WHAT IS ABOUT MIPS THAT IS MAKING PHYSICIANS UNHAPPY?

This ongoing period is the MIPS 2018 reporting season! Physicians and MIPS consulting services have buckled up their shoes to assemble appropriate clinical data that best favors medical practice in terms of financial matters and physicians’ reputation.

MIPS QPP promises physicians to take their financial journey one-step more towards the progressive road leading to a better healthcare system. The eventual objective is to build a healthcare system that makes both patient and physicians happy; patients with value-based care service and physicians with accurate reimbursements, incentives, and bonuses.

From the past two years, physicians tend to have several reservations regarding MIPS. In their first year, they were not sure about reporting criteria and MIPS quality measures. However, for MIPS 2018 reporting period, physicians learned from their mistakes and performed to actually use this system in their benefit.

MIPS Quality Measures Are Huge Set Back for Physicians

Even though, CMS acted upon some reservations for 2018. Still, there are voices raised against MIPS 2018 to trap physicians within penalty cycle that ultimately will lead to poor-quality services for patients.

  • According to the research of members of the American College of Physicians, around 37% of the 86 MIPS quality measures are not up-to-the-mark and can’t contribute to improved quality-care standards.
  • Physicians also explained that the given measures are not meaningful. In addition, the investment made to improve the quality of these measures just increase the administrative cost.

Approximately, medical practices are spending $15.4 billion per year in the USA-healthcare industry that means about $40,000 per physician to report for MIPS.

There is a debate that whether MIPS quality measures for the industry’s improvement are worth investment or not. Because, if they are not good enough, they are just a waste of money on the patient’s behalf.

For Instance,

According to Dr. Catherine MacLean (lead author of the analysis and chief value medical officer at the Hospital for Special Surgery), there is a quality measure that ensures all patients to have a blood pressure of 140/90 or lower. However, this may be lower for some patients.

The Medicare Payment Advisory Commission has raised similar concerns. Therefore, Problematic areas of MIPS need to be overcome in order to improve healthcare quality standards and the payment model.

CMS Website Should be Updated on a Regular Basis

Moreover, physicians were facilitated with an online database to view their status. However, the CMS website doesn’t update on a regular basis. This may have led physicians to not meet reporting standards on time. All of the practices rely on the information provided by CMS. If data is not updated duly on the site, how will physicians ensure the accuracy of MIPS requirements? After all, the ultimate burden would have to be bear by physicians as a penalty or less MIPS score.

CMS is trying to Rectify Errors in MIPS!

According to the spokesperson of the CMS, they are very dedicated to look into every issue that is a hurdle in raising the quality levels of the healthcare system.

MIPS Success Depends Upon How Much CMS Pays Attention Towards Reservations!

The MIPS 2018 performance period is over however, it is compulsory for CMS to render each problem that is making physicians unhappy, rather than, forcing them to report aimlessly without any attraction.

Another way to ensure success in MIPS reporting is via hiring a professional MIPS consulting service as P3 Healthcare Solutions that provide the best MIPS solutions.

Follow our LinkedIn page for more information: https://www.linkedin.com/company/p3-healthcare-solutions

P3CARE OFFERS WHAT PHYSICIANS EXACTLY WANT!

Healthcare industry is evolving at a fast pace. This revolution has led all stakeholders to adapt un-conventional ways of attending patients. Moreover, MIPS payment model has turned the quality of medical services upside down. It serves to comprehend the importance of valuable health services along with the financial needs of physicians.

P3Care isn’t a new name and been known as a legendary MIPS qualified registry in the competitive industry. Their focus is entirely on accurately reporting MIPS to support and uplift revenue cycle management (RCM) for medical practitioners. The reporting pattern is so precise that saves physicians from penalties and makes them eligible for incentives and bonuses.

Getting a star rating from physician compare portal is not any problem for their professionals. The Centers for Medicare and Medicaid (CMS) and the National Committee for Quality Assurance (NCQA) monitor and ensure the quality of medical service and reward accordingly. P3Care is well aware of their standards and help physicians to get a prominent position in the healthcare industry.

How P3Care’s MIPS Reporting Services Credit to a Physician’s Success?

The Efficient MIPS Consulting Service

MIPS has been operational for two years now. It has changed quite a lot in terms of higher standards and reporting requirements. The threshold for eligibility and penalty prevention is also increased as compared to last year.

The reporting experts at P3Care are experienced and trained enough to recognize the tricks and tactics that can benefit in higher MIPS score. Preventing physicians from penalties is not their goal. Rather, they aim for incentives to increase revenue and get appreciation in the respective industry.

What Makes P3Care Different from Others?

When you have the goal of helping physicians and hospital systems to accomplish their objectives at first place, your efforts should match respectively. P3Care no doubt possesses this quality.

It doesn’t matter if your practice is a small-scale or a well-established one, maintaining the balance of eligibility for higher points without putting too much pressure on practice to spend more, is an art. And, P3Care is a pro in this field.

  • The credentialing specialists at P3care ensure your legitimacy and enable you to get the rightful fame in the healthcare industry.
  • They spend quality time understanding the services you offer to patients and suggest improvement methods in your system.
  • From a budget point of view, they are very flexible and report clinical data as per your expertise.
  • Moreover, only by understanding your medical expertise, they plan and select the right MIPS quality measures to confirm that you get more MIPS points.

HIPAA – Compliant Medical Billing Services

P3Care is a renowned qualified registry for last two years. However, it is also known as a leading medical billing service in the USA. Gone are the times when creating medical bills was that simple. Ensuring the patient’s and physician’s privacy is equally important. Therefore, HIPAA – compliant medical billing services serve the purpose.
Using the latest technologies such as; EHR technology to target Medicaid Meaningful Use (MU) and protecting the private information is their expertise. Patients feel secure and trust healthcare provider for the confidentiality of their data.

They have separate dedicated teams for creating medical claims and submitting to payers and reporting clinical data to CMS, according to the requirements.

P3Care – Your One Stop Place for Reporting Services

Many happy and satisfied clients testify P3Care performance. According to the founder of SunCoast, RHIO, Lou Galterio stated in a telephonic interview for Clutch. Co that his experience with P3Care has been immensely amazing! Their team is dedicated and leaves less room for error.

If your practice is unable to improve revenue cycle management and can’t find break-through for a penalty-less spot, consult P3Care services and experience what it likes to be in a prominent position in the healthcare system.

To talk to their H I.T consultant, visit their website https://www.p3care.com or call right away 1-844-557-3227

TAKE ADVANTAGE OF MIPS 2018 REPORTING STANDARDS & SCORE HIGH!

2018 has been a revolutionary year for MIPS in healthcare. MIPS has faced much criticism as physicians were not comfortable with its payment model. The minimum threshold for a penalty-less spot was unacceptable for many clinicians, as it didn’t seem to bring any improvement in the healthcare industry in any manner. Physicians only worried about saving themselves from negative adjustments and that’s just it.

CMS replaced prior MIPS reporting rules with the new ones to address such reservations and to benefit physicians and the healthcare industry’s growth.

Apart from the changes in the percentages of the performance categories, the changes that CMS proposed for MIPS quality measure reporting; let’s look at them and analyze how we can target incentives and bonuses instead of just worrying about penalties.

Virtual Group Participation is now LEGAL

  • This year, a terrific advancement is seen in MIPS reporting guidelines as CMS is offering virtual group participation.
  • Virtual groups should consist of solo practitioners and an eligible group of 10 or fewer clinicians. They should work together VIRTUALLY for the MIPS performance year.
  • Generally, the participants in a virtual group report against all four performance quality measures and meet all reporting standards same as any non-virtual MIPS group would.

The requirement for a Virtual Participating Group

  • Groups and solo medical practitioners who want to participate, as a virtual group needs to go through an election process.
  • The election process must end before the performance year and can’t change in-between. For Example, the election date for MIPS 2018 was from October 11- December 31st, 2017.

Low-Patient Threshold Update

Low-Patient threshold has been increased to exclude individual clinicians or groups with less than or equal to $90,000 in Part B allowed charges or less than or equal to 200 Part B beneficiaries. It is done in the determination period or during or prior to the performance year.

Bonuses for Care Services of Complex Patients

CMS grants 5 points as a bonus to the final MIPS scorecard by adding average Hierarchical Conditions Category (HCC) risk factor. The information is based on the complexity of the medical condition of the patient.

MIPS Favors Small Healthcare Practices

When small medical practices either individually or as a group submits data on at least one performance category, they get an additional 5 points in their final MIPS score. Thus, MIPS 2018 understands struggles that small medical practices go through and is trying to uplift such practices by favoring them.

Submit Hardship Exception Application for Extreme Cases & Save Yourself from Penalty

If the eligible clinician doesn’t use CEHRT- Certified EHR Technology, due to uncontrollable circumstances, for instance; natural disaster, he can submit Hardship Exception Application for reweighting Advancing Care Information (ACA) performance category. It increases the percentage of other remaining categories in the final MIPS score.

An update in this regard is that 31st December 2018 is the last date for hardship application submission.

According to CMS estimation, around 572,000 clinicians will participate for MIPS 2018 reporting. They also propose that clinicians will receive approximately $173million as positive payment adjustments via MIPS consulting services. So, why not report clinical data to CMS, the way it wants and get more payment incentive than expected.

The threshold for Penalty-Less Spot has increased

In its first year, keeping yourself safe was just a matter of three points. Now, the bar has been raised to at least 15 points. This way, clinicians have improved their care standards drastically and the overall pace of the healthcare industry improved.

Keeping track of all the changes is surely hectic for the clinicians; therefore, consulting a MIPS qualified registry becomes a necessity. P3Care has a distinguished name as a professional MIPS consulting service.

Follow us for inquiries: https://www.linkedin.com/company/p3-healthcare-solutions

HOW P3CARE HANDLES MEDICARE MIPS REPORTING FOR CARDIOLOGISTS

P3Care.com sort things out with the payers and at the same time keep the communication lines open on behalf of the providers. This way the patients receive the best care and the insurance reimbursement workflow keeps on moving.

Everyone is happy.

In addition, P3Care has a strong grip over the Quality Payment Program under MACRA. The Merit-Based Incentive Payment System (MIPS) track reporting mechanism for both the specialty-specific clinicians and the primary-care physicians brings in both incentives and reputational benefits.

What is P3?

The three “Ps” stands for –

  • Providers
  • Patients
  • Payers

P3Care Simplifies MIPS Reporting for Specialists

Merit-Based Incentive Payment System (MIPS) is an integral part of the value-based system. In addition, CMS recognizes P3Care as a MIPS Qualified Registry vendor in back to back years of 2017 and 2018. That makes it a favorable enterprise for physicians who want to choose a registry as their MIPS submission method.

The recognition puts a bigger responsibility on our shoulders in terms of performance and meeting your expectations.

The US healthcare system revolves around a working relationship between providers, patients, payers, and medical billing services. If there are disparities at any level, at any step, there is a high probability of bottlenecks.

The government has set the course for MIPS in healthcare to go the distance and want all the clinicians to accept it. If they fail to comply with MIPS, they must be ready to face financial penalties along with putting their integrity on the line.

Heart specialists or cardiologists choose quality measures, outcome measures (or high-priority measures) from specialty-specific sets and start their journey for incentives through MIPS reporting. We take a few minutes of your time and finalize measures before submitting to CMS.

Peace of Mind for Cardiologists

What do the cardiologists say?

First, they are ready to participate in the Merit-Based Incentive Payment System (MIPS). They are actually more excited about it than the general physicians. However, more than half of the cardiologists working in the healthcare industry have reported fatigue and higher stress levels due to excessive documentation.

If IT regulations ease up, it may give them ample time to treat patients and rest as well. P3 Healthcare Solutions is here to help you report MIPS in a timely manner. Connect with us 909-245-8350 to discuss.

CMS Incentivizes Practitioners

The doctors’ job is to treat the patients, but instead, they work 10 to 20 hours a week on paperwork. That is the fact, unfortunately.

The ground reality is that CMS has allocated $20 million on the smooth transition to Merit-Based Incentive Payment System. All these initiatives are going to improve healthcare down to the grassroots level. It must do so and silence those voices screaming the phrase, ‘Americans not getting the treatments they deserve’.

To make it more difficult for cardiologists, the data coming out of the EHR system is vague and doesn’t help with the diagnosis. Often it is descriptive rather than suggesting crucial care points. P3Care brings a solution to this problem by synchronizing the medical billing service with the practice management system.

Specialty-Specific Demotivating Factor

There are no standards set for specialty-specific clinicians when it comes to MIPS quality measures. Hence, there is no way to compare the scores of specialists. The result is a low MIPS Final Score, and there may be no bonus payments at all. It is derogatory and depressing.

Quality measures outlined by the Qualified Clinical Data Registry (QCDR) reporting mechanism also have a similar story. Generally, many specialists vote in favor of QCDR.

Data Submission for Physicians and Specialists

After the month of March, CMS takes around 6 months to generate detailed results on MIPS reports.

Medicare MIPS reporting on Quality measures through a registry is highly suitable because it helps to identify and list down probable errors in the report. There is no other way to identify any ambiguities because CMS directly publishes the results. We can’t afford to make mistakes. However, at the end of those evaluations, CMS gives time to practitioners to ask for a review if they are not satisfied with the MIPS final score.

MIPS Cost Measures

Cost is an additional category in MIPS 2018. It accounts for 10% of the composite performance score (CPS). As a cardiologist, you don’t need to worry about it, though. CMS directly manage this category according to your billing to Medicare.

P3Care has a plan in place for the cost category so that CMS gives you the highest ratings on it. If you’re a specialist, please follow us on LinkedIn https://www.linkedin.com/company/p3-healthcare-solutions/.  We are technologically tenable and keep a close eye on news, views, happenings, and information regarding the US healthcare industry.

When you add the inpatient and outpatient costs, the average of which is compared to the national standard set in the specialist category.  That is an overview of how the cost category is calculated. The lower the cost, the better the ratings!