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MIPS Quality Measures 2020, MIPS incentives, MIPS Quality measures, MIPS data submission, MIPS quality reporting, submit mips data, MIPS registry, healthcare Solutions, MIPS 2020, MIPS consulting firm, MIPS consultant, MIPS data via clinical quality measures, MIPS solutions, MIPS CQM

MIPS Quality Measures 2020 and Specifications for MDs and DOs

Am I eligible for MIPS incentives in 2022?

The question that we hear a lot. And, I have to say it is your right to know.

Whether you are a general physician or a surgeon, submission of MIPS Quality measures leads the way to incentives.

Why?

The government started MIPS back in 2017 to incentivize eligible clinicians, and in return, improve the quality of healthcare. In short, it ensures ECs submit measures for the good of their patients – they will have permanent access to quality care.

The purpose here is to write down a MIPS Quality measures list that includes at least some measures and leave the rest to update in the future. Therefore, you’ll see some of them if not all; we’ll keep updating it, hopefully.

I also hope to provide info not only for family and general physicians but for specialists too. In an ideal system, the MDs, and DOs work in rhythmic harmony for better care coordination and patient experience.

Difference between an MD and a DO

For those of us who don’t know what an MD is, it is short for Medical Doctor, while DO stands for Doctor of Osteopathic Medicine.

Although both of them may use all the available methods to treat their patients, including drugs and surgery, DOs believe in a more holistic approach. DOs emphasize preventive medicine, musculoskeletal health, and holistic care. It doesn’t mean MDs are any less skilled or something like that. Both are equally capable.

Define the Quality Performance Category

One of the categories of the Merit-based Incentive Payment System (MIPS) is the Quality performance category! It holds a 45% weight in the total score.

What does it account for?

It measures your performance in clinical activities and patient outcomes. MIPS data submission through Quality measures helps assess health care processes, manage results, and patient experiences. As a result, we can expect the highest quality of care while keeping expenses to a minimum. Hence, the achievement of the value-based care purpose.

Understanding CMS MIPS Quality Measures

  1. Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) 

Diabetes, a menace, to say the least, shadows quite a part of the US population. How can we put a lid on it? Well, the answer lies in value-based care. More importantly, it is MIPS quality reporting that will eventually decrease the number of diabetics across the country.

This particular measure says to submit data on your patients from the age of 18-75 with diabetes who had hemoglobin A1c > 9.0% during the measurement period.

A CMS eCQM is available for this outcome measure. The collection types for this measure include:

  • Medicare Part B Claims
  • eCQM (electronic-clinical quality measure)
  • CMS Web Interface
  • MIPS CQM (clinical quality measure)

Since one of the collection types of this measure is MIPS CQM, you can submit it through a registry. It is one of the most effective of all the MIPS data submission methods thus far.

You can submit it if you are part of the following areas, provided you fulfill the low-volume threshold for MIPS:

  • Family medicine
  • Internal medicine
  • Preventive medicine
  • Nephrology
  • Endocrinology
  • Nutrition/dietician
  1. Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

Measure number 2 is related to the heart. American Academy of Cardiologists

It includes people aged 18 and above who were diagnosed with heart failure (HF) with a present or past left ventricular ejection fraction (LVEF) < 40% and were prescribed beta-blocker therapy either within a year of procedure in an outpatient setting or at each hospital discharge.

Reporting MIPS through this measure sets the tone for the management of chronic conditions. Gladly, it is available in both eCQM and CQM type, thus acceptable through various sources.

Specialties for which this measure is suitable to include:

  • Cardiology
  • Family medicine
  • Internal medicine
  • Hospitalists
  • Skilled nursing facility
  1. Anti-Depressant Medication Management

Psychiatrists act as pillars of healthcare when it comes to mental health treatment. Especially, their role is critical through the COVID-19 pandemic. Could there be a worse time for mental health issues to rise? Well, it could be worse!

Being grateful and using empathy as a tool to interact with people around us is needed for sure. The description of this measure that we have with us is mostly for eligible psychiatrists. MIPS 2020 presents numerous measures to report with accuracy and data integrity as the two requirements.

It is quality measure #9, according to the official fact sheet released by CMS.

How do we describe it?

It aims to find a percentage of people aged 18 years and above who were treated for mental illness and prescribed antidepressants. As per their depression symptoms, they have prescribed medication for months. You should report the following two types:

  1. First, the percentage of patients who were on antidepressants for at least 84 days (12 weeks)
  2. Second, the percentage of patients who were on antidepressants for at least 180 days (6 months)

Why is this measure meaningful?

It is in line with the prevention and treatment of opioid and substance use disorders. A MIPS consulting firm helps you select the right measures to report. More importantly, it is the accuracy and data completeness that matters to maximize MIPS incentives.

The collection type available for this measure is eCQM. Moreover, the specialties that this measure services include:

  • Family medicine
  • Internal medicine
  • Mental/behavioral health
  1. Age-Related Macular Degeneration (AMD): Dilated Macular Examination

Eyes let us see the beauty around us, thankfully. They show us the world as it is. In this quality measure, people aged 50 years and above are to participate. As an EC, you are to report it once they are diagnosed with age-related macular degeneration (AMD), followed by a dilated macular examination.

Further, it led to the recording of the presence or absence of macular thickening or geographic atrophy or hemorrhage and intensity of the damage caused during one or more office visits within the 12-month assessment period.

Henceforth, this measure assesses the chronic conditions management area. Ophthalmologists are to report it through their MIPS consultant. MIPS solutions and to send MIPS data via clinical quality measures type is doable with plenty of support from qualified registries.

The collection type for this measure includes:

  • Medicare Part B Claims
  • MIPS CQM

In fact, it is only available for ophthalmology specialty.

QPP MIPS, MIPS Quality measures, MIPS reporting services, healthcare industry

How Can Physicians Increase Patient Referrals?

Survival in the healthcare industry is getting tough day by day. The cost factor to provide value-based healthcare services is doing well in patients’ favor, but it’s also been a burden for physicians. While MIPS reporting services, MIPS Quality Measures are the parameters to show progress in terms of interoperability, cost, quality, and improvement activities.

Other than making efforts to earn incentives and bonuses and to remain protected from penalties, MIPS has been a great help. But, first physicians have to meet the criteria of checking 200 patients and bill more than $90,000 for Part B covered services.

Why Referrals are Important?

Referrals are an excellent way to keep up with the high number of patients. Word of mouth from fellow physicians and patients also helps to maintain goodwill in the industry.

It helps to grow the practice and improves the worth of your services rapidly.

How to Increase Referrals for your Practice?

Here are several suggestions upon which medical practitioners can thrive and get referrals without any problem.

  1. Connect with Fellow Physicians

Find those physicians in the industry with which you can build a give and take relationship.

For Instance, if you can refer a patient for any service to another physician, he should be able to do the same for you for your area of expertise.

  1. Increase Patient’s Engagement Level

Make processes easy and less hectic for patients. Such as a simple or automated way of patient scheduling system automatically improves patients’ engagement.

Another way is to send follow up messages to remind patients about their appointments.

These tactics can help to get referrals from patients.

  1. Have a Friendly Behavior at Work

When someone treats you with kindness, it leaves an impact on you. The same rule works for organic referrals. If a physician treats his patients with a smile, listens to them, and take time to make things easy for them, he is more likely to get referrals.

  1. Be Kind to the Staff Working for You

Nurses, physician assistants (PAs), and others spend a major deal of effort and time for the well-being of patients.

Spend time with them, and make small talk to release work stress. In this way, your behavior and kindness will reflect across the board. Not only it does improve your performance but also makes an ideal working environment.

Additionally, it helps to know your staff’s relationships with others in healthcare. Through them comes the goodness for a practice. In fact, physicians can definitely deduce better results from this strategy.

  1. Embrace Technological Innovations

Adopting technology gives points for Improvement Activities (IA) in QPP MIPS. This way you get the reputation of a progressive medical practice and achieve higher MIPS points for incentives.

Medical practitioners can use the following things:

  • Make their own app if possible
  • Create a user-friendly website for their services
  • Figure a way to make the appointment scheduling process easy and automated
  • Use technology to offer support to staff and patients alike
  1. Be Informative & Unique with your Website

The website is the first portal to reach patients. Patients search online about what services they want and what doctor they need.

If you have all the information on your website, it’s easy to get referrals from others against your user-friendliness.

  1. Make Referral Process Easy

Another way to increase patient referrals is by making the referral process easy and simple.

Follow-up services after or during the appointment, thus, play a crucial role. It helps you provide quality healthcare to patients, which you can use to submit MIPS quality measures.

Moreover, if the patient has any problem giving a referral, it is easier for them to seek help from you.

Medical practices can handover a referral form during the treatment, stating the demographics, reason for referral, and other important information. It is indeed an added step for front desk staff or medical billing services can help cater to this process. The response will be quicker. But, in the long run, it will value your referral sheet.

Given above are just a few ideas to improve physicians’ worth in the industry and getting referrals. More referrals mean more patients and ultimately reimbursements and incentives to straighten up revenue cycle management.

So, get started now.