Posts

MIPS 2021, MIPS 2021 reporting, MIPS Qualified Registry, Quality Payment Program, MIPS Quality Measure, MIPS eligible clinician, MIPS 2021 quality reporting, healthcare provider, MIPS qualified clinicians, MIPS 2021 Qualified Registry, Electronic Health Records, Certified Electronic Health Record Technology, Promoting Interoperability, Merit based Incentive Payment System, pre-existing quality reporting programs, MIPS program, Electronic Prescribing

MIPS 2021: All About the Promoting Interoperability Measures

MIPS

MIPS (Merit-based Incentive Payment System) is a part of the Quality Payment Program (QPP), which came into effect in 2017. Its purpose was to move the Medicare part B providers to a performance-based payment system.

It replaced three pre-existing quality-reporting programs (PQRS, VBM, and MU) and made a single system with categories, based on which a score is determined called the MIPS composite or final score.

Categories

There are four categories in the MIPS program, which are

  1. Quality
  2. Improvements Activities (IA)
  3. Promoting Interoperability (PI)
  4. Cost

Each category makes up a certain percentage of the final score. And are responsible for determining how much of a positive payment adjustment a clinician will be receiving against the performance year. Moreover, the rules and regulations regarding each category change or get updated each year as well. It is the same case for MIPS 2021.

Today we will be focusing on the Promoting Interoperability (PI) category, its basics, and which requirements clinicians need to fulfill for successful MIPS 2021 reporting.

Promoting Interoperability (PI)

This category replaces the Medicare Electronic Health Records Incentive Program (EHR and Meaningful Use Program) and composes 25% of the final score.

It deals with patient engagement and the exchange of information through Certified Electronic Health Record Technology (CEHRT), in general.

Categories and Measures

There are 11 measures in this category, which are divided into four objectives or categories.

  1. Electronic Prescribing (e-prescribing)
  2. Provider to Patient Exchange
  3. Health Information Exchange
  4. Public Health and Clinical Data Exchange

Each of the chosen measures needs to be reported for 90 consecutive days, which can be done via a MIPS Qualified Registry.

E-prescribing 

This category consists of two measures.

It requires MIPS eligible clinicians to write at least one prescription and transmit it electronically through CEHRT.

This measure is worth 10 points.

  • Prescription Drug Monitoring Program (PDMP)

It is a bonus MIPS Quality Measure and does not need a mandatory attestation.

Moreover, it requires a MIPS eligible clinician to use data from CEHRT to examine PDMP for drug history regarding Schedule II opioids, following the applicable law.

There needs to be at least one Schedule II opioid prescribed electronically using CEHRT during the performance year to qualify for this.

It is worth 10 points. So, if you submit this measure with MIPS 2021 quality reporting data, you have a chance to gain high points in the MIPS PI category.

Provider to Patient Exchange

This category has one measure. In case you are not familiar with it, you can hire a third-party vendor, a MIPS Qualified Registry to submit their measures.

  • Provide Patients Access to their Healthcare Information

It requires the clinician to ensure that the patient or their representative has access to their health information. Including being able to transmit it, view it, and download it.

Any application or software can do this task. However, that tool is supposed to meet the Applications Programming Interface (API) specifications in the CEHRT.

It is worth 40 points in MIPS 2021 reporting.

Health Information Exchange

This category consists of three measures, which come as two options.

Option 1

  • Support Electronic Referral Loops by Submitting Health Information (Medical Records or Others) 

It requires the MIPS qualified clinicians to refer at least one of their patients to another healthcare provider. Including creating a summary of their care record using CEHRT and electronically exchanging it.

If submitted this MIPS quality measure, you can receive 20 points.

  • Support Electronic Referral Loops by Receiving & Reconciling Health Information

This requires the clinician to be the receiver of at least one electronic summary of a care record regarding patient encounters, including a transition of care record or a referral. Or it can be the acquisition and collection of information regarding a new patient, for reconciliation of information concerning medication, medical allergy, and current list of issues.

It is worth 20 points.

Option 2

  • Health Information Exchange (HIE) Bi-Directional Exchange

It requires MIPS-eligible clinicians for the bi-directional exchange of information with an HIE to support transitions of care and is worth 40 points.

You can choose to attest to either option as they both hold the same points. Moreover, it is up to you to go for MIPS 2021 reporting as an individual or via a MIPS Qualified Registry.

Public Health and Clinical Data Exchange

This MIPS quality category consists of five measures.

  • Immunization Reporting

It requires MIPS 2021 reporting clinicians to be in active engagement with a public health agency for the submission of immunization records and to receive immunization histories from the public health immunization registry or the immunization information system (IIS).

  • Syndromic Surveillance Reporting

For this measure, the MIPS eligible clinician needs to submit syndromic surveillance information with a public healthcare agency, preferably from an urgent care setting.

  • Electronic Case Reporting

It requires the clinician to actively engage with a healthcare agency to submit data regarding reportable cases.

  • Public Health Registry Reporting

For this, the clinician needs to be engaging with a public agency for information submitted to public health registries.

  • Clinical Data Registry Reporting

For this measure, the MIPS qualified clinician needs to actively be engaging with a clinical data registry for information submission.

You can choose any two measures out of the five listed here for reporting, and they will be worth 10 points in total.

Reporting and Submission Criteria

Clinicians can collect data for their respective measures and report it by using an Electronic Health Record (EHR) that meets the following criteria:

  1. Technology that meets the 2015 Edition certification criteria, or
  2. Technology that meets the 2015 Cures Update criteria, or
  3. A combination of both

You can ask your MIPS 2021 Qualified Registry in this regard.

Data collection for most measures from each objective takes place for a consecutive period of 90 days.

In addition to submitting the measures, clinicians also must provide their EHR’s CMS Identification Code. However, this code must come from the Certified Health IT Product List (CHPL) and then add a “yes” for each of the following:

  1. The Prevention of Information Blocking Attestation
  2. The ONC Direct Review Attestation
  3. The security risk analysis measure

The data for MIPS 2021 reporting regarding each measure can be submitted by:

  1. The clinicians
  2. a representative of a practice, a virtual group, or an APM Entity
  3. Third-party intermediaries as a Qualified Registry

Hardship Exceptions 

A clinician can apply for Promoting Interoperability Performance Category Hardship Exception in MIPS 2021 reporting. It allows them to not participate in activities from this category, which is permitted on the following grounds if you:

  1. Are MIPS eligible clinicians with a small practice
  2. Are a MIPS eligible clinician using a certified EHR Technology
  3. Have poor internet connectivity
  4. Are undergoing extreme and uncontrollable circumstances
  5. Lack of control over the availability of CEHRT

If your application is approved, then you will receive a 0% in the Promoting Interoperability category. Its 25% will get redistributed to another objective (or categories).

But, if you are a clinician with a special designation based on status (hospital-based) or type (physical therapist), you will not need to submit this application.

If you are a part of a group or a virtual group, all the clinicians included in the group will have to qualify for reweighing for the entire group to be reevaluated, unless they too have special status designations.

Conclusion

If you are a MIPS eligible clinician, this information will help you strategize better for the PI category. Assistance from a MIPS Qualified Registry will take all of your load to submit MIPS 2021 data timely to CMS.

You can learn more about the program here: https://p3healthcaresolutons.blogspot.com/2021/09/avoid-penalty-for-mips-2021.html

healthcare industry, Merit Based Incentive Payment System, MIPS Quality measures, Physicians, healthcare professionals, Quality Payment Program, HIT consultant, MIPS consulting services, Healthcare Solutions providers, MIPS compliant, Centers for Medicare and Medicaid Services, CMS, MIPS track, podiatrists, MIPS data submissions, MIPS reporting

A 2019 Guide to Top-rated Podiatrists in New Jersey (NJ)

The senior population of America is expected to grow in the upcoming years which means more people’s ankles and feet are at risk. We must look for ways to deal with this situation before it gets too late. In fact, one of the ways to achieve better care coordination is to lace the healthcare industry with the best podiatrists not only in New Jersey but in every state.

How many of you agree with this notion? I am hoping plenty!

The younger generation’s help could actually play be a gamechanger in this whole scenario. They are young, energetic, and result-driven, one push in the right direction could lead us to a better care environment. Ultimately, however, the responsibility falls on the shoulders of practices and care teams to show capabilities of healing on every patient they treat. The reason we want the best podiatrists in New Jersey is that it is not only a matter of health but to save a generation.

On the other side, the field of podiatry has to comply with the Merit-Based Incentive Payment System (MIPS) moving forward. The incentive program has its own Quality measures and other relevant measures eligible podiatrists are supposed to fall in line with.

MIPS in 2018/19 – The Differentiating Factor

To remain the best podiatrist in New Jersey, clinicians ought to participate in MIPS. MIPS is the program to judge their care credibility. Once they do participate, it is going to show on their resume in addition to the Physician Compare portal. In short, MIPS in healthcare is an evaluation criterion of your credibility as a physician and a healthcare professional. Moreover, the Quality Payment Program (QPP’s) final score at the end of each evaluation period influences the overall reputation of the participating clinician.

The Best Podiatrist in New Jersey vs. Participation in MIPS

The 2019 participation and a score above 70 are worth the incentives in 2021. Despite the selection of the best criteria for measures, talking to a qualified HIT consultant can double the chances of incentives as well as bonuses.

Hence, the trick here is to find experienced MIPS consulting services and share data with them so they can make informed decisions on your behalf. P3 Healthcare Solutions provides such services to clinicians since 2017. If you haven’t tried us, please do give us a call and we’ll do everything we can to get you MIPS compliant.

How to Find the Right Podiatrist in NJ?

The Centers for Medicare and Medicaid Services (CMS) is the federal authority behind incentive programs. At a time when the MIPS track of the Quality Payment Program impacts healthcare outcomes, the ratings on the Physician Compare portal hold the secret to a clinician’s reputation. As a result, the people of America discover the top-rated podiatrists across the country. It is a way to materialize search for the best doctor.

Admittedly, we Americans, deserve the best care and nothing can make us qualify for anything less.

Authoritative Websites to Facilitate the Search for Podiatrists

As a matter of fact, www.njdoctorlist.com is used to search for doctors and their whereabouts. Here, you will find the top providers registered and credentialed across the state of New Jersey. Authorities also back this initiative in the best interest of locals.

If the weather shows minimal snow and zero warnings of a snowstorm, it is easy to head out to the nearest practice.

Foot and ankle centers in New Jersey cure patients in abundance, especially through these portals.

In general, the website for the American Medical Association (AMA) furnishes DoctorFinder and finds the best doctors in town for patients in NJ.

As patents, they don’t need any introduction and Google promotes them by default.

Big Names in the Industry

The US healthcare industry passes through a critical time when the clinicians gradually ascend towards value-based care and adopt the cost-saving methods nationwide. Compliance is applicable to them if they pass the eligibility criteria.

MIPS Quality measures for podiatrists include obligations that are mandatory for every physician with a few exceptions. We will cover them in detail in the upcoming articles.

According to Google and webpages on the first page, there are many physicians making the list of top podiatrists in New Jersey.

The foot and ankle specialists of New Jersey include names like:

  • Dr. Eric J. Abrams
  • Dr. Craig A. Shapero
  • Dr. Jordan Drucker
  • Dr. Stephen Guiliana
  • Dr. Nicholas R. Taweel
  • Dr. Jerry A. Silberman

The top 6 podiatrists according to ratemds.com, another gem of a website mentions them with grandeur.

The deadline for MIPS 2018 data submissions, April 2, 2019, continues to be a constant reminder. If you are a podiatrist who has MIPS reporting pending, call 1-844-522-3227 for immediate assistance.

MACRA, MIPS, MACRA and MIPS, Quality Payment Program, QPP, Merit-based Incentive Payment System, Alternative Payment Models, P3Care, MIPS consulting services, Medicare billing, MIPS performance categories, MIPS score, Improvement Activities, clinical practice, Medicare providers, physicians, MIPS quality measure, healthcare services, MIPS 2017, MIPS 2019, MIPS 2021, revenue cycle management

MACRA & MIPS: A Closer Look

MACRA

Talking about MACRA & MIPS, it is important to learn that in 2016, MACRA (Medicare Access and CHIP Reauthorization Act of 2015) was officially introduced, ruling out the existing and outdated Sustainable Growth Rate method.

Previously, providers received payments based on the number of Medicare patients they provided care to rather than for the quality of care they provided. So, not only was this method was ineffective for the patients but drastic effects were observed when it came to receiving financial support for Medicare expenses. Treating a high volume of patients (quality or no quality) basically meant higher payments for providers.

MACRA established a Quality Payment Program (QPP), a method that will motivate providers to deliver well thought out quality care to patients. And it will reward them with payment adjustments. Moreover, eligible providers are able to choose one of two pathways in the QPP, MIPS (Merit-based Incentive Payment System) or APMs (Alternative Payment Models).

An estimated 500,000 providers will be eligible to participate in the first year of MIPS. Likewise, the amount MACRA will provide for positive payment adjustments is quite overwhelming, up to 3 billion dollars in the next six years! Now, let’s take a closer look at MIPS, and how P3Care can provide you with MIPS consulting services to ensure you understand how to take full advantage of this new and improved payment process.

MIPS

In order to take part in MIPS, you must meet the requirements associated with Medicare billing (Part B). Selecting this route of the QPP focuses on receiving payment adjustments based on the specific data you have submitted.

For the 2017 transition year, there are three different categories. To help better understand how CMS scores physicians under MIPS, we have specific weights per category. This will allow you to divide your attention accordingly. You will also need to determine if you are participating in MIPS individuals or as a group.

Here’s a closer look at the MIPS performance categories for 2017.

Quality

60% of the data submitted will pertain to this category; signifying the main purpose of eliminating the previous method, and implementing MIPS. Moreover, in this category, providers which practice solely report up to 6 quality measures (out of 271), which are the most associated with their specialty.

Clinicians will get scores based on the number of days they have submitted data for (read more below), along with the accuracy and completion of all the required specifications for each measure. Moreover, closely assessing each measure helps determine if clinicians achieved the high-quality healthcare goals. The total number of points earned on 6 quality measures + any bonus points will determine your final score of the Quality category.

Advancing Care Information

Taking up 25% of the total MIPS score, this category replaces the previous Meaningful Use program. You’ll need to select one of two reporting measure sets, depending on your EHR edition.

Each option includes different measures; therefore it’s essential you only report on which option relates to you. There are three subcategories that will determine you’re total score for this category, they include Base Score, Performance Score, and Bonus Score.

Failing to complete all of the requirements in the Base Score category will result in a 0 in the overall Advancing Care Information category.

Improvement Activities

The remainder of the score (for 2017) will come from the Improvement Activities category, weighing at 15%. And this category allows CMS to determine if clinicians are improving clinical practice to its highest potential.

A few key aspects include providing quality care by involving the patients in decisions:

  • Continuous coordination between provider and patient
  • Providing self-management techniques
  • Patient/family education
  • Providing follow-ups
  • Using safe technology and being reasonably accessible

You’ll have the opportunity to choose from a variety of activities, that best suit your practice, to report data on. Each activity is categorized as either has High or Medium; high-weighted activities are worth more points. Individual Medicare providers will need to submit data on up to 4 activities for a minimum of 90 days, in order to earn full potential points.

Cost

In last but not least, Cost is the fourth category, upon which CMS measures physicians’ MIPS score.

Physicians don’t have to report separate data for the cost category. However, CMS calculates this MIPS quality measure by analyzing the submitted administrative data.

For the year MIPS 2017, the cost category had a value of 0% in the final scorecard. On the other hand, in MIPS 2018, it was the first time that cost category weighed 10%. This score accounts for the lower cost expenditure while physicians provide high-quality healthcare services to patients.

Right now, we are passing through MIPS 2019, which is the 3rd year of this value-based program.  And the cost-quality measure is a significant part of this year as well. It accounts for 15% of the final MIPS score.

MIPS is running quite successfully with more and more clinicians taking part in it every year. Its impact on the healthcare industry is progressive and physicians upon realizing its importance for revenue cycle management are subject to adopt modern and cost-effective healthcare ways.