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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?

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QPP MIPS 2021, MIPS Qualified Registry, MIPS Quality measures, MIPS incentives, MIPS consultants

Get up to 5% Incentives from CMS as Payment Adjustments in 2023

QPP MIPS 2021 is a chance to target up to 5% Medicare payment incentives. So, if you want your medical practices to be financially strong, here is an opportunity to leverage.

Do you know CMS (Centers for Medicare and Medicaid Services) updates performance categories every year? Starting from the Quality category that was 45% of the total MIPS score in the previous year is now set at 40%. The Promoting Interoperability (PI) category is set at 25%, Improvement Activities (IA) at 15%, and Cost category is set at 20%.

It is a Chance to Improve RCM!

Especially amidst the peak pandemic hours, the healthcare industry has suffered significantly. There were lesser resources and more patients. All thanks to the healthcare workers, they have managed everything quite impressively.

Where we are commending the roles of healthcare workers, we should also realize that medical practices have suffered on the financial front. They delivered more than their capacity and actually incurred the loss.

So, when there is an opportunity to compensate for the losses, why not utilize it!

P3Care, being the MIPS Qualified Registry, for five years now, has been helping eligible clinicians to report specialty-specific MIPS Quality measures to CMS. The outcomes for our physicians have been quite fruitful.

Not only they managed to avoid a penalty but also targeted MIPS incentives respectively. You can also be a part of the list whose name comes in a good light in the Physicians Portal.

Stakes Are High with MIPS 2021

Yes! The stakes are quite high with QPP MIPS reporting 2021. The reporting requirements have changed. Some quality measures got topped out, while some are the new additions to the list. No doubt, there is a lot of administrative load on eligible clinicians that need laser-focused attention. Otherwise, there will be no point in catering to this incentive payment program with below-average performance.

MIPS consultants allow you to cater to all such worries with their experience and latest resources. So the final verdict is if you want to receive up to 5% incentives as payment adjustments in 2023, it is time to plan and implement successful strategies.