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P3Care and Trump Administration Encourage Practices to Reopen

America should adopt smarter ways to counter COVID-19 as it reopens for patients and clinicians. In the meanwhile, CMS has come up with a guide for patients and beneficiaries as they decide to visit providers for in-person care.

As a result of the surge in COVID-19 patients, many providers were left with no option except to restrict care at their facility. They had to do that for the essential treatment of COVID-19 patients.

However, with a much-improved situation now, the government encourages private practices and clinics to resume their normal operations. They are to continue with their postponed non-emergency treatments and carry out in-person patient visits as we speak.

The patient guide ensures the safe reopening of healthcare facilities with patients receiving the much needed in-person care. National public health emergency took over, causing this delay in normal appointments, procedures, and treatments.

We can’t thank President Trump enough for his vision, the expansion of telehealth, to be specific, in a very short time. In this way, all this time when America was closed, patients were able to talk to their clinicians from the safety of their homes.

Ms. Seema Verma, Administrator of CMS, reinforces the vitality of in-person care and refers to it as a gold level of care. Such steps by the government are in favor of patients who have long been waiting at homes for procedures, vaccinations, operations, and evaluation of chronic conditions.

She further explained healthcare is the right of every American and our healthcare heroes are working day in and day out to deliver it safely. We should all feel confident when going for in-person care recommended by our providers.

On April 19, CMS issued the first part of recommendations to safely start in-person care activity in areas with a low occurrence or relatively low and constant number of COVID-19 cases. Hence, we move ahead with another set of recommendations.

CMS leaves no stone unturned when it comes to patient and clinician safety as healthcare systems, practices and clinics further enhance in-person care standards. Recommendations include a list of topics to ensure safety regulations are in place for patients and providers including facility measures; testing and sanitation levels; personal protective equipment and stock of supplies; and workforce presence.

The easy access to healthcare for everyone can be restricted to some extent. However, this decision can’t be prolonged due to financial discrepancies.

During the COVID-19 epidemic, healthcare professionals have lost a major amount of revenue as the resources were redirected towards the pandemic response. Now as the Trump administration is asking to bring normalcy in the economy under strict SOPs, we can expect a gradual balance between expenses and revenue.

As it was with part 1 of recommendations, decisions to reopen should be in line with federal, state, and local rules, CDC’s guidance, and association with the state and local public health authorities.

As the country continues to move on the path of reopening, patients have concerns about when to check-in with their providers for in-person visits.

CMS also acts as a guide with empathy for patients to make the right decisions as they prepare to meet their providers in person. Ultimately, it is in their best interest to follow the new rules.

Find guidelines for patients for in-person visits in English here: https://cms.gov/files/document/covid-what-patients-should-know-about-seeking-health-care.pdf and in Spanish here: https://www.cms.gov/files/document/covid-what-patients-should-know-about-seeking-health-care-spanish.pdf

To read one of the previous updates, go here – P3 investigates: Trump Administration plans to reopen nursing homes

To read about the work of the White House Coronavirus Task Force reaction to COVID-19, go to www.coronavirus.gov. For specific information about CMS, keep reading our blog updates.

Medicare MIPS Reporting Essentials for Physical Therapists

Physical therapists (PTs) are now a breathing part of the Quality Payment Program (QPP). It is a choice they have to make because they can’t back out. Medicare MIPS reporting through a MIPS Qualified Registry or an EHR system can get them through the maze of value-based care smoothly.

Primarily, they have an option to choose between the Merit-Based Incentive Payment System and an Advanced APM. Though AAPMs have a strong influence over clinicians, the popularity of MIPS as an incentive program considerably outweighs it. Therefore, MIPS is the go-to program for most eligible PTs.

Now, PTs who do not meet the low-volume threshold (LVT) can participate voluntarily.

Why?

They must be prepared for what lies ahead and no better way to do it than participating in it.

Medicare MIPS Reporting for Quality and IAs

The good news for PTs is that they are NOT required to report in all the four performance categories. Instead, they are required to report in only two – Quality and Improvement Activities.

Fewer categories mean they have a decreased number of measures to report to CMS. With all the focus on MIPS Quality measures and IA measures, they are more than capable to score high and handsome. It also keeps them very much in the game without the possibility of burnout.

A yearlong report against Quality determines the final score, failing to do so; there are consequences in the form of negative payment adjustments.

Medicare MIPS reporting best happens through certified electronic health record technology (CEHRT) or MIPS Qualified registries such as P3 Healthcare Solutions. Please follow us for effective MIPS solutions on LinkedIn – https://www.linkedin.com/company/p3-healthcare-solutions

Advanced APM Participation Track

Physical therapists who follow Advanced APM as their participation track cannot go after Medicare MIPS reporting. At one time they can only utilize one track.

They can expect an additional reward of +5% to your Medicare earnings of 2019 if the reporting results are at par with the benchmarks set against measures. Additionally, the high scorers have a chance to collect bonus rewards from the $500 million pool.

While PTs become an active part of the value-based payment system, the removal of functional limitation reporting (FLR) is a healthy change adopted by CMS.

P3Care Reports for PTs and PTAs

The submission of MIPS data is unlike any other data submission. It requires your NPI/TIN and account creation on the QPP portal. Health IT consultants at P3Care activate your accounts with ease and with mutual collaboration, we get to report to CMS on behalf of our clients. In short, accuracy is the key to it. They happen only once so make sure they are errorless.

What about Telehealth?

The final rule doesn’t allow PTs to be reimbursed against Telehealth. The virtual check-ins by physicians and specialty-specific clinicians call for timely reimbursements; moreover, P3Care backs the initiative of Telehealth for PTs and PTAs. Who knew the year 2020 would make Telehealth a necessity rather than an alternative.

Direct Submission Method

PTs can use the registry method for direct submission. For it to happen smoothly, MIPS Clinical Quality measures (CQMs) has to be the collection type. Medicare MIPS reporting 2019 returns optimum results if you are both accurate and smart in terms of selecting high scoring measures.

Generally, outcome measures and high-priority measures hold significance in achieving bonus-worthy scores. They, eventually, turn into financial rewards.

For small practices, individual clinicians and clinician groups can collect and submit measures for Quality through Medicare Part B claims.

Groups with 25 or more clinicians may use the CMS web interface for Medicare MIPS reporting.

Deadline for the QPP 2019 Program

MIPS eligible clinicians have time until March 31, 2020, to submit data for 2019. In addition, if your mode of submission is through claims, you have until 60 days after the closing of the performance year.

Improvement Activities (IA)

For PTs and OTs, the category holds 15% weight in the total score. It estimates 40 points and only the top-performing clinicians will be able to reach that number. The improvement activities you should consider reporting to CMS are –

  • Care Coordination
  • Patient safety
  • Beneficiary engagement
  • Participation in APM
  • Achieving health equity
  • Emergency preparedness and response
  • Population management

However, take note of the number and format to report in by the following classifications.

  • Two high-weighted measures
  • One high-weighted measure and one medium-weighted measure
  • Four or more medium-weighted measures

After the selection of activities to submit, you are ready for Medicare MIPS reporting through QCDR, Qualified Registry, or an EHR system. For those interested in the MIPS attestation process on their own, they can submit activities by logging on to the QPP portal.

Do you think you can gather data and report on your own or is it better to hire third-party intermediaries?

Reply in the comments below, as we’d love to hear your thoughts.