Merit-based Incentive Payment System (MIPS) has entered 2020, and, so have the Quality, Promoting Interoperability (PI), Improvement Activities (IAs), and Cost categories. It is a no-brainer to write a thoughtful comparison between the two years regarding MIPS quality measures.
Hence, we are here to discuss the Quality category in detail; the six measures adding up to the final score; any new requirements; and why P3 Healthcare Solutions is a smart choice to report registry-specific measures.
It’s not about the passing years that we have managed to make it to the next year of value-based care, but the essence of MIPS in Medicare lies in its delivery. Each year calls upon MIPS eligible clinicians to adopt a certain set of measures and activities and report them to the Centers for Medicare & Medicaid Services (CMS). 2020 is no different as long as you are on the right track of submission.
The reporting occurs through legitimate submission methods only, the result of which conforms to performance evaluation and incentive payments.
MIPS Quality Measures 2019 and 2020 – The Types
I have to admit there are more similarities than differences between the two, because, for starters, they have the same collection (measure) types.
In MIPS 2019 and MIPS 2020, participants get to submit 6 quality measures data for 12 months (from January 1 to December 31, 2019, and January 1 to December 31, 2020, respectively). The amount of data to undergo submission depends on the collection (measure) type.
CMS finalized 6 collection types for both 2019 and 2020 CMS MIPS Quality measures. These measure types include:
- Electronic Clinical Quality Measures (eCQMs)
- MIPS Clinical Quality Measures (CQMs)
- Qualified Clinical Data Registry (QCDR) measures
- CMS web interface
- Medicare Part B claims measures, and
- The CAHPS for MIPS survey
As a rule, participants must submit a total of six quality measures from the above types.
General Reporting Requirements Vary
If you talk about 2019, the data completeness factor was 60%, i.e. clinicians were to report performance data for 60% of their patients eligible for a chosen measure. For MIPS 2020, clinicians are required to report data for 70% of their patients eligible for a certain measure. It is 10% more than the last year which means CMS plans to cover a wider population of patients and bring them into the fold of value-based care.
Quality measures refer to the improved standards of care delivery and patient satisfaction, and the data completeness constraint is an extension of expending one’s expertise to most patients. The increasing performance thresholds also reflect CMS’ vision of encouraging everyone to opt for quality healthcare.
MIPS Submission Types
In the case of MIPS submission types, there are 4 ways to submit quality measures. These include:
- Medicare Part B claims
- Sign in and upload (a MIPS consulting service can report on your behalf)
- CMS web interface
- API submission which is the direct method of submission
A total of six quality measures was the requirement back in 2019, and in 2020, it hasn’t changed much. We have a total of six MIPS quality measures in 2020 as well. It includes one outcome measure, but in case, the outcome measure is absent, go for a high-priority measure instead.
Practices, groups, and virtual groups with 16 or more clinicians will be automatically calculated on a 7th measure, the All-Cause Hospital Readmission Measure.
The Curious Case of Bonus Points
Although CMS requires improved quality, it doesn’t mean that they don’t want clinicians to target incentives and bonuses. You can qualify for the strict criterion with the help of a Qualified Registry and improve revenue.
Bonus points sound charming enough to know more about their details. Therefore, we will try to find out how to make those bonus points ours and maximize our rewards in 2021 and 2022.
For MIPS Quality measures 2019 and 2020, you can earn bonus points on the following terms.
- Submit 2 or more outcomes or high-priority measures. It doesn’t apply to the outcome measure or high-priority measure that is already there, but two separate measures are required to get your hands on bonuses. P3, as a MIPS consulting service, reports Quality measures for its clients across the US. Opioid-related measures are part of the high-priority measures list.
- In MIPS 2020, measures that are part of the CMS web interface don’t qualify for bonuses, but if you report the CAHPS for MIPS along with the CMS web interface, you have a chance to win bonuses.
- Submission using Certified Electronic Health Record Technology (CEHRT)
- Besides, six additional points are there for small practices that submit at least one quality measure. Practices include individuals, groups, and virtual groups.
- 10 additional points for practices that exhibit improvement in their Quality reporting from the previous year.
Before I end this article, I want you to stay illuminated by the present and the future requirements of reporting as long as you have us on your side. P3 Healthcare Solutions prides itself on reporting MIPS for clinicians across the United States. To get in touch, please call 1-844-557-3227.
We have a comprehensive piece written on MIPS 2020 on our LinkedIn page. If you have some questions related to it, you may go through it when you have some time.