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MACRA MIPS, QPP MIPS, MIPS Reporting, MIPS program, MIPS data submission, MIPS Qualified Registry, MIPS consultants, MIPS solutions, How to Report MIPS Data, healthcare services, Promoting Interoperability

MACRA MIPS – What it Means for Physicians?

MACRA MIPS (The Medicare Access and CHIP Reauthorization Act of 2015 – Merit-based Incentive Payment System) is a program that caters to physician finances under Medicare. Not only that, but it determines the quality of care within hospitals, practices, and clinics should meet certain standards.

The program is now in its fifth year (started back in 2017) and it would be right to say that it facilitates the whole physician reimbursement process. MIPS 2020 submission is not rocket science; however, it requires a certain skill set to achieve good scores.

Key Elements of QPP MIPS

MIPS program has four categories that cater to meaningful quality healthcare services.

  • Quality
  • Improvement Activities (IA)
  • Promoting Interoperability (PI)
  • Cost

The quality category replaced the PQRS (Physician Quality Reporting System) and reflects the efforts to improve the quality of care.

Improvement activities translate patient convenience and satisfaction in quality healthcare delivery.

Promoting Interoperability replaced Advancing Care Information (previously known as the meaningful use program) to integrate technology in healthcare.

The cost category replaced the value-based modifier program and translates the efficiency of the cost factor.

Each category has different weights. The respective percentages change each year under MACRA MIPS. Eligible clinicians, who exceed the minimum performance threshold get positive payment adjustments and avoid a penalty of a certain percentage.

MIPS Full Form in Healthcare

Large medical practices already know the implications of MIPS data reporting. However, it is small healthcare organizations or non-eligible clinicians that need to understand MACRA MIPS to the core.

Now, the performance bar has gotten high. Although CMS (The Center for Medicare & Medicaid Services) facilitates small/rural/underprivileged medical practices to much extent, the appropriate approach is to consult a MIPS Qualified Registry for MIPS solutions.

What Physicians Can Get from MIPS Reporting?

There are many advantages that eligible physicians can get by submitting data to CMS under MACRA MIPS.

  1. Physicians get to improve care quality.
  2. They can improve ranking among fellow physicians via the Physician Compare portal, thus, improves patient rate.
  3. Against the exceptional performance, physicians can receive incentives.
  4. High achievers can even receive a share from the $500 million bonus pool.

However, MACRA MIPS requires consistent efforts, but practices could get help from MIPS consultants to guide them through the process. In case you are one of the practices with pending MIPS 2020 reporting, there is still time for you to submit until March 31, 2021.

Should Physicians Report Data Despite Corona Pandemic?

There are lots of benefits if MIPS eligible clinicians choose to report data despite hardships.

For instance, MIPS incentives and bonus pool worth $500 million are worth a try, and reputation on Physician’s Portal can help to improve patients’ volume. However, it all depends on how individual clinicians, groups, and virtual groups, report data to CMS.

The first rule is to deeply analyze your strengths and select MIPS Quality Measures that are most suitable for the medical practice. The more specialty-specific measures you report, the more chances you have for maximum points. Consequently, a smooth revenue cycle management is what you all get at the end of the reporting period.

How to Report MIPS Data?

Eligible clinicians can choose different ways to report MACRA MIPS. However, the easiest and comprehensive way is to report data via the MIPS Qualified Registry as P3Care.

We choose specialty-specific measures to submit data from the list as per the final rule proposed by CMS.

Conclusion

MIPS data submission under MACRA is a lot to take in, but as the years went by, it is in the best interests of physicians to attest to the quality payment program.

Especially with COVID, clinicians have lost millions of bucks to cater to the surge of patients. In such times, incentive payment programs are a ray of hope as they facilitate in many ways. Moreover, CMS also offered flexibility in the administrative load. So, there is no point in avoiding participation in such programs, right?

Healthcare, Healthcare Solutions, MIPS 2019 reporting, Quality Measures in 2019, quality payment program

MIPS 2019 Reporting Is the Future of Quality Healthcare

MIPS 2019 reporting is a progressive path for the qualitative analysis of the healthcare industry. Through the program, CMS ensures the quality of care by measuring the performance of clinicians.

To stand apart from its competitors, P3 Healthcare Solutions is on a mission to promote quality. As proof, Clutch ranks P3Care on their leaders’ matrix. You can also see the names of other successful companies in the health IT sector through this link: https://clutch.co/bpo/medical-billing/leaders-matrix. 

MIPS 2019 Reporting Requires Critical Thinking

A MIPS Qualified Registry allows only the registry-specific measures; for every submission type, there is a list of acceptable measures.

Merit-Based Incentive Payment System is one of the tracks of the Quality Payment Program (QPP) with the Alternative Payment Model (APM) as the other one. Both of these value-based reimbursement models have their own benefits. To be honest, most eligible clinicians choose MIPS 2019 as their payment model.

Testimonials

Clutch.co reports P3 Healthcare Solutions to be one of the leading organizations in medical billing. Reviews are an interpretation of the quality and performance of an organization, and if they are in favor, the company gathers worth.

Founder, SunCoast RHIO, Lou Galterio says, “P3 Healthcare Solutions enables our providers to get paid faster, and they make billing consistent and reliable”.

He continues his interview with Clutch by declaring:

“They’re incredibly responsive, answering my questions on the weekends and at night. We’re a few hours ahead of them, but they still answer our calls, even when it’s early in the morning for them. They’ve also trained some of our internal team to understand their products.”

There is a famous saying, “All is well that ends well”. It means client satisfaction is the only factor that stands between performance and non-performance. If a client is happy, it is the maximum output of a company – the ultimate criterion that matters in the end.

Essentials to Report Quality Measures in 2019

Quality is one of the four performance categories of MIPS 2019. It carries 45% of the weight toward the final score. Contrary to that, it was 50% weight back in 2018.

Why is there a difference?

It is an effort to reduce the burden of MIPS 2019 reporting requirements of eligible clinicians according to the proposed rule.

First, to fulfill the Quality category, ECs have to undergo MIPS 2019 reporting over a span of 12 months.

Second, there are four ways to submit quality measures:

  • Electronic Clinical Quality Measures (eCQMs);
  • MIPS CQMs (Previously “Registry Measures”);
  • Qualified Clinical Data Registry (QCDR) Measures; and
  • Claims-based measures for small practices

Reporting as a Group

With the condition to report as a group of 16 or more clinicians, under the 200 Medicare beneficiaries criteria, the administrative claims-based all-cause readmission measure will automatically count as the seventh measure.

To stay on top of MIPS 2020 reporting, the Qualified Registry option is the most feasible option.

With P3Care as your third-party intermediary, you, as a healthcare professional, can focus on your patients. We become part of your cure to people in distress.

The Case of Specialty Measure Sets

MACRA MIPS never falls short of requirements. ECs, as individuals and groups, have the flexibility to choose between a specialty and subspecialty measure set.

Note: Generally, each eligible clinician is required to submit at least six measures in a specific measure set while CMS Web Interface users have to report all the 10 required quality measures for the full year (January 1 to December 31, 2019).

Value-based care enters the third year successfully and CMS tones down the reporting requirements for clinicians. CMS faces the challenge of physician burnout; they took down some of the measures to reduce their burden. In this way, they can look after their patients in a better way. The lack of patient association and engagement is attributed to difficult EHR handling.

What do you think is a common problem clinicians will likely face in MIPS 2019 reporting?