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MIPS 2020, MIPS 2019, MIPS Medicare, Mips submission methods, MIPS submission types, Mips qualified registry, Qualified registry for mips, Cms mips quality measures, MIPS consultants, Mips consulting service, medical billing services, health IT

MIPS Quality Measures 2019 Vs. 2020 – Registry Investigates

Merit-based Incentive Payment System (MIPS) has entered 2020, and, so have the Quality, Promoting Interoperability (PI), Improvement Activities (IAs), and Cost categories. It is a no-brainer to write a thoughtful comparison between the two years regarding MIPS quality measures.

Hence, we are here to discuss the Quality category in detail; the six measures adding up to the final score; any new requirements; and why P3 Healthcare Solutions is a smart choice to report registry-specific measures.

It’s not about the passing years that we have managed to make it to the next year of value-based care, but the essence of MIPS in Medicare lies in its delivery. Each year calls upon MIPS eligible clinicians to adopt a certain set of measures and activities and report them to the Centers for Medicare & Medicaid Services (CMS). 2020 is no different as long as you are on the right track of submission.

The reporting occurs through legitimate submission methods only, the result of which conforms to performance evaluation and incentive payments.

 MIPS Quality Measures 2019 and 2020 – The Types

I have to admit there are more similarities than differences between the two, because, for starters, they have the same collection (measure) types.

In MIPS 2019 and MIPS 2020, participants get to submit 6 quality measures data for 12 months (from January 1 to December 31, 2019, and January 1 to December 31, 2020, respectively). The amount of data to undergo submission depends on the collection (measure) type.

CMS finalized 6 collection types for both 2019 and 2020 CMS MIPS Quality measures. These measure types include:

  • Electronic Clinical Quality Measures (eCQMs)
  • MIPS Clinical Quality Measures (CQMs)
  • Qualified Clinical Data Registry (QCDR) measures
  • CMS web interface
  • Medicare Part B claims measures, and
  • The CAHPS for MIPS survey

As a rule, participants must submit a total of six quality measures from the above types.

General Reporting Requirements Vary

If you talk about 2019, the data completeness factor was 60%, i.e. clinicians were to report performance data for 60% of their patients eligible for a chosen measure. For MIPS 2020, clinicians are required to report data for 70% of their patients eligible for a certain measure. It is 10% more than the last year which means CMS plans to cover a wider population of patients and bring them into the fold of value-based care.

 MIPS Submission Types

In the case of MIPS submission types, there are 4 ways to submit quality measures. These include:

  • Medicare Part B claims
  • Sign in and upload (a MIPS consulting service can report on your behalf)
  • CMS web interface
  • API submission which is the direct method of submission

Six Measures

A total of six quality measures was the requirement back in 2019, and in 2020, it hasn’t changed much. We have a total of six MIPS quality measures in 2020 as well. It includes one outcome measure, but in case, the outcome measure is absent, go for a high-priority measure instead.

Practices, groups, and virtual groups with 16 or more clinicians will be automatically calculated on a 7th measure, the All-Cause Hospital Readmission Measure.

The Curious Case of Bonus Points

Bonus points sound charming enough to know more about their details. Therefore, we will try to find out how to make those bonus points ours and maximize our rewards in 2021 and 2022.

For MIPS Quality measures 2019 and 2020, you can earn bonus points on the following terms.

  • Submit 2 or more outcomes or high-priority measures. It doesn’t apply to the outcome measure or high-priority measure that is already there, but two separate measures are required to get your hands on bonuses. P3, as a MIPS consulting service, reports Quality measures for its clients across the US. Opioid-related measures are part of the high-priority measures list.
  • In MIPS 2020, measures that are part of the CMS web interface don’t qualify for bonuses, but if you report the CAHPS for MIPS along with the CMS web interface, you have a chance to win bonuses.
  • Submission using Certified Electronic Health Record Technology (CEHRT)
  • Besides, six additional points are there for small practices that submit at least one quality measure. Practices include individuals, groups, and virtual groups.
  • 10 additional points for practices that exhibit improvement in their Quality reporting from the previous year.

Conclusion

Before I end this article, I want you to stay illuminated by the present and the future requirements of reporting as long as you have us on your side. P3 Healthcare Solutions prides itself on reporting MIPS for clinicians across the United States. To get in touch, please call 1-844-557-3227.

We have a comprehensive piece written on MIPS 2020 on our LinkedIn page. If you have some questions related to it, you may go through it when you have some time. Here’s the link to it: Getting to know the changes in MIPS 2020 ahead of time.

MIPS Qualified Registry, Qualified Clinical Data Registry, MIPS, QPP, QCDRs, CMS, MIPS 2019 reporting process, MIPS submission methods

MIPS Qualified Registry VS Qualified Clinical Data Registry

There are not many agencies in the US healthcare system that earns the status of MIPS qualified registry. Each of the seven MIPS submission methods has its own advantages, and eligible clinicians can choose to submit data via anyone.

However, healthcare organizations or physicians often confuse MIPS qualified registry and Qualified Clinical Data Registry (QCDR). Particularly, physicians who don’t have much knowledge about the MIPS 2019 reporting process and mechanism, find it difficult to decide the submission strategy.

P3Care being the MIPS qualified registry for three years now has the expertise and knowledge to know how things work with different submissions methods.

Here’s a quick overview of the two most confusing terms in the MIPS QPP.

A MIPS registry reports clinical data on behalf of eligible clinicians or healthcare organizations.

While QCDR is a CMS-approved entity that collects clinical data for CMS on physicians’ behalf. This entity is generally not managed by an individual. It also differs from the former submission method, as it is not restricted to certain measures for data submission.

The qualified clinical data registry is also allowed to host non-MIPS measures, which are approved by CMS.

The categories for QCDR reporting measures are as follows:

  • National Quality Forum (NQF) endorsed measures
  • Current 2019 MIPS measures
  • Measures in regional quality collaborations
  • Other measures approved by CMS
  • Measures used by boards or specialty societies
  • Clinician and group consumer assessment of healthcare providers and systems (CAHPS), measures reported by CAHPS certified vendor
  • National specialty societies administer or endorse registries/ QCDRs

Reporting Mechanisms

Depending upon the reporting type and category, physicians can submit data via any mechanism.

Either as a group, individual, or virtual group, there are four performance categories to report on, Quality, Improvement Activities (IA), Promoting Interoperability (PI), and Cost.

For the cost category, you specifically don’t need to submit data, but CMS will use administrative claims data.

Both submission methods, qualified registries for MIPS and QCDRs can report for a total of six measures and all-cause readmission measures for groups of sixteen or more.

Which Method to Choose?

Either whatever method you choose to report, the decision should not be supported by the number of available measures. Instead, it should be well thought of to score high in the final score of MIPS in healthcare.

Think of the following points before finalizing the submission method.

  • If measures are related to your practice
  • The benchmark for available measures for each submission method
  • Performance rate achievable for selected measures
  • If there are bonus points available for the selected measures
  • Information about which measures are topped out

A correct decision can make all the difference. The path to get incentives and bonuses leads to improved revenue cycle management.

Medical practices when improving the quality of healthcare services move towards progression, and MIPS QPP is a way to measure and judge the performance of how far we have come across.

Either you report via a MIPS qualified registry or any other method, the thing is to clear mind, put forward pros and cons, and then strategize to report clinical data to MIPS via the most suitable method.

MIPS data submission, MIPS quality measures, MIPS submission method, MIPS qualified registry, quality measures

Right MIPS Submission Methods Lead To Successful MIPS Reporting!

MIPS – a quality payment program for physicians is one of a kind and progressive step that benefits both, physicians and even the patients. The prior tangled and twisted reimbursement method failed to contribute to the healthcare industry via any advancement. Thus, MIPS came as light at the end of the tunnel for physicians to direct their financial matters in the right direction.

Reporting accurate data, according to the medical practice and with the appropriate submission method is inevitable to score high in the MIPS scorecard. The period for submitting MIPS qualified measures is already short so there is no time to waste.

This article discusses all the queries regarding MIPS submission methods so that physicians successfully report clinical data to CMS.

First, Do Your Research Well!

The first step in MIPS reporting is to recognize what submission method will suit your practice, the best. The right decision will have a huge impact on your submission. Otherwise, you’ll end up scratching your head for unnecessary delays caused by poor research, as many factors are important for a professional MIPS submission.
In addition, MIPS data submission seems easy. However, it is not as simple as one may estimate. Let us briefly explain the MIPS reporting process.

How to Report MIPS?

Physicians work day and night treating patients to deliver quality-based medical services. MIPS eligible clinicians report their performance data on a yearly basis to CMS. There are four performance categories for MIPS:
• Quality holds 50% of the total MIPS score
• Promoting Interoperability (PI) holds 25% of the total MIPS score
• Improvement Activities (IA) holds 15% of the MIPS score
• Cost holds 10% of the total MIPS score

As per the CMS submission requirements, physicians report against three categories. However, the CMS authorities themselves measure the cost category. They calculate performance for this category by administrative claims data.

Now, Choose Between MIPS Submission Methods!

Clinicians can choose from a number of submission methods as per their requirement,
• CMS Web Interface
• Administrative Claims
• Electronic Healthcare Records (EHRs)
• Qualified Clinical Data Registries (QCDR)
• Qualified Registry
• CAHPS for MIPS Reporting Survey Vendor
• Attestation

Another factor that plays an important role in the successful MIPS data submission is finding the right and specialty-specific MIPS quality measures to report.

Physicians can consult MIPS qualified registries, which help them choose the measures relevant to their practice. Reporting data against the relevant measures gives the chance to score high.

How to Report MIPS Data?

Physicians have the freedom to report either as an individual or in a group.

As an individual identified by individual National Provider Identifier (NPI) with a single Taxpayer Identification Number (TIN)

In a group of two or clinicians with a single TIN, identified by NPI

There is also another option to report via a virtual group.

Consider the Following Points When Choose a Submission Method!

  • While considering what submission methods will result in your favor cost-effectively, you also need to ponder upon their limitations.
  • Clinicians are only allowed to report data via a single submission method for a single performance category.

Look out for all possible scenarios that can occur with the submission method. As each MIPS submission method has its benefits and limits as per the medical practice. Therefore, carefully check all the logistics and your organizational structure before submitting data. It may leverage your performance score for positive or negative payment adjustment.

Not only deciding the right submission method is time-consuming, but it also requires thoughtful planning, resourceful implementation, and the ability to incorporate progressive steps of your organization.

All this Process is Hectic but you can Stay Stress-Free with P3Care!

Physicians may be worried about how they’ll manage to choose the right MIPS submission method along with their responsibilities. Don’t worry and let us share your MIPS reporting burden. P3Care has been MIPS qualified registry for two years. Our specialized methods, resources, and experience in this field speak for itself. Moreover, we as an H I.T consultants help to choose you the right quality measures and the submission method.

For further information, visit https://www.linkedin.com/company/p3-healthcare-solutions