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MIPS 2021 in healthcare leaves you with a great reputation besides incentives and bonuses. The only alternative to healthcare MIPS is the other track – Alternative Advanced Payment Models (APMs). Once you are eligible, you must submit MIPS in order to avoid a penalty – a few thousand dollars are cut from your Medicare reimbursement. For assistance with COVID and in general, Hardship exceptions apply, and practices in rural areas can take benefit from them accordingly.
Medicare Access and CHIP Reauthorization Act (MACRA) is bipartisan legislation turned into law on April 16, 2015. President Obama did the honors back then. Not only does it drive MIPS but everything that comes with it. That is indeed the power of MACRA.
MIPS 2021 reporting window is open until March 31, 2022, so you can submit data if it is still outstanding. The year 2021 is going to be the toughest year yet because CMS has increased the performance threshold score from 45 to 60 to avoid a penalty. After the success of QPP 2018, QPP 2019 and QPP 2020, P3, as a MIPS Qualified Registry, continues to report QPP 2021 on behalf of eligible clinicians and practices.
MIPS & MACRA function side by side. MIPS bases itself on quality, value, and accountability. As long as the purpose is met, eligible clinicians (ECs) have nothing to lose and everything to gain. In the end, MIPS incentives are there to provide the right impetus to your practice.
MIPS Performance Categories
Quality
Replaces PQRS
Promoting interoperability
Replaces MU
Improvement Activities
New Category
Cost
Replaces VBM
What is MACRA?
MACRA is the law that governs several programs, and the QPP is no exception. QPP combines the Physician Quality Reporting System (PQRS), the Value-based Modifier (VBM) and Medicare Electronic Health Record (EHR) program into one program that we know as the Merit-based Incentive Payment System (MIPS). Thus, allowing MACRA & MIPS to be inseparable.
Value-based care navigates through the veins of the healthcare system via the MIPS program. Centers for Medicare and Medicaid Services (CMS) defines MACRA as an enactment of the new payment order that rewards clinicians for demonstrating better care instead of looking after more patients.
Furthermore, MIPS suggests clinicians perform in four performance categories such as Quality, Promoting Interoperability (PI), Improvement Activities (IA) and Cost. A high MIPS final score depends on all of them as each category has measures to support and report. MIPS Quality measures are the common factor as they are similar in number (usually six) for practices.
TAKING A TRIP DOWN MEMORY LANE
MIPS Quality Reporting Steps
Final Score Calculation Chart According to Category Weights – An Example
Clinician-Friendly Packages
As a MIPS Qualified Registry, we have come up with three packages to cover every reward that is out there in the name of this program.
- MIPS Essential – Avoid penalty
- MIPS Budget-Neutral – Avoid penalty and earn up to 3”x” incentives
- Benchmark MIPS – Avoid penalty, earn up to 3”x” incentives, and become eligible for bonuses out of the $500 million pool
How to Submit MIPS Data to CMS?
Step 1
A health IT expert spends 30 minutes with you on the phone to understand the clinical workflow and requirements
Step 2
Shortlisting measures and informing the practice manager of the reporting activity
Step 3
We take care of the Cost component making sure no workload is on your practice
Step 4
Self-educating ourselves through feedback based on TIN level QRUR reports
Step 5
Regular reporting of updates in terms of compliance and CMS reporting criteria