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        • We cater to all specialties and offer dedicated officers that are experts in their medical billing and coding.

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MACRA & MIPS

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

qulaity 02

Quality

Replaces PQRS

information 02

Promoting interoperability

Replaces MU

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Improvement Activities

New Category

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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.

MACRA

TAKING A TRIP DOWN MEMORY LANE

MIPS PERFORMANCE YEAR 2017

  • 84% CLINICIANS EARNED POSITIVE PAYMENT ADJUSTMENT FOR EXCEPTIONAL PERFORMANCE

  • 12% CLINICIANS EARNED A POSITIVE PAYMENT ADJUSTMENT

  • 4% RECEIVED NEUTRAL PAYMENT ADJUSTMENT

  • 0% RECEIVED NEGATIVE PAYMENT ADJUSTMENT

MIPS PERFORMANCE YEAR 2017
Clinicians in MIPS 2018

MIPS PERFORMANCE YEAR 2018

  • 84% OF CLINICIANS EARN AN EXCEPTIONAL PERFORMANCE ADJUSTMENT

  • 13% OF CLINICIANS RECEIVE A POSITIVE PAYMENT ADJUSTMENT

  • 0% OF CLINICIANS RECEIVE A NEUTRAL PAYMENT ADJUSTMENT

  • 2% RECEIVE A NEGATIVE PAYMENT ADJUSTMENT

MIPS 2017MIPS 2018

MIPS Quality Reporting Steps

  • Step 1

    Understand Your Reporting Requirements

  • Choose Your Quality Measures

    Step 2

  • Step 3

    Collect Your Data

  • Submit Your Data

    Step 4

  • Step 5

    Review Performance Feedback

PreviousNext

P3Care demonstrates optimized performance in the MIPS program on behalf of eligible physicians, surgeons, and clinicians in general.

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Mips Macra

Fee for Service to Pay for Performance

Department of Health and Human Services (DHHS) is responsible for the implementation of the MIPS program. As one of the MIPS submission methods is through a Qualified Registry, it gives us immense pleasure to be of value to the system, and doctors across various specialties. Not only do the doctors but clinicians across the board help us help them report MIPS to the CMS.

As mentioned in the heading, US healthcare gradually moves from fee-for-service payment model to the pay-for-performance model. It is the value-based reimbursement model, a dire need of the hour for the end-users, the patients.

Healthcare MIPS appears well-directed, and purpose-driven if you ask us as health IT consultants. However, sometimes it doesn’t do justice to clinicians due to its reporting burden. Physician burnout happens as a result and goes to the credit of EHR and its burdening list of measures. Subsequently, CMS has removed some of the measures in MIPS 2019 as an effort to reduce some stress.

MIPS for Eligible Clinicians

Since each of the MIPS performance categories has to undergo reporting for a specific period, P3 Healthcare Solutions, Ontario, CA knows what it takes to report them. We are not only a medical billing service but have undergone PQRS successfully in the past before 2017.

As a plastic surgeon, dentist, orthopedic, pediatric, family medicine physician, physical therapist, urologist, psychiatrist, ophthalmologist, nephrologist, neurologist, pain specialist, optometrist, gastroenterologist, cardiologist, chiropractic, pathologist, cardiothoracic surgeon, radiologist, physiologist, gynecologist, obstetrician, rheumatologist, endocrinologist, and public health specialist, reporting MIPS is the easiest through a MIPS Qualified Registry such as ours.

Check Your Eligibility
MIPS FOR ELIGIBLE CLINICIANS
DATA VALIDATION

Data Validation and Verification

MIPS data submission requires you to choose one of the collection types first. With us, clinicians get to choose MIPS CQMs (Clinical Quality Measures) to report ahead. Proper validation and verification of the measures to report have to happen to score above 75. That is where the incentives are, with bonuses to follow.

As a third-party intermediary, P3 follows tradition with excellence and submits on behalf of practices. You have an option to report CMS MIPS Quality measures as an individual or a group.

CMS recognizes registries and approves them year after year based on set standards criteria. On the whole, a MIPS consulting firm, which is also a registry, is your answer to care-free and accurate submissions. In this way, you do what you are meant to do, i.e., look after your patients.

Get started on your specialty measure set reporting today through a MIPS consulting service that has come of age.

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MIPS 2019 SPECIFICATIONS

  • Quality and Cost performance categories are to be reported over a 12-month period
  • Improvement Activities (IA) and Promoting Interoperability (PI) performance categories for continuous 90 days
  • Deadline for submitting MIPS 2019 reporting is March 31, 2020
  • CMS provides performance feedback to 2019 participating clinicians in 2020
  • MIPS payment adjustments (positive, negative or neutral) are applied to each claim: starting January 1, 2021
QPP 2019

MIPS 2020 SPECIFICATIONS

  • Quality category has a 12-month performance period (January 1 to December 31, 2020). The collection of data for each measure goes on for the whole year.
  • Improvement Activities (IA) and Promoting Interoperability (PI) categories are to be performed for 90 consecutive days.
  • Given the history, MIPS submission deadline is probably March 31, 2021.
  • CMS provides performance feedback to 2020 participating clinicians in 2021.
  • MIPS payment adjustments (positive, negative, or neutral) are applied to each claim: starting January 1, 2022
QPP 2020

MIPS 2021 SPECIFICATIONS

  • The time frame for the quality performance category for MIPS 2021 goes for the whole year. The cost category covers 20% of the total MIPS score but does not require any data submission.
  • Clinicians need to perform Improvement Activities (IA) and Promoting Interoperability (PI) categories for 90 consecutive days.
  • The MIPS data submission deadline is March 31, 2022.
  • CMS provides performance feedback to 2021 participating clinicians in 2022.
  • MIPS payment adjustments (positive, negative, or neutral) are applied to each claim: starting January 1, 2023.
QPP 2021

Final Score Calculation Chart According to Category Weights – An Example

MACRA MIPS

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.

  1. MIPS Essential – Avoid penalty
  2. MIPS Budget-Neutral – Avoid penalty and earn up to 3”x” incentives
  3. 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

How many measures are there in the MIPS Quality measures list?

In 2020, eligible clinicians get to choose and report out of 200 MIPS Quality measures. These measures are available through a range of collection types, one of which is a MIPS registry. As a MIPS consultant, it is on us to report most efficiently for you to score high and handsome. In short, it is a burden-free MIPS data submission method leveraging ease, peace of mind, and incentives at the same time.

How many incentives should I expect with my submission?

In 2020, while we submit your data before the deadline, you can expect up to 5% incentives with P3 Healthcare Solutions.

Why is the registry method better than other collection types?

Because it is hassle-free. You don’t have to take the burden of reporting, instead, it is the registry that takes the stress on your behalf. CMS-recognized registries establish, verify, and validate data as per the requirements of your specialty or practice.

What is required of me from MIPS in physical therapy?

First, your eligibility has to confirm. Second, you have to share your input in selecting measures. MIPS full form in healthcare returns profits on your Medicare reimbursement resulting in increased revenue. Give us a call; we won’t take much of your time and get right to it.

Is MIPS billing too much to handle?

Not at all. It’s pretty easy on the pocket. However, it is not a one-size-fits-all thing with the pricing. Since your practice may have more than one clinician who has to report MIPS, prices vary. Besides, they also vary from specialty to specialty. Therefore, it is best to leave your info such as NPI, the best time to call, whom to talk to at info@p3care.com; and, we’ll try to back to you as soon as we can.

We primarily provide HIPAA medical billing services and MIPS consultancy, among other services. As your HIT consultant, we optimize providers’ performance for improved RCM.

info@p3care.com

(844) 557-3227

3200 E Guasti Rd Suite 100, Ontario, CA 91761, United States

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