Report to the highest payment incentive models against your value-based healthcare services!

What “QPP” Means for In the Modern Healthcare Industry?

Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 created this program to shift the Medicare payment model from a volume paradigm to one that prioritizes patients, their health, and safety with technology innovation.

This program revamps the previous SGR formula (Sustainable Growth Rate) to a new P4P (Pay-for-Performance). Considering CMS has always been to modernize the outdated services and regulations that seem to do nothing better but confuse clinicians. So, starting from 2017, we have a framework for Medicare Part B providers.

Quality Payment Programs to Physicians Rescue

QPP is a way to get rewards for your quality-driven services via accurate reporting. You spend hours and hours treating and caring for your patients. Then why not get incentives for it.

Why P3Care?

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

Experienced Consultancy

We have years of experience that is reflected through our reliable and data-driven MIPS solutions.

Streamlined Workflow

P3Care’s MIPS consultancy services include a seamless approach right from data collection to submission.

Proactive Approach

We go with the proactive approach to ensure the accuracy of your data before it reaches the CMS door.

Reliable Support

Right from the eligibility check to MIPS quality measures selection to the data submission, we cover it all.

What Payment Options Do QPP Addresses?

The two pathways for the QPP reporting are:

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. It includes the demonstration programs such as Accountable Care Organizations (ACO), Bundled Payments Models, Medicare Shared Savings Program (MSSP), and Patient-Centered Medical Homes (PCMH).

The Era of Quality Care Begins with Value-Based Incentive Payment Programs

Many clinicians spend so many hours struggling with the complexities of the healthcare system. However, technology incorporated in the clinical operability not only empowers clinicians with the advanced procedures but also facilitates patients.
Don’t you think these procedures must create financial opportunities for clinicians? MIPS does exactly that!

MIPS & MACRA

Does MIPS Reporting Really Register Your Efforts to CMS?

The Medicare incentive payment program (MIPS) helps physicians earn positive payment adjustments for their quality-based efforts. So, Yes! CMS does reward physicians for showing exceptional performance against the following categories.

Quality (Previously PQRs)
Improvement Activities (IA)
Promoting Interoperability (PI)
Cost (Previously VBM)

Who Is Eligible for MIPS Participation?

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

Offer professional healthcare services to more than 200 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)

Who Can Attest as the “Eligible Clinician”?

CMS considers the following clinicians “Eligible”

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

Who Is Exempted From MIPS Participation?

The following clinician types are exempted from MIPS reporting.

Qualifying APM participants
Healthcare providers in their first enrollment year with Medicare Part B
Healthcare providers with a minimum volume threshold of patients or payments

How CMS Measures Performance?

There is a composite MIPS score of 100 points, which includes all four performance categories. Moreover, eligible clinicians have the option to participate either as an individual or in a group against different combinations of NPI/TIN. So, no matter what data submission method you choose, you will be receiving scores individually for the individual submission and in a group for group participation.

MIPS 2022 Is Here! Are You Ready for Its Participation?

P3Care is here to help you avoid up to a 9% penalty for 2022.

Perks of MIPS 2022 Participation

Eligible clinicians can target up to 5% of MIPS incentives with successful participation.

Cons of Not Participating in MIPS

With no or poor participation, despite your eligibility can leave you with up to 9% of negative payments.

Payment Adjustment Ratios Over the Years!

Your performances in MIPS program will determine your positive payment adjustments in 2024.

Get Help from Our Quality Payment Program Specialists

Let’s Talk

An Overview of Payment Adjustments Over the Years!

Quality Payment Program