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QPP Elevating the Bar of Value-Based Healthcare

The Quality Payment Program (QPP) shifts the Medicare payment model from a volume to value-based paradigm, promoting a care delivery culture that prioritizes patients, their health, and safety with technological innovation. One example is MIPS reporting services program.

This program revamps the previous SGR formula (Sustainable Growth Rate) to a new P4P (Pay-for-Performance). Thus, CMS tried to modernize outdated services and regulations that seem to do nothing better but confuse clinicians.

Discover How QPP Benefits You

Quality Payment Programs for Physicians Rescue

You spend hours and hours treating and caring for your patients. Then why not get incentives for it via the MIPS reporting services program?

Why P3Care?

We are a trusted MIPS Qualified Registry known for delivering outcomes as per CMS requirements.

01 Experienced MIPS Consultant Services

Our years of experience reflect our reliable and data-driven incentive payment solutions that benefit the revenue cycle.

02 Streamlined & Accurate Workflow

P3Care’s consultancy includes a seamless approach right from data collection to MIPS quality measures submission.

03 Proactive Approach for Timely Reporting

We analyze every measure via a proactive approach to ensure the accuracy of your data before it reaches the CMS door.

04 Reliable and Dedicated Client Support

From the eligibility check to MIPS quality measures selection to the data submission, we are with you at every step.

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What Payment Options Do QPP Addresses?

The three pathways for the QPP reporting are:

MVPs

(MIPS Value Pathways)

(MVPs is a new framework introduced under the Quality Payment Program (QPP).

MVPs have been designed to align reporting requirements around specific specialties, clinical conditions, or episodes of care.
It combines measures and activities across the four MIPS performance categories into more meaningful sets.

The MVP reporting option was first made available in the performance year 2023. In the coming years, CMS plans to expand MVPs further to reduce clinician burden and enhance patient care outcomes.

MIPS

(Merit-Based Incentive Payment System)

MIPS has streamlined the previously existing quality Medicare reporting programs as:

Value-Based Payment Modifier (VM)
Medicare EHR Incentive Program (MU)
Physician Quality Reporting Program (PQRS)

Most clinicians did qualify for the MIPS reporting in its first year, 2017. However, as the years progressed, CMS established some eligibility rules and performance parameters to enhance quality care and reward satisfaction.

APM

(Advanced Alternative Payment Model)

This framework provides an alternative payment strategy for eligible clinicians to register their high-quality and cost-efficient care to authorities to receive incentives. It focuses on the following aspects:

Special Clinical Conditions
Care Episodes or Population

MIPS-eligible clinicians participating in an APM are also subject to MIPS reporting services. It includes demonstration programs such as Accountable Care Organizations (ACO), Bundled Payments Models, Medicare Shared Savings Program (MSSP), and Patient-Centered Medical Homes (PCMH).

Who Is Eligible For MIPS Value Pathways (MVP) Participation?

To be eligible to participate in MVPs, you must:

Be a MIPS eligible clinician or part of a MIPS-eligible group or APM Entity
Meet the MIPS low-volume threshold or choose to opt-in if below the threshold
Register for an MVP during the CMS designated registration period
Use Certified Electronic Health Record Technology (CEHRT) to report your MVP data

Who Is Eligible For MIPS Reporting Participation?

To meet the eligibility criteria for MIPS quality measures submission, you must:

Offer professional healthcare services to more than 199 Medicare beneficiaries
Provide more than 200 covered professional services to Part B patients
Bill more than $90,000 per year for covered professional services under the Medicare Physician Fee Schedule (PFS)

Limited-Time Discount on MIPS Reporting

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Who Can Attest as the “Eligible Clinician”?

To meet the eligibility criteria for MIPS quality measures submission, you must:

Physicians (including doctors of medicine, osteopathy, dental surgery, dental medicine, podiatric medicine, and optometry)
Chiropractors
Nurse practitioners
Physical therapists

Physician assistants
Qualified audiologists
Clinical psychologists
Occupational therapists
Clinical nurse specialists

Osteopathic practitioners
Qualified speech-language pathologist
Certified registered nurse anesthetists
Registered dietitians/Nutrition professionals
Clinical social workers
Certified nurse midwives

HOW DOES CMS MEASURE PERFORMANCE?

Eligible clinicians participate either as individuals or in groups/virtual groups using different combinations of NPI/TIN. Regardless of the data submission method chosen, CMS assigns a composite score out of 100 based on performance. This final score determines eligibility for payment incentives or penalties.

Are You Ready for MIPS Participation?

Participating in MIPS can help you avoid payment penalties and maximize incentive opportunities, and we’re here to support you throughout the process.

Consequences of Not Participating in MIPS

Clinicians who are eligible but do not participate may face negative payment adjustments.

Benefits of MIPS Reporting

Eligible clinicians have the opportunity to earn positive payment adjustments by successfully participating in the program.

Payment Adjustment Trends Over Time

CMS updates incentive and penalty rates regularly to encourage clinician participation and improve quality care outcomes.

An Overview of Payment Adjustments Over the Years!

Ready to Get Assistance with MIPS Reporting Services for Your Medical Practice?

Ensure QPP compliance with MIPS reporting services and report MIPS data in a timely manner to improve services for your patients and your practice’s reputation.

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