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MIPS 2020, MIPS 2020 reporting, MIPS solutions, MIPS Qualified Registry

4 Things to Consider before Adopting Health IT Innovation

With MIPS 2020 just around the corner, eligible clinicians are ready to submit quality data to CMS in order to improve their financial situation.

We all are rooting for quality healthcare services, and technology incorporation is an efficient way to achieve this goal. For the same reason, MIPS eligible clinicians from all specialties are adopting health IT.

Benefits of Health IT

Technology is in the best interests of the healthcare industry. Undeniably, the digital transformation where improves the care delivery system, it also helps in MIPS 2020 reporting.

Time efficiency of providing healthcare has improved.

The administrative load has been reduced.

The communication gap has gotten better between stakeholders.

The numerous benefits do not end here. The list goes on and on, varying in advantages to different specialties. The trend of technology in healthcare has just started, and with years to come, we can expect more advancement in this sector benefiting MIPS solutions.

How to Make Most of Health IT?

The incorporation of health IT is only going to increase in the future even in small medical practices. A month ago, the Harvard Business Review mentioned some interesting tips before embracing health IT innovation.

If you’ll be able to adopt these methods, you can optimize operations in the best way possible and empower every stakeholder from patient to healthcare service provider.

Let’s get through.

Build Healthcare System around Patient Satisfaction

Every medical practice should have a system that adds value to the patient satisfaction level. Moreover, the MIPS performance category, Improvement Activities (IA) also rewards points for quality patient experience.

For Instance,

Giving easy access to patients allows them to participate in improving quality, which ultimately maximizes the QPP MIPS score.

Therefore, adopt any technology that is efficient and safe to use by patients.

Hire Specialty-Specific Resources

The success of any medical practice lies in a diverse expert team dedicated to each task.  For Instance, if you need to submit MIPS 2020 data to CMS, the best option is to consult a MIPS Qualified Registry that is dedicated to this task.

They know how to handle the administrative load, and they process information quite well. Thus, there is a lesser chance to mess up when you go for MIPS data submission via professionals.

The same goes for other tasks. If you have different experts for all operations, their outcome will be optimized.

Incorporate Technology that Benefits Your Practice

Just because many adopt a technology, it does not guarantee that it will bear the same results for you as well. While moving towards health IT, we should be clear about how it will work for us.

For Instance, you adopt EHR (Electronic Healthcare Records) but do not have the resources to use it efficiently, it will only add to your expense.

The idea behind promoting interoperability as specified in QPP MIPS 2020 is to use technology to simplify the operations and to reduce burnout.  If you still cannot achieve results as desired, there is no point in investing in certain technology just for the sake of it.

Intend for User-Friendly Systems

Another factor to promote technology at every level is to adopt user-friendly systems. The more user-friendly interaction is between the machine and the user, the more beneficial it is for the medical practice.

Conclusion

These are just a few tips that can help you adopt technology in the most useful way. By keeping these factors in mind, healthcare service providers can establish health IT infrastructure across their organization and promote efficiency and productivity as per their requirements.

The ultimate benefit will be in terms of financial stability via MIPS 2020 data submission, improved healthcare quality, and the overall progressive healthcare system.

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

MACRA MIPS – What it Means for Physicians?

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

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

Key Elements of QPP MIPS

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

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

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

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

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

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

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

MIPS Full Form in Healthcare

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

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

What Physicians Can Get from MIPS Reporting?

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

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

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

Should Physicians Report Data Despite Corona Pandemic?

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

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

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

How to Report MIPS Data?

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

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

We Are in the Middle of MIPS 2021 Performance Year!

Now, it’s almost halfway down to the QPP MIPS 2021 performance year, which means we should be getting ready to strategize our reporting process.

Like every year, we know reporting requirements change, and only with the help of MIPS consultants, we can efficiently target incentives and bonuses. You do not have to report the Cost category, which CMS measures based on the claim submissions. However, to maximize points in the other categories, Quality, Promoting Interoperability, and Improvement Activities, eligible clinicians must be ready to implement the profitable strategies.

It is an opportunity to improve revenue cycle management, so further delays can dent the financial matters in 2023.

Conclusion

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

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

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 they may use all the available methods to treat their patients, including drugs and surgery, DOs believe in a more holistic approach. By definition, DOs emphasize preventive medicine, musculoskeletal health, and holistic care. It doesn’t mean MDs are any less skilled or vice versa. Both are equally capable.

The Expertise of Both Specialists

Both specialists, MDs and DOs, can choose to practice in any specialty. Both lend their expertise to promote the quality of healthcare to patients translating CMS MIPS quality measures.

AMA (American Medical Association) studied that in 2018, up to 57% of more DOs preferred to practice in primary care compared to 32% of the MDs.

The total statistics for DOs participation in primary care were:

  • 9% went for family physicians
  • 8% went for internists
  • 8% went for pediatricians

However, both programs offer a license, thus, it does not matter what program a student pursues.

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 the 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 the ophthalmology specialty.

  1. Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

As the title clearly says, the measure goes against the menace of diabetes and its effect on the eyes. Value-based care becomes viable to bring back quality into healthcare, and at the same time dial-down, healthcare costs.

The measure specifications for clinicians help in its understanding. Our research concluded this measure to be part of the MIPS Quality measures list released officially by CMS.

Essentially, MIPS 2020 covers the continuing process of our healthcare, moving in the right direction. Let us see what the measure means:

“Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months.”

Willing to go after MIPS data submission for this measure? It is most likely to score high if reported accurately. That is where P3 comes in to report to CMS on your behalf. The basics of this measure put it amongst the CQMs and eCQMs. Moreover, it is a high priority measure applicable to the ophthalmology specialty.

  1. Communication with the Physician or Other Clinician Managing On-Going Care Post-Fracture for Men and Women Aged 50 Years and Older

It is a measure that directly informs of the health of our seniors as far as their fractures and overall health is concerned. The meaningful area under discussion here is the Health Information Exchange (HIE) and Promoting Interoperability.

What does the measure exactly mean?

According to CMS, it derives the following explanation:

“Percentage of patients aged 50 years and older treated for a fracture with documentation of communication, between the physician treating the fracture and the physician or other clinician managing the patient’s on-going care, that a fracture occurred and that the patient was or should be considered for osteoporosis treatment or testing.”

It is submitted by the physician who treats the fracture and who therefore is held accountable for the communication. A high priority measure, to begin with, you can use Medicare Part B Claims and MIPS CQMs as its collection types.

As an EC, if you are part of the following specialties, you can choose to report this measure.
• Family medicine
• Internal medicine
• Orthopedic surgery
• Preventive medicine
• Rheumatology

  1.   Advance Care Plan

The Advance Care Plan deals with many branches of healthcare, including Cardiology, Family Medicine, Gastroenterology, General Surgery, Neurology, Obstetrics/Gynecology, and more.

How Do We Describe this MIPS Quality Measure?

MIPS in healthcare defines this measure by the percentage of the patients aged 65 years or older with an Advance Care Plan. This measure is also valid for those patients who document another decision-maker on their behalf as a surrogate on authentic medical records.

Another situation is when the medical records show that the Advance Care Plan was discussed with the patient, but they could not provide a surrogate neither they wished to.

MIPS 2020 Reporting Instruction for Advance Care Plan

MIPS eligible clinicians can submit this quality measure for just one patient seen throughout the performance period. There is no specific diagnosis attached to this MIPS Quality Measure. However, the MIPS Qualified Registry on behalf of physicians can submit data for the quality services provided to the patient based on the measure-specific denominator coding.

It is to note that that this measure applies to all healthcare settings, be it nursing home, etc., except for emergencies.

Measure Submission Type

Individual clinicians, groups, and third-party intermediaries such as a MIPS Qualified Registry submit the related data to CMS. However, only those third-party intermediaries can submit data, which used Medicare Part B claims.

Conclusion

Thus, paying special attention to the MIPS quality measures can maximize the chance to earn positive adjustments and even incentives.

It all depends on the CMS MIPS quality measures that you submit to CMS. Therefore, MDs and DOs, take time to strategize MIPS solutions properly and improve your financial situation.