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MIPS 2020 reporting, MIPS Qualified registry, QPP MIPS, MIPS 2020 program, MIPS 2019

Surgeons: Tips for Successful MIPS 2020 Reporting

One thing that we learn from the year 2020 for sure is uncertainty. COVID-19 pandemic has left us in a state of doubt where we can’t be too sure of our present and, clearly, not of the future.

QPP MIPS reporting program of 2019 also had to face delays due to this catastrophe with overburdened staff, doctors, and suppliers associated with them any capacity. The closing date for MIPS 2019 went one-month further to facilitate clinicians busy dealing with the surge in COVID-19 patients. It was indeed a rollercoaster ride for them from the very first day.

MIPS 2020 reporting, however, is still very much happening and clinicians are required to submit data as individuals, groups, and virtual groups to receive positive payment adjustments. One of the ways to do that is to score above 45.

Contrary to the previous years, MIPS 2020 program requires clinicians to submit data for all the reportable performance categories to avoid negative payment adjustments. Regardless of the method you use, it is not possible to score above 45 by submitting only the Quality measures.

  1. Check Your Participation Status

The first thing to do while reporting MIPS 2020 is to check whether you are eligible for the program or not. Special statuses qualification also awaits certain surgeons. Once you are there, include your NPI to display the required participation status.

Surgeons with special statuses may get bonus points and also have their categories reweighted.

  1. Select Quality Measures Carefully

Instead of being casual about the Quality measures, my next tip is to be careful about them. It is crucial to choose only those Quality measures with benchmarks that do not limit your points that you may score on that measure.

For example, many surgery-driven measures are topped-out, and you can score as much as 7 points through them, which may tempt you to look for other measures, outcome measures, or high-priority measures resulting in bonus points.

  1. Participate in COVID-19 Clinical Trials Improvement Activity

While the COVID-19 pandemic has left us with many questions, it poses a challenge to humanity to figure a way out of it. Thankfully, MIPS 2020 reporting, now, has a new high-weighted COVID-19 clinical trial activity to add to the total scores for MIPS eligible clinicians. While it is an opportunity to score high, it can help you receive recognition for breakthroughs you are making against COVID-19.

The two ways you can utilize this IA and receive credit for it:

  • Participate in a COVID clinical trial and have that data become part of a data portal for an ongoing study; or
  • Caring for COVID patients, you may submit clinical data to the clinical data registry for future references.

National Institutes of Health (NIH) hold Covid-19 clinical trials, and that is where participation starts. The goal of this Improvement Activity (IA) is to innovate and improve the collection of COVID-19 information that the clinicians have and develop best practices in patient care as COVID-19 drags on.

Let’s hope for the best outcomes shortly. MIPS Qualified Registries submit measures for all the reportable measures. Therefore, signing up with one of those registries is a good start.

Scoring Cases for Clinicians with Special Statuses

The cost category is excluded from the examples below because the category uses complex claims data to calculate scores.

  • Scoring example for clinicians who are eligible for PI exemptions

    • 25% of the weight of the PI category transfers into Quality, reweighting it to 70% of the total score.
    • (26 measure points in Quality are equal to 30 MIPS points approximately) + (IA’s complete submission is equal to 15 points) = 45 points
  • Scoring example for physician groups of 15 or fewer

    • If they report at least one Quality measure, they receive six bonus points for the Quality category.
    • (20 measure points + 6 bonus points in Quality = around 30 MIPS points) + (IA’s complete submission is equal to 15 points) = 45 MIPS points

Recommendation of the American College of Surgeons

45 is the safest score for MIPS 2020 submissions regardless of the submission method you use. American College of Surgeons also recommends the above techniques to score high and handsome and stay at ease in the compliance program.

There are no changes in eligibility status and opt-in determinations. The criteria are simple, and with the COVID situation going on, MIPS eligible clinicians can also report their preparation and planning in regards to receive reimbursements.

The threshold is certainly high this time, but clinicians who are prepared and have good specialty-specific measures to report can show outstanding performance.

So, there’s nothing to fear. It’s just a program for clinicians to get incentives as a reward to improve their quality care delivery.

How CMS determines MIPS eligibility?

MIPS 2019 reporting, Healthcare Solutions, MIPS QPP, MIPS 2020 reporting, MIPS quality measures, Medicare and Medicaid Services, MIPS qualified registry, MIPS consulting services

3 Points to Consider Before MIPS 2019 Reporting

Physicians! It’s time to prepare for the MIPS 2019 reporting period. There’s only a little time left.

This time may be hectic and stressful, even for MIPS qualified registries. But don’t worry, P3 Healthcare Solutions has come up with effective tips to target high MIPS scores.

Let’s be honest, MIPS QPP can be a daunting approach to earn incentives for those who are not careful.

On the other hand, it can be rewarding and tends to appreciate clinicians’ efforts for showing remarkable performance.

Now, the bad performance can’t be blamed over a misunderstanding. It’s been three years since MIPS if you still can’t perform well, you should expect financial setback.

Financial Risk Is Increasing!

  • This year, the performance threshold is thirty points.
  • Financial risk is up to 7%.

You can imagine that the reporting complexities will be higher than the years before. Some people will win this game while others will lose. The only way forward is to strategize beforehand and report according to the specified guidelines.

So, just let’s dig into three important points to consider before MIPS 2019 reporting.

Understand the Criteria for the Minimum Performance

Did you know that only by correctly reporting for Improvement Activities (IA) and Promoting Interoperability (PI) categories can give points up to 40? It is at least 10 points more than the minimum threshold that can save from the penalty.

Speaking about the reporting strategy, keep in mind that this year, PI category data submission has especially been strict. Now, it’s not enough to just say that yes! I did it. You have to provide substantial evidence for the performance.

Pay Attention to MIPS Quality Measure

You might be thinking that if reporting for just IA and PI is enough to save your face, why not just stop there.

But we suggest, NO! You should not only be considering penalties but the goal should be incentives and bonuses.

Striving for better opportunities give margin to stay ahead of game from those physicians, who might only have taken measures to prevent themselves from penalties.

So, working not only to save yourself but to earn incentives and bonuses should be included in strategies, and reporting for MIPS quality measure is an efficient way to do that.

Don’t Wait Until the Very End for Data Submission

CMS – The Centers for Medicare and Medicaid require data for 90 days of PI and IA performance categories. The same is not the case with Quality and Cost measures.

CMS also has a specified timeline in which eligible clinicians can report data to them. However, if you consult a MIPS qualified registry, you are able to save data and make relevant changes from time to time.

March 31, 2020, until 8 p.m. EDT is the last date for QPP MIPS 2019 data submission. During this period, eligible clinicians can also update their data if required. So, until the submission window stays open, you have time to make changes to comply with the CMS requirements to score high in the end.

This strategy reduces the chances of errors and data redundancy. MIPS is a bit complex, but the key to success is comprehending the reporting criteria, which is an easy process when collaborated with MIPS consulting services as P3 Healthcare Solutions.

Small medical practices or hospitals need their time to plan, but a smart strategy can go a long way to maximize returns, optimize time, and efforts.

So, start planning today.

Learn about MIPS quality measures specifications 2019 in a nutshell.

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medical billing service, MIPS Qualified Registry, CMS news, Trump’s Guidelines, COVID-19, coronavirus , COVID-19 outbreak, MIPS 2020 reporting, QPP MIPS, MIPS 2020 reporting registry, QPP 2020 Reporting

P3 Investigates: Trump Administration Plans to Reopen Nursing Homes

P3, as a medical billing service and a MIPS Qualified Registry, keeps in touch with CMS news as it happens. CMS, yet again, informs the public of the plans, the government has for nursing homes to reopen safely with the pandemic still around. While state and local officials follow it to ensure safe beginnings for nursing homes across the country, they are a part of President Trump’s Guidelines for Opening Up America Again.

Why were the restrictions put in the first place? The government had to take stern action against nursing homes and put them under quarantine to prevent the spread of COVID-19, including severe infection prevention, ample testing, and investigation.

This plan that the government has come up with will be a guide through troubling times as life gets back to normal for nursing homes.

When stats suggest that 8 out of 10 COVID-19 deaths are of citizens 65 and above, the more careful we are the better. We owe it to the seniors of this country more than we owe it to anyone else.

By acting upon this guide, nursing homes will be able to mitigate the risk of COVID-19 exposure and prevent its spread within facilities.

In light of these issued recommendations, states should observe if nursing homes are taking the appropriate and necessary steps to ensure resident safety; moreover, they should know the right time when to reopen doors to the public.

In finality, the information you find here should support states and nursing homes bring families together, reunite them with their loved ones in a gradual manner.

Administrator Seema Verma has led from the front during the crisis; this time, she said and I am paraphrasing it; the coronavirus has had a shocking impact on our nursing homes, and as we reopen the country, we want to be sure that we are doing everything in our power to protect our most vulnerable citizens.

She continued by saying that their constant focus is on the protection and quality of life of the nursing home residents. While we reach the stage when we finally reopen, she said, we want to make sure that the communities have a set strategy moving forward.

Further, CMS recommends additional criteria for the safety of the nursing home residents since COVID-19 poses a direct threat to them as the country passes through the reopening phase. It is to complement the Trump Administration’s broader idea of the Reopening of America Again.

A nursing home, as part of the recommendation, must not advance through phases of reopening until all residents and staff have received their baseline test results.

CMS wants state survey agencies to keep an eye on nursing homes if they suffered from a serious COVID-19 outbreak before reopening.

As its final recommendation, CMS states that homes should remain in the highest state of restriction even if they see relaxation in the community around them, to ensure the preservation of lives.

Moving on, nursing homes will start taking in visitors in phase three, which will only occur when health reports show considerably less COVID-19 cases. Visitors must go through screening and wear a face-covering during the visit.

The guidance was released a couple of days back on May 18, 2020, but we thought by revisiting the recommendations, we can make a difference. P3, as QPP MIPS 2020 reporting registry, has considered it an honor to go the distance for the health of US citizens; this, specifically, goes out to seniors to whom we are grateful.

State leaders in collaboration with local health departments and state survey agencies would implement the guidance to limit COVID-19 exposure in nursing homes. Relaxation of the intense measures in a nursing home should only occur after a careful review of the following factors:

  • Number of COVID-19 cases in the local community
  • Number of COVID-19 cases in nursing homes
  • Available staff members
  • Baseline tests of all residents; weekly tests of all staff members; social distancing; face coverings
  • Presence of enough personal protective equipment (PPE)
  • Nearby hospital’s capacity

State and local leaders have a responsibility to see to these factors now and then and adjust their strategies accordingly, depending on the intensity of coronavirus spread in their vicinity. CMS is committed to taking measures that ensure the safety and revival of nursing homes.

P3Care, medical billing, MIPS 2020 reporting, Misconceptions about Coronavirus, Coronavirus

P3 Clears Five Misconceptions About Coronavirus

P3Care counters misinformation around topics of medical billing or MIPS 2020 reporting about the much-talked-about coronavirus. Yes, the Wuhan-born virus is breaking news on every news channel in the world.

A session held on Friday in New York City by the Center for Disaster Medicine at New York Medical College (NYMC) about the virus recorded someone from the audience asking, “Is it safe to eat Chinese food?”. That is what news without investigation can do to you. There is much wrong information floating around that it has become hard to differentiate between facts and fiction.

There are 5 common misconceptions about the virus with counterarguments for the greater good of the people.

And, yes, eating Chinese is safe. It is ‘not’ a safety hazard by the World Health Organization (WHO) or the Centers for Disease Control and Prevention (CDC).

Misconception 1: Coronavirus is more dangerous than any other virus and is spreading fast

P3Care, medical billing, MIPS 2020 reporting

Wrong. The measles virus is much more dangerous than coronavirus (2019-nCoV). The only reason it has not spread quickly is that most people are already vaccinated for measles. Voila! It doesn’t make it to the news or social media.

The experts say that this virus can affect 2 to 3 people around. However, this data has a lot of uncertainty because it has not gone through scientific-peer assessment yet.

Misconception 2 – It can kill you

In a session, held by NYMC, Mary Foote, MD, MPH, Senior Medical Coordinator for Communicable Disease Preparedness at the NYC Department of Health said that it is believed that everyone who gets affected by the new virus eventually dies. But people are at greater risk from heart disease, cancer, old age, and any other life-threatening disease than by this virus.

People are at greater risk of influenza and chances of them ending up in hospitals from influenza are higher. Stating a fact, Flu kills tens of thousands of people every year in the US and 291,000 to 646,000 people in the world (according to a study published in The Lancet). CDC stresses on getting flu shots on their website and social channels for public protection as we speak. Hence, people ought to be more concerned about protecting themselves from the flu rather than the coronavirus.

Misconception 3 – It was manufactured in a laboratory and is being used as a biological weapon

medical billing, MIPS 2020 reporting

The news that was spread earlier by a large number of Russian domestic channels suggested the involvement of the United States behind this outbreak. The misinformation further spread like fire saying the US has created this bioweapon against China and that US pharmacists were making billions from this.

Similar conspiracy theories are creeping up in China and, oh surprise, surprise, some of them are coming from within the U.S. All of these are just conspiracy theories and nothing more. No, there is no evidence that this was a human-designed strain of the virus created to destroy countries or dismantle governments.

Misconception 4 – A cure is available

A vaccine is not developed in the blink of an eye. There hasn’t been a vaccine until now because it is a new virus and producing a vaccine to counter will take some time. Public and private organizations are cooperating to assist scientists in finding a remedy for this virus as quickly as they can.

Misconception 5 – Every person with fever and coughing is infected with coronavirus

This is misinformation #5 on this list. Since the public is unaware of reality, they think every person with the common flu is infected with the coronavirus. CDC has stressed the importance of flu vaccination several times. Medicare offers to reimburse providers if they claim for giving flu shots to their patients. The same facility is for the beneficiaries to get their flu shots on time in which they don’t have to pay any out-of-pocket costs. Health plans are in full support of this cause.