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MIPS, MIPS Quality measures, MIPS incentives, MIPS reporting, MIPS qualified registry, CMS, EHR System

The 2020 CMS Quality Conference Speaks of Objectives & Accomplishments

CMS has come up with practical solutions for the healthcare industry; it has constantly fought against physician burnout by reducing reporting requirements. We, as a MIPS Qualified Registry, appreciate their efforts and of their administrator, Ms. Seema Verma.

In the recent CMS Quality Conference 2020, the captain spoke herself and mentioned the achievements of the agency and what lies ahead. Starting with the accountability of her team, she said she has identified the set of objectives moving forward. In fact, she stressed on quantifying and measuring progress as they go through the 16 strategic initiatives.

The Three Objectives

mips 2019 reporting, MIPS 2020, mips quality measures, mips qualified registry

CMS has a mission and a goal to achieve. According to administrator Verma, CMS is going to be relentless in their approach. In brief, they will accomplish the objectives below:

  1. Improve the quality and bringing healthcare within the means of all Americans;
  2. Drive healthcare towards a value-based system from a volume-based system;
  3. And, don’t let the bubble of American healthcare spending go bigger.

Quality is the top objective CMS is looking to nail. Without good quality, Ms. Verma indicated, efforts to lower cost and improve healthcare availability are fruitless. What good is a health plan when the care you get is below par?

The Unique Role of the Government

Similar to the rules for the airline industry or the food sector, the government must set for the healthcare industry as well. Not only do they ensure a high standard of care, but the guidelines will protect the patients’ rights from the very beginning.

The consumers have to know and have to be sure that the hospitals are safe for them, thus the government’s role is crucial now more than ever.

On the whole, a lot depends on nursing homes in the years to come. They are places where our seniors go on to live their lives. Their safety has to be A-grade. Similarly, when we talk about laboratory tests, a lot depends on their accuracy. It is all about dignity when it comes to hospice care.

CMS has an overall responsibility to oversee quality not because they are the nation’s largest insurer, but because people look up to them. Moreover, they are responsible for setting the safety and quality standards for every facility that receives Medicare reimbursement. They believe that the government has a unique role to play to create and preserve an unbiased rulebook for a healthy competition.

In that sort of environment, patients are protected and providers compete against each other to provide the highest quality of care. Soon after MIPS 2019 reporting, we have MIPS 2020 to look up to, so that high-quality care prevails across the country.

The physician compare or hospital care portals populate for the sake of patients to make informed decisions. Choose the right clinician with reviews and performances in the Quality Payment Program (QPP).

mips 2019 reporting, MIPS 2020, mips quality measures, mips qualified registry

Trump Administration’s Take on Quality

Trump administration has a keen interest in healthcare, and over the past three years, it has come up with several Presidential executive orders to ensure quality and price transparency, Advancing American Kidney Health, and redefining Medicare.

To realize Trump’s vision, CMS is the enforcing body to implement these orders for better quality outcomes. Since the elections are near, the Trump administration’s stance on the quality of care in hospitals, facilities, and practices is going to be key. As a matter of fact, healthcare is going to be the difference in his win. Whether Bernie Sanders or Joe Biden, in my opinion, whoever takes a bold initiative on healthcare will make the underlying difference.

 

CMS’ New Quality Strategy

In this recently held conference, Ms. Seema Verma unveiled the new quality strategy that will implement the Trump administration’s vision in letter and spirit. It was a proud moment for her and the agency that dedicates most of its time to healthcare management, improve patient experience, and focuses on patient engagement for distinct results.

Last year, the framework that was initiated for the safety and quality of nursing homes was incredibly successful. As a result, CMS has announced to apply the same framework in other areas with room for improvement. The MIPS in healthcare is a step in that direction in which we can have a close to a perfect system.

mips 2019 reporting, MIPS 2020, mips quality measures, mips qualified registry

The Four Pillars of the New Quality Strategy

  • CMS will establish government standards for quality care. They will set measures such as MIPS Quality measures.
  • Improve the knowhow of the system and enforce quality protocols for accountability.
  • Share quality information with the public to promote transparency and competition. In short, it promotes a grand patient experience.
  • Modernize quality activation efforts by the use of technology and data analytics.

MIPS Value Pathways in 2021 will Navigate the Quality Measures

One of the ways the new quality strategy will see the face of implementation is in the form of Merit-based Incentive Payment System Value Pathways in 2021, according to Medscape. Instead of using the six quality measures, MIPS Value Pathways will allow physicians to choose measure sets most relevant to their specialty or patient population.

EHR system, EHR technology, EHRs, Healthcare, HIPAA, Meaningful Use of EHR

The Future of Meaningful Use (MU) of EHR Systems

The Healthcare industry is moving at a fast pace via Healthcare Information Technology (HIT). Everybody knows that electronic healthcare records (EHRs) are the most advanced practice of innovation in the healthcare industry. The meaningful use of EHRs (MU) is not limited to a certain sector of healthcare, which is capable of heavy investment. In fact, it is widely accepted by physicians of every scale and expertise.

Healthcare Chief Information Officers (CIOs) are making sure that their organizations maintain a certain standard of interoperability. Only this way, the actual progression in the industry will be observed.

HIT leaders’ investments in EHRs are not substantial only for today’s use, but they have an eye on the future of meaningful use of EHRs. EHRs are already an advanced form of technology, making patients and physicians empowered.

So what is the Future of Electronic Healthcare Records (EHRs)?

According to the officers of Healthcare IT and the leading EHRs vendors, automation, telemedicine, and advanced analytical tools will have a huge impact on EHR technology.

Impact of Automation and the Advanced Analytical Tools

The automation in the care services in diagnostic, treatment procedures, and in administrative processes has cut down costs. It helps physicians to focus their attention on the work of their expertise, rather than on managerial issues.

The same is the case with Genomics – Informed Medicines which require the genomic information of a patient for his treatment. This approach is quite useful in understanding the diseases’ causes and their impact on patient’s health. This type of medicine also facilitates preventive medicines. Thus, the dimension of reporting of medical records will change drastically.

Telemedicine is the discipline, in which patients and physicians are not present in front of each other. As this technology will strengthen its place in the near future, the way one access, and views EHR will be changed. The virtual delivery of healthcare services has transformed, and this will affect the outcomes of the interoperability measures.

In short, there are different ways to leverage healthcare services. Thus, the devices and algorithms to process or detect illnesses will require a different recording method.

For Example,

How EHR will react towards diagnostic procedures conducted in a home setting, but the test result been given back to the medical organization, especially, when they are to be given to an algorithm or machine as well.

How Increased Interaction Influences Meaningful Use of EHR?

With technology advancement, the virtual diagnosis will move towards increased interaction and user satisfaction. In addition, it will reduce unnecessary cost expenses.

The accommodation of innovation techniques will be difficult to manage as tangible results. Thus, the Meaningful Use of EHR in the future will be helpful in recognizing serious health areas, and it will be using machine learning and predictive models to support the latest technology.

Developing such, intelligent EHRs will be challenging when there is a big issue that is the complexity of the EHR system to handle a large amount of data.

Health IT leaders predict that human-centered designs will resolve this problem. Cloud-based service and aligning work operations to support mobile services will increase the efficiency of electronic healthcare records (EHRs).

With a cloud-based EHR platform, interoperability will also increase via improved security features and the HIPAA-Compliance will be possible to a greater extent.

Mobile-Based EHR Systems

Even today, many professional EHR vendors have developed systems that offer specific functionality of EHRs on smartphones. Everybody knows the accessibility and the scalability of mobile-based systems. By completely incorporating this method into reality, medical records will be at their fingertips and the physicians-patients engagement will be easy.

The main purpose of EHR technology is to support a large population of data without any redundancy. The second purpose is to streamline artificial intelligence to increase a better understanding of healthcare data and remove vulnerabilities in the healthcare system.

Get Ready for the Highest Level of Interoperability via Meaningful Use EHRs

Cloud-based APIs will have a great say in the progressive healthcare system. Smart applications and the additional medical components will form the base of a more secure healthcare system.  The only need is to accept change with open arms.

MIPS&MACRA, MIPS in healthcare, MIPS reporting, MIPS 2019, MIPS quality measures, MIPS qualified registry

MACRA MIPS – Get Ready For These Changes In 2019!

For those covered by Medicare, the paperwork requirements wait for your attention, as a physician, and you can’t take a step back from those duties.

Why has this become crucial for medical practices? Because the Medicare Access and CHIP Reauthorization Act of 2015 and MIPS incentives depend on fulfilling these requirements in the new value-based care system!

And, once you have followed these requirements in letter and spirit, 5% incentives add to your 2020 Medicare payments. Those of you, who don’t think much of this payment adjustment, think again! Because the adjustments increase your finances by huge numbers!

Not all of us are in it for monetary benefits. Nevertheless, the reputational advantage as a clinician will take your practice to the next level. People are going to recognize you as a clinician with superior healthcare knowledge and consider you as an authority in the industry.

To consider MACRA into your practice, upgrade your outdated EHR system to the 2015 certified EHR technology edition. And, consider doing so in case you are an old-fashioned paper-based practice. In addition to that, ensure the technology vendor is trustworthy and has a history of meeting government proposals. A tip to remember here is that proper training of the staff goes hand in hand with the newly installed EHR system.

Prepare yourself for the few changes regarding exemptions under extreme conditions, an increase in the cost category’s weight, an increase in low-volume thresholds, and a boost to the cost performance category in 2019.

Change 1 – Exemptions under Harsh and Uncontainable Situations

Get ready for changes in The MIPS

CMS owns the fact that extreme conditions can affect gathering, storing, and submitting patient information. Hence, in 2019, it gives more space to such clinicians under intense circumstances. According to Clinician Today, in the performance year 2017, the clinicians were not scrutinized for any lack of information if they had to face extreme conditions such as California wildfires.

The automatic exemptions expect to continue going forward in 2019. God forbid, if there are any acts of God or natural disasters, as a MIPS reporting physician, CMS will not put you on a penalty list. First, we pray that neither a flood nor a wildfire breaks around your practice. Second, choose P3 Healthcare Solutions MIPS consulting service for Quality measures and reporting other categories properly 1-844-557-3227.

info@p3care.com is the address you’ll be emailing your queries to.

Change 2 – Expect an Increase in the Weight of the Cost Category

As the Medicare reimbursement model transforms into the value-based care model, MIPS in healthcare will have the cost category hold more weight than in 2018. It was at 10% of the total weight in the previous year and it is going to stay that way or go higher in 2019.

Clinician Today mentions that the cost category is going to accommodate 30 percent of the total MIPS score (CPS) by the year 2022. By preparing early and maximizing on this category, your practice can achieve a decent MIPS final score. Consequently, everything falls in line with quality-based care.

To maintain the balance between categories, expect a formidable decrease in the weight of the Quality category at an equal level.

Change 3 – Expansion in Low-Volume Thresholds (LVT)

A Low-Volume Threshold (LVT) depends on the number of allowed Medicare Part B charges and the number of patients cared for by an eligible clinician. There is a consistent increase in the LVT in subsequent years until 2018. And, 2019 is not going to be any different.

Currently, the LVT has more than or equal to 200 Medicare patients or your practice/group has billed more than or equal to $90,000 in Medicare Part B allowed charges. It was an uptick to MIPS 2017 requirements of 100 Medicare Part B patients or $30,000 Medicare Part B allowed charges.

You may not be eligible in the past year, but there is a high probability of your eligibility for MIPS submissions in 2019. Therefore, be well aware, and as soon as you reach the Low-Volume Threshold, P3Care being a MIPS qualified registry, reports on your behalf so that you receive high incentives.

Change 4 – MIPS Cost Category to Experience a Boost

We can see the cost category weight rise to 15% in 2019. MIPS 2019 reporting is not going to be a child’s play because the focus on trimming healthcare expenses is now more than before. CMS suggests adjusting this raise by offsetting the Quality category from 50 to 45%.

Hence, be on the lookout for any changes in government regulations around Medicare reimbursements! Quality reporting aims to improve healthcare delivery and better compensation to physicians.

We try to give you insight into the world of medicine as it crosses paths with medical billing. P3 Healthcare Solutions deals with the revenue cycle management process efficiently when it comes to MIPS consulting and medical billing service in general. One remedy to stay updated with the latest Medicare MIPS reporting requirements and to provide quality billing services to clinicians.

News

Medical billing services, medical billing and coding services, EHR system, healthcare services, health IT leaders, medical billing services process

U.S. Clinicians Spend 90 Minutes on Medical Billing Services

Recently the Journal of the American Medical Association and Medical Care published a report stating the time spent on EHRs by clinicians of several countries. The study particularly focused on the physicians, who prefer in-house medical billing services.

Research Background

The JAMA study compared the data of U.S. clinicians to those in Canada, Western Europe, Northern Europe, Middle East, and Oceania. Looking into their data, it was evident that clinicians in the USA spend more time in data management via EHRs (Electronic Healthcare Records) than other physicians do.

It was Harvard and Stanford University that collected the metadata of 371 ambulatory care health systems all around the world. All healthcare service providers with scheduled patient appointments and advanced practice practitioners participated in this study.

Statistically, U.S. clinicians spend ninety minutes on average for medical billing and coding services. While clinicians of other countries spend just an hour/day. Moreover, the Medical Care study also mentioned that it generally took 1.2 minutes more in the scheduled examination appointment for the primary healthcare services.

What to Take Away From This?

Both these studies suggest the inconsistencies in the EHR system and the inefficiency of clinicians for medical billing services. This time also lags other administrative tasks such as scheduling appointments.

The timestamps of the EHRs provided all the necessary data to review the time spent by physicians other than on patients.

The clinical activities included:

  • Notes
  • Orders
  • Clinical review
  • In-basket messages

Physicians’ data was judged based on the above-mentioned points.

It is also to consider that U.S. clinicians on average received thirty-four messages per day. Moreover, they spend a lot more time than the clinicians of other countries do on EHRs.

The Impact of Lagged Time on Patient Experience

The study also gave insights into the issues in appointment scheduling and patient experience. For Instance, short-time appointments are more likely to get delayed as compared to the longer ones. It is one of the major reasons that lead to burden down physicians. Ultimately, it also adds to poor communication with patients, resulting in unsatisfactory care quality.

Medical billing services are not clinicians’ forte. And, to help them in the process, it is necessary to lower down the administrative burden from their shoulders. That is why many physicians in the USA tend to outsource medical billing and coding services to others.

Administrative Load for Medical Billing Needs to Change

Journal of the American Medical Informatics Association also analyzed that women clinicians have to spend more time on EHRs than male clinicians. The time difference is estimated to be thirty-three minutes. Thus, this study is a reflection of the efforts that female healthcare service providers put into their work.

Conclusion

All in all, this study pointed out the inaccuracies in the U.S. medical billing services process. The best option for physicians is to outsource the administrative data to a qualified company.

Whereas, health IT leaders need to come up with effective solutions that are cost-effective and time-efficient for everyone. Only then, our healthcare industry will be truly progressive.