs are also currently used for providing feedback for the MIPS transition year.
  • CMS will be calculating the cost measure performance. The clinicians do not need to take any action.
  • The new changes offer Virtual Groups with participation options for Year 2, providing clinicians with another way to participate in MIPS. The Virtual Groups can contain Solo Practitioners and Groups containing 10 or fewer eligible clinicians. They are eligible to participate in MIPS, coming together virtually with at least one such other Solo Practitioner or Group for participating in MIPS. In general, clinicians’ being part of a Virtual Group would have to report as a Virtual Group for four different performance categories. They will also need to meet the same performance category requirements and measures as that of the non-virtual MIPS groups.
  • Virtual Groups need to conduct their elections at the beginning of the performance period. It cannot be changed once the performance period starts.
  • Groups and Solo Practitioners wanting to participate in a Virtual Group have to go through the election process.
  • The period given for election is from October 11thto December 31st, 2017, for them to be considered for the 2018 MIPS performance period.
  • To increase the low volume threshold by excluding individual clinicians or groups eligible for MIPS having < $90,000 in Part B allowed charges. It is also applicable to those individual clinicians or groups with < 200 Part B beneficiaries falling within the low volume threshold determination period occurring during a performance period or a prior period.
  • CMS is not changing the way it defines non-patient facing clinicians. Individuals <100 patient-facing encounters, and for groups, it stands at > 75% NPI’s billing under the group’s TIN falling within a performance period and labeled as non-patient facing.
  • Under the Complex Patients Bonus, there is an adjustment applied to up to 5 bonus points by adding average HCC (Hierarchical Conditions Category) risk score to the final score. The score addition would be anywhere from 1 to 5 points given to the clinicians depending on the patient’s medical complexities.
  • The Small Practice Bonus will adjust the final score of an eligible clinician or group working in a small practice as defined in the regulation, applicable to 15 or fewer clinicians. It would add 5 points to the final score provided eligible clinician or group submits the data for at least one performance category within the applicable performance period.
  • There are payment adjustments by CMS for Extreme and Uncontrollable Circumstances, approximately given to 572,000 eligible clinicians. They would have to participate in MIPS for the 2018 MIPS performance period. Under the newly proposed rule, the payment adjustment for the 2020 payment year may range from =5% to +5X%. (X is the adjustment factor that allows MIPS program for staying budget neutral.)
  • If the CEHRT for an MIPS clinician is unavailable due to uncontrollable circumstances like a natural disaster, public health emergency, or hurricane, etc. the clinician can submit a hardship exception application for getting reconsidered for reweighing of Advancing Care Information performance category. The application is due with a cut-off date of December 31st, 2017.
  • There is a final rule with comment period extending this reweighting policy for the performance categories of Improvement Activities, Cost, and Quality which starts with the 2018 MIPS performance period. The deadline for this hardship exception application is December 31st, 2018.

As far as 2018’s submissions are concerned, the deadline was April 2, 2019. Moving on, if you were eligible back then, you are eligible in 2019 as well.

MIPS consulting services job is to satisfy your end of the deal with the authorities for compliance and data completeness. That is what we do for our clients!

Moreover, those of you who weren’t eligible then may be eligible now. Give us a call or simply fill-up the form on the homepage to notify us. P3 Healthcare Solutions connects clinicians to high scores which means rewards and a better reputation.

QPP 2019 is prevailing and it is important to submit measures against Quality, Meaningful Use (MU) or Promoting Interoperability (PI), Improvement Activities, and Cost performance categories. With the promise of less reporting burden by CMS, we can expect the program to become clinician-friendly as time goes by. Please follow us on LinkedIn here – https://www.linkedin.com/company/p3-healthcare-solutions

What is next?

What changes to expect in MACRA-MIPS 2019?

For questions out of this knowledge base, or on instructions on how to get started call a MIPS specialist today at 1-844-557-3227 (1-844-55-P3CARE) or email at info@www.p3care.com.