MIPS 2024 Reporting Calls for Equitable Scoring for Inpatient Clinicians
The MIPS 2024 policy guide contains a detailed list of new reporting policies and measures. Overall, the rule addresses every medical practice and specialty in depth. With considerable insights, the new rule was finally released, with lots of surprises for healthcare providers. Here, let’s confine our focus of discussion to hospitalists, and more precisely, inpatient clinicians.
In this blog, we will analyze the new MIPS reporting challenges for inpatient clinicians. Also, as a MIPS qualified registry, we will address how we can overcome these challenges with equitable scoring.
Now, without further delay, let’s get started with a little introduction to inpatient clinicians. Also, what difference has the MIPS 2024 policy brought to them?
How are Inpatient Clinicians?
Basically, inpatient clinicians are just like simple medical providers. Anyhow, they differ on the basis of their area of service and the patients they deal with. Inpatient clinicians or hospitalists usually work as a multidisciplinary team. During their service, they encounter hospitalized patients in need of complex care. Thereby, they are involved in coordinated care during the hospitalization period of patients.
The New Challenges for Clinicians Underlined in the MIPS 2024 Policy
Since we have the final policy for MIPS 2024, we have to revise our reporting strategies. Once you understand the policy completely, you must look for its impact on your practice. Here we will pinpoint the issues for inpatient clinicians in MIPS reporting specifically.
MIPS 2024: Scoring Issues for Inpatient Clinicians
Under the MIPS program, clinicians report measures and activities covering four broad performance categories. However, the Quality category among all causes the major impact on the inpatient clinicians score. It constitutes 55% of their MIPS final score; thereby, it is the most important category. Inpatient clinicians must aim for scoring the maximum points to stay safe in MIPS 2024 PY reporting.
Things seem very clear to this extent. Anyhow, it is not so in actuality. We must consider all the things and then estimate the impacts. Well, according to the PY 2024 policy, CMS has raised the bar for data completeness in quality. In other words, the participants have to report 75% of their eligible encounters instead of 70%. Don’t you think it will be burdensome? It will have an ultimate impact on inpatient clinicians as well.
Scoring Limitations in the Quality Category
The situation becomes more severe when it comes to scoring limitations within the Quality category. Let’s see how!
Consider the Hospitalist Speciality Measure Set here.
- Catering especially to inpatient clinicians, this set contains four measures. However, three of these measures are the capped measures in MIPS 2023. It means inpatient clinicians can get a maximum of 7 points for each of these measures. Even with the finest performance for these measures, nothing is going to change. Scoring 7 points for each is the last limit set by CMS.
- Now, if we estimate the achievable score in the Quality category, it will not be more than 42.6 points. So, it raises another question for inpatient clinicians.
- Last but not least, 2 out of 4 measures in the Hospitalist Speciality Measure Set are difficult. They often fall below the 20-patient volume for individual clinicians. So, it will be hard to compete with the 75% MIPS data completeness criteria for Quality.
Inpatient Clinicians are in Dire Need of Change
MIPS 2024 reporting doesn’t give equal reporting terms for inpatient and outpatient clinicians. In contrast to hospitalists, outpatient clinicians have access to a wider array of MIPS measures. With all these limitations in the new MIPS policy, there is no fair competition for inpatient clinicians. Therefore, it is necessary for them to raise their voice and communicate their concerns to CMS. The hospitalists can advocate for more equitable MIPS scoring for them.
Our Suggestions for Inpatient Clinicians
For now, the commenting period for MIPS 2024 rule-making has ended. So, inpatient clinicians can’t forward their concerns to CMS this way. During this phase, when CMS presented the proposed rule, there was a golden chance for hospitalists. They could present their concerns to CMS without any barriers. And it was more likely that CMS could take action on it within time. But now let the bygones be bygones.
Now, try to compete with a compelling reporting strategy, as we have no choice to lose a single point. Report all the measures and give the best of your performance in MIPS 2024 reporting. Our MIPS consulting services can be a great help for you to develop a strategic reporting plan. Catch us in no time.
Endnote
For MIPS 2024 scoring to witness positive transformation, active participation from inpatient practices is imperative. While outpatient clinicians enjoy a diverse range of available measures, their inpatient counterparts grapple with limitations that unduly affect their scores and revenue. The persistence of this discriminatory scoring policy may drive inpatient clinicians to explore legal avenues, seeking justice and a fair financial playing field.
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