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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.

Medical billing services, Medical billing company, MIPS in healthcare, Healthcare Solutions California, HIPAA medical billing company, Meaningful use of EHRs

5 Front Desk Basics to Improve Your Medical Practice

Like in any business, front desk staff plays a vital role in healthcare affairs. The business of knowing the right person for the right job matters in healthcare more than it matters anywhere else. Because whether it is a hospital or a private practice, patients need all the attention they can get. Moreover, if it is missing out from a crucial place such as the front desk, they can expect the worst outcomes later on.

P3 Healthcare Solutions, Ontario, CA analyzes this aspect of healthcare while it deals with the IT side. Since first impressions are usually the last ones, we have to make the most of them. Otherwise, we can’t promise patients to become a long-term asset of the practice.

Greet Patients As You Mean It

Every human, related or unrelated, deserves care. When a patient decides to check-in, they deserve to be treated in the best manner by the front desk staff. Greet them with a smile because what happens at the front desk sets the tone for the rest of their visit. Making lasting first impressions and treating them like someone you care about is the key to running your medical practice. Believe me, it makes a huge difference. Higher patient satisfaction level depends on the positivity that starts right after a patient checks-in and registers their presence by the front desk.

Speak Politely on the Phone

To get by your day rather smoothly, treat everyone on the phone in a polite way. It is similar to having a patient in real in your office and talking to them. A friendly attitude, calmness in manner, and providing appropriate information are the three factors to an ideal patient-practice relationship. Because they are not well in the first place, and when someone is not well, emotions take over rather quickly. Anything that’s said and done in that situation lasts forever.

As a medical billing service, we start proceedings with clients both old and new with positivity, and replying carefully to their queries. There’s a QA team present behind the calls to check them for quality, and ensuring seamless delivery of service.

A Clean Environment Influences the Most

A clean and well-maintained waiting area has wider implications than one can imagine. A sick patient can get better just by spending some time in it. As a doctor, you speak of cleanliness now and then. How can you expect your patients to sit in a dirty room? It won’t do your practice any good.

Wipe chairs and tables with a disinfectant before they arrive and make sure the place smells good. Put the trash in the bin where it belongs. A seemingly neat and tidy place can look all messed up if the magazines are not returned to the shelves. What matters is that the visitors enjoy their stay while they wait for the physician.

Smooth Patient Workflow Needs to be In Place

From the time a patient checks-in to the time they go out of the doctor’s office, the workflow needs to be in place. I am talking about timely notifications of the arrival of the patient to the doctor. A seemingly simple visit to the doctor’s office can become a complex problem when the front desk staff fails to function.

Furthermore, the front desk has to notify patients of any delays in their check-ups. And if there are any system failures, before the IT staff can deal with it, it has to come to the notice of both the patients and their doctors. When the front desk delivers to the best of their abilities, a smooth patient flow happens as a result.

Full HIPAA Compliance for Patient Records

As a HIPAA medical billing company, P3 considers the safety of patient records as its number one priority. Because breaches of any sort can result in fines and even jail time in some cases. The same is the case with a doctor’s office.

Verification of patient information is the first thing that happens when a patient checks-in. The front desk has to stay updated on the demographic and other relevant data like the date of birth, address, and phone number.

MIPS in healthcare is an incentive program that rewards clinicians with incentives year after year with performance categories such as promoting interoperability in action. The category was previously meaningful use of EHRs ensuring quality use of Certified Electronic Health Record Technology (CEHRT). Hence, electronic health records are crucial as the US healthcare industry moves into the next phase of value-based care.

To read more about medical billing services, go here – 5 advantages of electronic medical billing services for providers

MIPS 2019, MIPS 2019 reporting, MIPS & MACRA, MIPS in healthcare, Quality payment program 2019

5 Key Takeaways from the Quality Payment Program by Year’s End

The Merit-based Incentive Payment System (MIPS) comes under the direct obligation of the Medicare Access and CHIP Reauthorization Act (MACRA), the law that regulates the incentive program across the US. It is the practical start of the value-based care model.

Eligible clinicians (ECs) have a responsibility to report MIPS 2019; they include physicians, osteopathic practitioners, chiropractors, physician assistants, nurse practitioners, and registered dietitians or nutritionists among others. To summarize, providers are to fulfill the low-volume threshold to qualify for MIPS 2019 reporting. Moving on to MIPS 2020, your next goal has its own set of requirements.

MIPS in healthcare gauges a clinician’s performance in terms of care delivery and reduced expenses. In this article, we come to an understanding of five key elements in relation to this program. In fact, the following data correlates with the preliminary data findings released by CMS on July 11, 2019.

  1. Two Branches for Positive Payment Adjustments

The Quality Payment Program (QPP) 2019 branches out into MIPS and Advanced Alternative Payment Models (APMs). Whichever path you choose, it results in incentives for eligible clinicians, clinician groups, and virtual groups.

Furthermore, MIPS & MACRA go side by side; it is the popular track with stats and reports going in its favor. MIPS incentives for 2019 are less as compared to incentives in MIPS 2020. On the whole, the program is evolving, but once it does, it will be the birth of an improved healthcare system.

It divides into four performance categories as Quality, Promoting Interoperability (PI), Improvement Activities (IA), and Cost. Each category has certain measures that have to be reported through a MIPS Qualified Registry, CMS Web Interface, EHR, or Qualified Clinical Data Registry (QCDR). Not to forget, there is another catch to it in the form of collection types, which are the actual measures according to their submission systems.

  1. Participation Level Increases Each Year

Since the start of the program in 2017, the participation level has gradually increased. It showed an increase from 95% in 2017 to 98% in 2018. Moreover, MIPS 2019 is only going to give us more eligible clinicians participating in it. The whole program suggests progression with higher participation levels across the country.

  1. Small Practices Clinician Participation Status

According to the Centers for Medicare & Medicaid Services (CMS), 90 percent of clinicians from small practices engaged in MIPS 2018 which was 81 percent in 2017. So, that’s a 9% increase.

The primary flexibilities introduced in the Physician Fee Schedule (PFS) rule for the 2018 performance year included an increase in Medicare patient count and Medicare Part B allowed charges.

What did it mean?

It meant fewer clinicians from small practices were eligible to report MIPS in 2018. On the contrary, they decided to report it anyway. It goes to show that the system adjusted itself with practitioners’ convenience.

It was mentioned in a blog post by Seema Verma, Administrator CMS on July 11, 2019.

  1. Advanced APMs Are Not Far Behind

Alternative Payment Model’s (APM) participation level isn’t far behind that of MIPS. CMS reports twice an increase of participants in 2018 as compared to 2017. There were 99,076 total participants in 2017, while the number doubled to 183,306 in 2018. We attribute this jump to new participation opportunities in 2018, especially through ACOs in the Medicare Shared Savings Program.

Even if we are to condemn MIPS in general, I can’t see any downside to opportunities and hope that clinicians continue to grab MIPS incentives year after year.

  1. Spectacular Results So Far

The program collects incentives for the participating clinicians year after year, but the payout occurs one year after the performance year. For example, the payout for MIPS 2017 happened in 2019 in which 93 percent of the participants received positive payment adjustments.

Similarly, MIPS 2018 participants will receive a payout in 2020 which is almost here. CMS reports that 97 percent of the clinicians will be the owner of positive payment adjustments in 2020 based on their performances in 2018.

P3 Healthcare Solutions, Ontario, CA keeps an eye on what goes around as the MIPS performance period 2019 enters the final stages.

2 New Healthcare Technologies to Rule In 2019!

Healthcare Information and Management System Society –HIMSS each year showcase new ideas and technologies to support the healthcare industry. By viewing these technologies or adopting these methods, physicians can actually progress in MIPS in healthcare, medical billing and coding, and health IT sectors.

HIMSS19 conference offers hundreds of opportunities for clinicians with the latest tools and tactics to improve the quality of healthcare services. Moreover, the ideas and innovative methods presented in such forums give insight to strengthen revenue cycle management. In addition, MIPS in healthcare and other incentive payment programs can be facilitated in terms of reducing cost-expenditure and efficient data storage systems. All of these efforts contribute to the advanced healthcare system.

What was there in the box by the vendors in HIMSS19, which may move this industry in upcoming years? Let’s review.

  1. IoT-Enabled Platform

VivaLNK is a popular name in the health IT industry. It has developed a wearable sensor platform with Internet-of-Things that consists of a number of items such as,

  • Sensors
  • Internet of Health Things (Data cloud)
  • Computing technologies

What Does This System Do?

The function of this technology is to capture patient’s or human’s biometric data and input it to the edge computing technology or the cloud computing service for analysis.

This technology will be a great addition in the healthcare industry and will support MIPS in healthcare and medical billing and coding services regarding data collection. It has the capacity to work wonders when deployed completely to its full potential. It will modernize proactive healthcare services and will predict flawed areas in a human body by analyzing symptoms and data.

The Purpose of This Technology

As with modern digital technology, the healthcare industry needs to change its curing methods. The focus should be on preventive healthcare procedures instead of treating a patient after a disease. Moreover, the complexity of diseases has doubled since the last years, making a challenging environment for physicians. The detection or seeing early symptoms of diseases has not remained easy.

This technology will help healthcare providers to identify diseases before they turn serious. Consequently, it will result in bringing a positive impact on the value-based services that MIPS in healthcare promises.

The success of this system lies in the accuracy of the data. Machine learning and artificial intelligence will come from user-fed data. This task is daunting and may not work as precisely as one may expect. Thus, sensors-equipped platforms will assist in this regard, providing medical-grade data directly from the patients and will be shared across the network via IoT.

This system is the next-level healthcare solution that benefits MIPS in healthcare and medical billing on larger grounds. According to physicians, healthcare service providers will be able to accelerate health IT efforts, especially for chronic diseases.

The system perfectly integrates health IT and value-based healthcare service for the patients’ betterment.

  1. The platform for Increased Patient Engagement

Another promising innovation at HIMSS19 was by TriFin Labs, named as Enlyt Patient Engagement Platform.

This system is designed to extend the application of the patient’s engagement via state-of-the-art technologies. It serves to save money and time while connecting physicians and patients in a reliable environment.

How Does It Work?

It a HIPAA-compliant and customizable platform to provide a one-to-one connection between patients and physicians.  It enhances customer-relationship management and has the potential to integrate with the electronic healthcare record (EHR) technology.

Its ability to provide customized operations allows clinicians to manage their systems as their requirements. Moreover, patients will be free to access their medical records whenever they want along with the other information i.e. a list of medications and treatments.

This system also holds opportunities for pharmacists to review past and present medicines at any time, ensuring value-based MIPS in healthcare.

Its other advanced features include a coordinated in-app connection that helps patients in remembering their appointments.  Thus, it makes perfect sense in terms of promoting interoperability and increasing healthcare workflow.

What do you think about these technologies? Do these seem like progressive steps to reduce healthcare costs? Share your thoughts with us at https://www.linkedin.com/company/p3-healthcare-solutions

 

Health IT, Healthcare, healthcare industry, MACRA, medical billing company, MIPS in healthcare

Switching to Cloud Isn’t Easy for Pharmaceutical Industry

The modern healthcare industry is the amalgamation of technology and medical services. With this growing trend of health IT, data security and privacy have become the main concerns for physicians. Be it, medical billing, MIPS & MACRA, electronic healthcare records (EHRs), digital collection and storage have taken the paramount place.

To take advantage of technology and to support MIPS in healthcare, pharmaceutical companies are interested in going cloud-based. However, they want surety to have a secure transition, which is not as simple as it seems.

The professional mapping of the data flows, frameworks and technology implementation requires amazing efforts. While doing all this, a proactive approach, anticipating the potential threats is compulsory.

What steps should be taken to have a safe cloud-based technology?

  • Take Measures for Security Breaches

Same as physicians have to protect patients’ data, and other sensitive information from hackers in the MIPS program, the pharma industry has to pay attention to security threats.

It is estimated that during the shifting process of the hand-written data to the cloud-based database, many incidents of data breaches will be experienced. Security experts that are well-aware of the data sensitivity and actively take measures against breaches are one of the major hurdles in implementing this migration.

A connected and heterogeneous cloud-based storage system is a complex process. Therefore, not just a secure database is to be designed but also with an efficient backup system.

Security failures can only be prevented when there will be the right personnel with the right expertise for this job.  Therefore, before moving towards cloud-based technology, the pharma industry needs to have a proper execution plan.

  • Be Prepared To Manage Risks

Translating the manual database to a cloud-based database may disturb the entire pharma company. Therefore, the calculation of the internal and external risks is equally important for the effective functioning of cloud-based technology in the pharmaceutical industry.

A reasonable solution is to convert data step-by-step until the whole staff gets comfortable with it. Test the cloud technology implementation and highlight errors that don’t meet the standard. Manage risks and measure return-over-investment.

  • Research about the Implementation Protocols

The Pharma industry will not just face problems regarding the right technology.  In addition, it needs to research all the pros, cons, and the working process of technology implementation. Vulnerabilities come across as major setbacks in an efficient running system. If there will not be a proper channel or sequence of operations to enter, fetch, and share data from the system, what will be the point?

In order to support MIPS in healthcare, which is one of the leading value-based incentive programs, pharma companies need to have a front role in understanding all the implementation details.

The Healthcare industry is already sensitive, and pharma being its part can’t be separated from its rules and obligations. There is a reason that the regulatory authorities highly govern this industry.

SaaS – Software as a Service model is getting popular in the pharma industry. However, there is a need to develop the understanding that the implementation of cloud-based services without seeing the capability of the system will cost more than ever.

Thus, flexibility is required but with the hint of sensibility to predict different case scenarios and the associated cost to check if this is the best-suited solution.

Surely, the pharma industry should move forward with the changing times. Nevertheless, the change should be transitive and be able to generate constructive results while making sure of all the security aspects.

In your opinion, what steps should be taken to ensure the reliable implementation of cloud technology in the pharma industry?

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.

We found a useful link – https://www.medicare.gov/physiciancompare/ – in which patients get to find podiatrists. This link is, in fact, home to providers who currently bill Medicare and participate in the MIPS 2018/19 program.

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.

MIPS in healthcare, MIPS incentives, MIPS reporting, MIPS quality measures, MIPS qualified registries, MIPS submission Methods,

How P3care Handles Medicare MIPS Reporting For Cardiologists

P3Care.com sort things out with the payers and at the same time keep the communication lines open on behalf of the providers. This way the patients receive the best care and the insurance reimbursement workflow keeps on moving.

Everyone is happy.

In addition, P3Care has a strong grip over the Quality Payment Program under MACRA. The Merit-Based Incentive Payment System (MIPS) track reporting mechanism for both the specialty-specific clinicians and the primary-care physicians brings in both incentives and reputational benefits.

What is P3?

The three “Ps” stands for –

  • Providers
  • Patients
  • Payers

P3Care Simplifies MIPS Reporting for Specialists

A merit-Based Incentive Payment System (MIPS) is an integral part of the value-based system. In addition, CMS recognizes P3Care as a MIPS Qualified Registry vendor in back to back years of 2017 and 2018. That makes it a favorable enterprise for physicians who want to choose a registry as their MIPS submission method.

The recognition puts a bigger responsibility on our shoulders in terms of performance and meeting your expectations.

The US healthcare system revolves around a working relationship between providers, patients, payers, and medical billing services. If there are disparities at any level, at any step, there is a high probability of bottlenecks.

The government has set the course for MIPS in healthcare to go the distance and want all the clinicians to accept it. If they fail to comply with MIPS, they must be ready to face financial penalties along with putting their integrity on the line.

Heart specialists or cardiologists choose quality measures, outcome measures (or high-priority measures) from specialty-specific sets and start their journey for incentives through MIPS reporting. We take a few minutes of your time and finalize measures before submitting them to CMS.

Peace of Mind for Cardiologists

What do the cardiologists say?

First, they are ready to participate in the Merit-Based Incentive Payment System (MIPS). They are actually more excited about it than the general physicians. However, more than half of the cardiologists working in the healthcare industry have reported fatigue and higher stress levels due to excessive documentation.

If IT regulations ease up, it may give them ample time to treat patients and rest as well. P3 Healthcare Solutions is here to help you report MIPS in a timely manner. Connect with us at 909-245-8350 to discuss.

CMS Incentivizes Practitioners

The doctors’ job is to treat the patients, but instead, they work 10 to 20 hours a week on paperwork. That is the fact, unfortunately.

The ground reality is that CMS has allocated $20 million on the smooth transition to the Merit-Based Incentive Payment System. All these initiatives are going to improve healthcare down to the grassroots level. It must do so and silence those voices screaming the phrase, ‘Americans not getting the treatments they deserve’.

To make it more difficult for cardiologists, the data coming out of the EHR system is vague and doesn’t help with the diagnosis. Often it is descriptive rather than suggesting crucial care points. P3Care brings a solution to this problem by synchronizing the medical billing service with the practice management system.

Specialty-Specific Demotivating Factor

There are no standards set for specialty-specific clinicians when it comes to MIPS quality measures. Hence, there is no way to compare the scores of specialists. The result is a low MIPS Final Score, and there may be no bonus payments at all. It is derogatory and depressing.

Quality measures outlined by the Qualified Clinical Data Registry (QCDR) reporting mechanism also have a similar story. Generally, many specialists vote in favor of QCDR.

Data Submission for Physicians and Specialists

After the month of March, CMS takes around 6 months to generate detailed results on MIPS reports.

Medicare MIPS reporting on Quality measures through a registry is highly suitable because it helps to identify and list down probable errors in the report. There is no other way to identify any ambiguities because CMS directly publishes the results. We can’t afford to make mistakes. However, at the end of those evaluations, CMS gives time to practitioners to ask for a review if they are not satisfied with the MIPS final score.

MIPS Cost Measures

Cost is an additional category in MIPS 2018. It accounts for 10% of the composite performance score (CPS). As a cardiologist, you don’t need to worry about it, though. CMS directly manage this category according to your billing to Medicare.

P3Care has a plan in place for the cost category so that CMS gives you the highest ratings on it. We are technologically tenable and keep a close eye on news, views, happenings, and information regarding the US healthcare industry.

When you add the inpatient and outpatient costs, the average of which is compared to the national standard set in the specialist category.  That is an overview of how the cost category is calculated. The lower the cost, the better the ratings!

Medicaid Meaningful Use, Medicare and Medicaid Services, MIPS, MIPS Quality Measures, quality payment program

MIPS Quality Measures 2017 Applicable To LTPAC Medicine

The following article looks at CMS MIPS quality measures for LPTAC medicine. However, before we go towards the MIPS quality details, we need to look at the underlying purpose and objectives.

Purpose

CMS (Centers for Medicare and Medicaid Services) is always working on improving the policy to provide better healthcare facilities. Therefore, the new measures are aimed to help improve the overall care delivery and also reward clinicians who are better engaging patients, families, and caregivers.

Here is how CMS looks at MIPS.

“To these ends, and to ensure the Quality Payment Program works for all stakeholders, we further recognize that we must provide ongoing education, support, and technical assistance so that clinicians can understand requirements, use available tools to enhance their practices, and improve quality and progress toward participation in APMs if that is the best choice for their practice.” healthcare facilities

Key Strategic ObjectivesMedicare and Medicaid Services

Let us have a look at the strategic objectives set by CMS.

  • The engagement of patients and the improvement of beneficiary outcomes.
  • To further the clinical experiences that offer flexible yet transparent programs.
  • Ensure meeting of diverse needs of the physician practices typically those with small practices.
  • Further the capabilities of the IT systems that meet various data needs of the end-user including reporting and submission.
  • Work on improving information and data sharing to ensure its timely availability.
  • Enable customized communication while keeping MIPS quality measures specifications into perspective.

Caveats for Individuals and Groups

The new MIPS quality measures take into consideration two LTPAC setting codes. These codes are the basis for the MIPS quality measures specifications. These MIPS quality measures are for application on individuals as well as groups.

Eligibility Criteria

Here are some considerations to undertake.

To qualify for the MIPS incentive payments you need to report on the following.

  • There are 6 measures with at least one of them as an outcome measure relating to poor diabetes control. The new quality measures mark high specialty and ambulatory practices.
  • Each measure’s applicability should be up to 90 days.
  • Around 50 percent of your patients have to qualify for one of those 6 measures.
  • The minimum number acceptable for the incentive payments stands at 20 patients.
  • The health practitioner can only report some measures after a specific diagnosis. Therefore, health clinicians have to be careful when selecting these measures.

Avenues for Submission

You can submit your measures to multiple avenues including EHR, claims, QCDR, and Registry. Registry seems to be the most suitable option for groups that aim to report when using the individual measures.

Why Consider Registry for Submission?

Here are the reasons why you must consider submission via Registry.

  • Since you can submit all 2017 QMs via Registry, you do not rely on any other methods.
  • Claims Reporting for 2017 QMs only supports a subset. Therefore, be careful to see the claims if the Claims Reporting offers support for it or you need to use Registry instead.
  • The group gets a measure of review or control when using Registry before you submit the data. Therefore, it gives a buffer, allowing you to remove any errors that you may find.

Avoiding Penalties is Critical

Make sure to always keep the benchmarks in perspective. By following them you can reduce your chances of getting a penalty. It will also help you satisfy base reporting requirements for MIPS.

Make sure that the data you submit for one patient satisfies that particular measure. If you are able to satisfy all six measures, the data would become a prime example for others to follow. In that case, you may be able to find your data published on CMS’s site for Physician Compare.

How 2017 MIPS Quality Measures Differ?

Previously, there was not much detail available. However, 2017 MIPS by CMS offers detailed benchmarking, relying upon the methodology which involves different performance points.

These individual performance points add to make a total score. Therefore, in 2017, you need to focus on performance as it is a critical year for it. Physicians should know the way they are graded to their performance, comparing it with the past year. It is vital to carefully select QMs which would help you score above-average performance.

Here is how CMS elaborates on this concept.

“By developing a program that is flexible instead of one-size-fits-all, we’re trying to meet clinicians where they are so that they can make the choice about how to participate in a way that is best for them, their practice, and their patients. Reducing burden, ensuring flexible program design, and improving how we measure cost and quality performance supports clinicians in doing what they do best – making their patients healthy.”

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MIPS 2017 – THE P3CARE WAY

MIPS Consulting Services

At P3Care, we understand the importance of participating in MIPS and achieving positive outcome goals. We go the extra mile, to ensure we are there to assist you every step of the way, no matter how big or small your practice is! From determining eligibility to explaining MIPS core requirements, to providing progress reports, we are committed to eliminate the stress associated with performance data and allow you to focus on providing high-quality care to patients.

P3Care’s analysts and consultants are trained and have comprehensive experience with Medicare Quality Care Programs. Our professional team of MIPS consultants will closely work with you to determine which quality measures are best suited for your practice.

In addition, we will apply all applicable codes to claims, provide you with monthly analysis and feedback reports, submit your performance data to Medicare by appropriate deadlines, and provide you with the best solutions to gain a positive or neutral payment adjustment. There is still time to avoid a negative payment adjustment for the transition year 2017.

Contact P3 today to find out how!

P3Care Tips on MIPS

  • Selecting measures that are the most applicable to your practice plays a key role in earning positive or neutral payment adjustments.
  • P3Care will go out of its way to make sure you earn full potential points in all the categories, along with bonus points!
  • Submit at least one quality measure or improvement activity, to avoid a potential -4% payment adjustment.
  • P3Care helps you in the distribution of work connected with the demonstration, making sure you have maximum time for patients. If you ignored quality reporting in the past due to workload, P3 is the place for you!

News

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 the 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.