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MEDICARE MIPS REPORTING ESSENTIALS FOR PHYSICAL THERAPISTS

Physical therapists (PTs) are now a breathing part of the Quality Payment Program (QPP). It is a choice they have to make because they can’t back out. Medicare MIPS reporting through a MIPS Qualified Registry or an EHR system can get them through the maze of value-based care smoothly.

The only choice the eligible PTs have is to choose between the Merit-Based Incentive Payment System and an Advanced APM. The popularity of MIPS as an incentive program outweighs the characteristics of the other track. Hence, MIPS is the go-to track.

The PTs who do not meet the low-volume threshold (LVT) can participate voluntarily.

Why?

They must be prepared for what lies ahead and no better way to do it than participating in it.

Medicare MIPS Reporting for Quality and IAs

Good news for PTs is that they are not required to report in all the four performance categories. Instead, they are required to report for only two – Quality and Improvement Activities.

It directly affects the number of measures they need to report to CMS. With all the focus on MIPS Quality measures and IA measures, they can score high and handsome. It also keeps them very much in the game without the possibility of burnout.

A yearlong report against Quality determines the final score, failing to do so; there are consequences in the form of negative payment adjustments.

Medicare MIPS reporting best happens through certified electronic health record technology (CEHRT) or MIPS Qualified registries such as P3 Healthcare Solutions. Please follow us for effective MIPS solutions on LinkedIn – https://www.linkedin.com/company/p3-healthcare-solutions

Advanced APM Participation Track

Physical therapists who follow Advanced APM as their participation track cannot go for Medicare MIPS reporting as it is one track at a time.

Expect an additional reward of +5% to your Medicare earnings of 2019 if the reporting results are at par with the benchmarks set against measures. Additionally, the high scorers have a chance to collect bonus rewards from the $500 million pool.

While PTs become an active part of the value-based payment system, the removal of functional limitation reporting (FLR) is a healthy change adopted by CMS.

P3Care for PTs and PTAs

The submission of MIPS data is unlike any other data submission. It requires your NPI/TIN and account creation on the QPP portal. Health IT consultants at P3Care activate your accounts with ease and with the mutual collaboration; you get to report to CMS. Accuracy is the key here because you can’t undo or redo these submissions. They happen only once so make sure they are accurate.

What about Telehealth?

The final rule doesn’t allow PTs to be reimbursed against Telehealth. The virtual check-ins will remain associated with physicians and specialty-specific clinicians, though P3Care backs the initiative of Telehealth for PTs and PTAs.

Moreover, there are no reimbursements for “Inter-professional Internet Consultations” for them.

Direct Submission Method

PTs can use the registry method for direct submission. For it to happen successfully, the collection type is MIPS Clinical Quality measures (CQMs). Medicare MIPS reporting 2019 returns optimum results if you are both accurate and smart in terms of selecting high scoring measures.

Outcome measures and high-priority measures hold significance in achieving reward and bonus-worthy scores.

For small practices, the clinicians and clinician groups can collect and submit measures for Quality through Medicare Part B claims.

Groups with 25 or more clinicians may use the CMS web interface for Medicare MIPS reporting.

Deadline for the QPP 2019 Program

MIPS eligible clinicians have time until March 31 of the next year after ending of the performance year. In addition, if your mode of submission is through claims, you have until 60 days after the closing of the performance year.

Improvement Activities (IA)

For PTs and OTs, the category holds 15% weight in the total score. It estimates to 40 points and only the top performing clinicians will be able to reach that number. The improvement activities you should consider reporting to CMS are –

  • Care Coordination
  • Patient safety
  • Beneficiary engagement
  • Participation in APM
  • Achieving health equity
  • Emergency preparedness and response
  • Population management

However, take note of the number and format to report in by the following classifications.

  • Two high-weighted measures
  • One high-weighted measure and one medium-weighted measure
  • Four or more medium-weighted measures

After selection of activities to submit, you are ready for Medicare MIPS reporting through QCDR, Qualified Registry or an EHR system. For those interested in the MIPS attestation process on their own, they can submit activities by logging on to the QPP portal.

Do you think you can gather data and report on your own or is it better to hire third-party intermediaries?

Reply in comments below, as we’d love to hear your thoughts.

HOW CAN MIPS CONSULTING SERVICES HELP INCREASE YOUR CPS?

MIPS has been an amazing initiative in the healthcare industry. This quality payment program instantly got attention from clinicians in terms of providing value-based services to patients. Therefore, the physicians’ participation rate has been outstanding since the very first year. This trend has also put pressure on the MIPS consulting services to use improved methods to better report clinical data.

Another reason for high participation is the fortification from the penalty that is imposed on non-participation or poor performance. This has to do a lot in changing physicians’ thinking to strive for being the top-scorer, especially, when there is so much to gain as incentives and bonuses.

Reporting MIPS quality measures with data completeness constraint requires accuracy and dedication from MIPS consulting services. The thing to consider is that healthcare organizations already have data and then consult MIPS qualified registries to report data.

Then, how can MIPS consulting services improve performance based on the present data? This question demands thorough analysis and this article give insight into four MIPS score-increasing tactics.

  • Document Data for a Large Set of Quality Measures & Look for High Performers

This is the simplest way to ensure that the data you have is best for the reporting MIPS quality measures. When healthcare organizations consult MIPS consulting services, most of them already know about the best-suited quality measures. However, there are some that at the start of the MIPS reporting period, run hundreds of tests to determine the most scoring MIPS quality measures.

The advantage of running this strategy besides the obvious one is to check if you can get extra points from the available data while submitting it to CMS. Moreover, the search for high-priority measures becomes easy for MIPS consulting services via this method.

Some professionally qualified registries or even healthcare organizations tend to chase a larger set of performance measures throughout the year. This way, they get the flexibility to report for the best performing measures at the end of the year.

  • Switch to Electronic Methods for Reporting

End-to-end electronic reporting method is the best way to earn bonus points, and thus requires data submission through Certified Electronic Health Record Technology (CEHRT) to CMS. It automates the data submission process with efficient data extraction and measures calculation.

This method helps MIPS consulting agencies to earn additional points per measure or even increase 10% of the total MIPS score.

  • MIPS Consulting Services Should Report Free Text Data

Qualified services should invest additional efforts in collecting free text data. It surely involves extra time and a bit of investment but can result in improving MIPS scorecard.

Going through patients’ reviews and medical codes can help taking out important points. A dedicated team is required to abstract data for this purpose. Otherwise, outsourcing companies can also do this favor for MIPS consulting services.

  • Review the MIPS Score for Individual & Group Performance

Getting incentives and eligibility for the bonus pool gear up physicians’ performance and it is only possible when MIPS data is optimized. Before data submission, reporting services should check performance rate both as individuals and even as a group.

It is possible that clinicians get more points while submitting data as a group for treating a similar set of patients. It also helps to add low-performing physicians in the group that may be excluded from the MIPS race as individual healthcare providers.

Thus, physicians can earn a high score when MIPS consulting services uses a few simple tricks. Indeed, these tricks require efforts and but continuous monitoring of score throughout the year, provide opportunities to increase revenue cycle.

As a MIPS consulting service, would you try these tactics or have any other ideas for high MIPS score, share with us at https://www.linkedin.com/company/p3-healthcare-solutions

BILL GATES SELECTS SIX HEALTHCARE TECHNOLOGIES FOR 2019

The article lists technologies to look out for in 2019, according to Bill Gates. After analysis of the MIT Technology Review’s yearly content around emerging technologies, he was able to select 7 of them with the most impact. These special applications have a future in healthcare because they come from none other than the maestro himself.

Bill Gates besides the selected bunch of applications wrote:

“We’re still far from a world where everyone everywhere lives to old age in perfect health, and it’s going to take a lot of innovation to get us there.”

“For now, though, the innovations driving change are a mix of things that extend the life and things that make it better.”

Healthcare IT makes the use of technology for better outcomes. Such applications will facilitate the reimbursement process and providers in general. P3, as a MIPS consulting service, assimilates with technology to report on behalf of the providers and value-based care will only benefit from these technological marvels. Please follow us on LinkedIn for a vitalized experience and find the latest information on the Merit-based Incentive Payment System (MIPS).

https://www.linkedin.com/company/p3-healthcare-solutions

The revolution is in their essence, and, nobody will be able to deny their absolute magnificence once the rollout of the benefit in public.

  1. The $10 Blood Test

We attribute this invention to the bioengineer, Stephen Quake of Stanford University.

What does it do?

Physicians will be able to identify women who are set to deliver before time.

Extraordinary, as it sounds, it will ease the pain of the parents, especially the mothers. Children born prematurely have a less chance of survival, but, due to this test, the survival rate is going to increase, big time!

When we talk in terms of MIPS Quality measures, such creations can improve, the mortality rates and reveal better population health outcomes. Patient satisfaction levels will go up while keeping healthcare quality-driven.

  1. Screen Environment Enteric Dysfunction (EED) Disease

The probe developed by Guillermo Tearney, MD, Ph.D., and a professor at Harvard Medical School, physicist and pathologist at Massachusetts General Hospital in Boston is going to show you evidence of this degenerate disease.

What does EED do?

It slows down or stops the absorption of nutrients.

Furthermore, the probe will replace the expensive endoscopy used in gastrointestinal cases.

Amazing, isn’t it?

The third world or poor countries have a reminiscent amount of EED patients. Therefore, this goes out to you – time to heal is soon, very soon.

  1. German Cancer Vaccine

The next invention comes from Germany, and, it is against cancer that has spun the world over its head. In 2019, BioNTech and biotech giant Genentech are having clinical trials for the first cancer prevention vaccine. It is going to destroy cells with cancerous elements attached to them.

Tremendous achievement, as it is, we are one up against the illness, and, now cancerous growth will find a legitimate challenger to stop things from going south.

  1. Reduce Greenhouse Gases

The next invention is going to reduce greenhouse gases and slow down the process of climate change. Intense weather conditions, too much heat or too much cold are weather conditions attributed to climate change.

David Keith, Ph.D., a climate scientist at Harvard University in Cambridge, Massachusetts implements ways to store carbon dioxide from the environment and convert it to synthetic fuels. Public health has only one way to go, and that is up!

  1. Toilets with Cleaner Outputs

Time has come for toilet wastes to stay away from disposal into water resources. Energy-efficient toilets are in focus as an effort to stop contamination of the environment. One of these models comes from Tampa, University of South Florida and the other from sanitation enterprise Biomass Controls.

The two toilets are self-sufficient and don’t need water to move fecal waste to the disposal site.

Water contamination causes the disease to spread from one population to another.

Nevertheless, with the help of these innovative waste stations, we will be able to process waste without using water and put an end to water-borne illnesses.

  1. Alexa – The Amazon’s Marvel

Despite intense marketing campaigns for the device, Alexa proves to be a helpful companion for real. The voice-enabled assistant has features which benefit hospitals and practices to understand speech in both emergency and normal situations.

The artificially intelligent gadget can be the difference between sickness and wellness, expanding its role in patient care.

We would love to see you come up with healthcare inventions we’ve missed in the comments below.

A 2019 GUIDE TO TOP-RATED PODIATRISTS IN NEW JERSEY (NJ)

The talk about podiatry or medicine that relates to podiatry is common in households in the US. We have a growing amount of aged population, and that means the feet and ankles are at risk. Moreover, the younger generation needs help in this regard at times. Since it is our health on the line, we want the best podiatrists in New Jersey and the best medical care in general.

In an era of value-based care, podiatry has to deal with the Merit-Based Incentive Payment System (MIPS) before anything else. The track offers MIPS Quality measures and measures for other performance categories for podiatry. To enable maximum participation of podiatrists in MIPS 2018/19, P3 Healthcare Solutions facilitates reporting duties for them. If you are a podiatrist in New Jersey, please find and follow us on LinkedIn – https://www.linkedin.com/company/p3-healthcare-solutions.

MIPS in 2018/19 – The Differentiating Factor

 In order to remain the best podiatrist in New Jersey, you ought to revisit your participation level in MIPS. MIPS in healthcare is an evaluation criterion of your credibility as a physician and a healthcare professional. The Quality Payment Program – QPP’s final score at the end of each evaluation period publishes on the Physician Compare portal and influences your authenticity as eligible professionals.

The Best Podiatrist in New Jersey vs. Participation in MIPS

The 2019 participation and a score above 70 out of 100 can get you incentives and a vote of confidence in 2021. Despite the selection of the best criteria for measures, talking to qualified HIT consultants paves the way for incentives and bonuses. Therefore, staying in touch with organizations trained to provide value to your practice under MIPS turns out to be a wise decision.

How to Find the Right Podiatrist in NJ?

The million-dollar question that is worth answering any time of the day!

We have an authorized entity in the form of CMS – Centers for Medicare and Medicaid Services. At a time when the MIPS track of the Quality Payment Program impacts healthcare outcomes, the Physician Compare portal is worth a shot. You’ll be able to pinpoint top-rated podiatrists nearby. It is a way to materialize your search for the best doctor.

Find the best podiatrist through https://www.medicare.gov/physiciancompare/ – An official Medicare resource of providers who currently bill Medicare and participate in the MIPS 2018/19 program.

Your health deserves the top podiatrist and nothing can make you qualify for anything less.

Authoritative Websites to Facilitate the Search for Podiatrists

One of these websites is www.njdoctorlist.com.  Here, you will find the top providers registered and credentialed and the State of New Jersey back them up in the best interest of the locals.

If the weather shows minimal snow and zero warnings of a snowstorm, it is easy to head out to the nearest practice.

Foot and ankle centers in New Jersey have a knack of curing patients, especially the ones found through these portals. The stamp of authenticity is enough to satisfy the patients while the cure speaks on behalf of the treatment.

American Medical Association (AMA) supports DoctorFinder and finds the best doctors in town for patients in NJ.

As patents, they don’t need any introduction and Google promotes them significantly.

Big Names in the Industry

The US healthcare industry passes through a critical time when the clinicians gradually ascend towards value-based care and adopt the cost-saving methods nationwide.

MIPS Quality measures for podiatrists include obligations that are mandatory for every physician with a few exceptions. We will cover them in detail in the upcoming articles.

According to Google and webpages on the first page, there are many physicians making the list of top podiatrists in New Jersey.

The foot and ankle specialists of New Jersey include names like:

  • Dr. Eric J. Abrams
  • Dr. Craig A. Shapero
  • Dr. Jordan Drucker
  • Dr. Stephen Guiliana
  • Dr. Nicholas R. Taweel
  • Dr. Jerry A. Silberman

The top 6 podiatrists according to ratemds.com, another gem of a website mentions them with grandeur.

The deadline for MIPS 2018 data submissions, April 2, 2019, continues to be a constant reminder. If you are a podiatrist who has MIPS reporting pending, call 1-844-522-3227 for immediate assistance.

HOW MIPS CAN BE AN ACCEPTABLE PROGRAM FOR CLINICIANS?

The argument that CMS needs to improve MIPS is a thing in the past. Now, the focus is on “how to devise ways that actually implement the change and stands true to its promise of a better healthcare system.

Let’s admit there is no standard way for any quality payment program to hit bull’s eye in its starting years. When a program is initiated and tested in a real-time environment, it gives insight on the actual performance and capability of the program; the same is the case with MIPS. Since, its first year in 2017, physicians are raising questions against its payment model.

Many leading healthcare organizations have proposed ideas that might help CMS to overcome related issues.

Reduce Un-Necessary Administrative Work

It is observed that there is a lot of administrative work associated with MIPS reporting. There is a lot of data that needs to be collected and managed to submit to CMS. One reason is the primary care and the value-based medical services that quality measures cover. This program can serve to be more physician-friendly if clinicians are not burdened with extensive administrative work.

MIPS solutions consist of elements from three major programs:

  • Physician Quality Reporting System (PQRS)
  • Value-Based Payment Modifier (VM)
  • Meaningful Use (MU)

CMS is working in this context and simplifying this quality payment program with the easy amalgamation of all elements.

However, clinicians are not satisfied and still face administrative burden while quality reporting. Most of the physicians have reservations regarding the relevance of MIPS quality measures to the program. Quality measures have been a special concern for surgeons because they have been evaluated on patient’s immunizations. This approach is particularly un-necessary for surgeons and reflects poorly on the intention.

Past president of The American Medical Association (AMA) David O. Barde, has provided with a list of suggestions in this regard.

  • Reduce the number of measures for which a physician can report.
  • Re-expand the definition of a facility in MIPS reporting to include all healthcare service providers; no matter wherever they are, such as post-acute care center.
  • Set a 90-day performance period for all MIPS measures.
    This way, physicians will be able to invest their energies in the right direction that is, on their patients.

Rethink and Modify Promoting Interoperability (PI) Category for MIPS

Promoting Interoperability (formerly known as Advancing Care Information (ACI)) performance category tests physicians’ patient the most. Via this category, CMS has tried to encourage physicians to incorporate certified usage of EHR technology.

According to some physicians, this category focuses entirely on EHR technology, instead of actual advancement in the healthcare system. However, they need to shift their focus on actual usage of technology and to translate digital health information on patient level. Only this way, the PI category will stand true to its name.
The reporting requirements for this quality measure should also be modified to make this category more useful for physicians.

Implement MIPS to its True Potential

MIPS has the potential to bring advancement in the healthcare industry. However, with the final rule of QPP for MIPS 2019, around 58% of the physicians are already excluded to even participate in this program. It will result in fewer payment adjustments for physicians who improved their healthcare quality.

According to the CMS, with higher reporting criteria, non-eligible physicians will have more time to improve their quality to the maximum level. Nevertheless, the question remains that the purpose of this program is to pay clinicians for their investment in medical practice, not to judge their improvement rate until it reaches a certain level.

In addition, small medical practices have fewer resources, therefore; their performance should be analyzed separately from large healthcare organizations. This will stir the air in the healthcare industry and encourage physicians to move towards valuable healthcare.

Many healthcare organizations want to target incentives and bonuses but due to the inflexibility of the program, they can’t strike on the right target. By acknowledging the resources and the improvement made by the medical practice, MIPS should recognize the efforts one made to comply with the burdensome MIPS reporting.

To receive the latest updates on the healthcare industry, follow us on LinkedIn – https://www.linkedin.com/company/p3-healthcare-solutions

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 upped their shoes to assemble appropriate clinical data that best favor medical practice in term of financial matters and reputation among fellow physicians.

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

THE POPULAR FAQS ABOUT MIPS – EXPLAINED!

Providing value-based healthcare services to patients and having a penalty-less spot in MIPS 2018 requires great effort. However, if strategize properly, physicians can get themselves incentives and bonuses from this program.

Knowing the MIPS program better and accordingly report MIPS quality measures to increase your chances of payment rate from CMS. Therefore, it is always the best to resolve any misconception that might disturb later.

Given below are some of the important FAQs about MIPS that might answer your MIPS queries.

Is saving from penalties in MIPS is not enough?

2018 was the second operational year of MIPS and the minimum threshold for penalties was 15%. This bar is expected to rise in the coming years with strict reporting criteria.

70 MIPS points are the threshold set to get incentives. However, when achieved score higher than that, physicians can qualify for the bonus pool of $500 million. Physicians’ score is displayed on website www.medicare.gov/physiciancompare. The high scorer physicians get an extreme reputation and well-renowned authorities like Medicare, AARP, and CMS endorse them as a brand in the healthcare industry.

Thus, targeting incentives rather than just aiming for a penalty-less spot can open success gateways.

If physicians are still eligible for MIPS, when not using EHR technology?

If you don’t use the 2014 version of EHR technology, physicians may not be able to earn points for Advancing Care Information (ACI), now known as Promoting Interoperability (PI). For maximizing your score, physicians can earn from MIPS quality measures of Quality and Improvement Activities (IA).

Does reporting data for more than 90 days increases chances of getting higher MIPS score?

Physicians can choose to report clinical data for 90 days or more for up to 12 months. However, your result is solely based on the performance you showed throughout the performance year.

Thus, choose report for the period that best suits your requirements and helps to increase the score.

What is the best practice, reporting as a group or an individual clinician?

Both practices benefit clinicians in their own manner so before deciding the best approach, consider the following points.

  • While reporting data to CMS in a group, all physicians will have the same payment rate. However, as an individual clinician, you’ll get your own payment rate. You have to decide which practice will benefit in more revenue generation.
  • Moreover, if any physician has a low-volume threshold, he will not be considered as an individual but as a member of the group.
  • In a multi-specialty group, some providers may find measures that are suitable for their practice, and conversely, they may not be suitable for others’ practice. In such cases, you have to choose measures that suit the single specialty of the medical practice.

Is there any exclusion for MIPS?

YES! Physicians are only excluded from the participation of MIPS when,

Medicare allowable is less than $30,000 or less than 100 Medicare patients in 12 months

The healthcare service provider is already a participant of Medicare Advanced APM

Hospital-based healthcare providers are exempted from ACI (MU) category. For them, 25% weight of this category is reassigned to Quality category making its worth to 85% in the final MIPS scorecard

What happens when a physician moves to another medical practice in the payment year?

MIPS score moves with the physician. Even, if you have moved to a new working place, your score will be based on the data reported in the last year, no matter what the medical practice is.

When you work in two different medical practices in the same year, your payment rate under the new TIN (Tax Identification Number) will base on the higher score among both.

What factors should be in mind while selecting MIPS Quality Measures?

Choosing the right MIPS measures, according to your practice is a difficult task so research properly about the following points.

There are 250 quality measures and 5 MIPS submission methods and some quality measures are only available for specific reporting methods, so how will you collect data and report to CMS?

Never report for a measure that has less than 20 eligible cases or no benchmark will receive 3 points.

Each reporting method has its own benchmark; thus, determine score by using the correct benchmark. For Example,

The same measure may have less benchmark when reported via a qualified registry as compared to EHR technology.

Above-mentioned points are the most frequently asked questions (FAQs). This article is all about clarifying those misconceptions, which may confuse physicians and block their way of success.

For detailed information about MIPS and its reporting services, visit our LinkedIn page https://www.linkedin.com/company/p3-healthcare-solutions

AVOIDANCE OF PENALTIES IN MIPS 2018! GET READY TO REPORT SMARTLY!

The American Medical Association (AMA) has clearly stated that the only way to avoid penalties regarding MIPS 2018 is to report on one of the three significant MIPS quality measures. In this way, physicians can prevent those negative payment adjustments waiting to happen in 2020. Connect with P3Care instantly on LinkedIn – https://www.linkedin.com/company/p3-healthcare-solutions/

The three quality measures are

  • Promoting interoperability
  • Quality
  • Improvement activities

How Reporting Criteria Changed Over Time?

Eligible clinicians can avoid the penalty by following a reporting strategy as per AMA’s advice. In 2017, it was compulsory for physicians to score at least three MIPS points to avoid a financial penalty at the start of 2019. It means that they only needed to report one quality measure to overcome the penalty risk.

Nevertheless, now the rules are stricter and the focus on value-based services is now more than ever. With this advancement and the modified requirement criteria in the healthcare industry, the new threshold for MIPS 2018 reporting is fifteen points. The clinicians having a score of 15 are able to avoid penalties in 2020. As an EP, if you fail to report the minimum amount of quality measures governed under the Quality Payment Program’s specifications, it results in a definite 5% decrease in reimbursements.

Therefore, scoring equal to 15 is essential for those eligible in this program.

Follow the tips below to avoid a financial penalty in 2020, improve your MIPS performance, and increase your Composite Performance Score (CPS).

Report on Improvement Activities (IAs) to Score Higher

The BEST WAY to meet the required threshold is to report Improvement Activities (IAs) immediately.

The Centers for Medicare & Medicaid Services (CMS) defined 113 measures under this performance category in MIPS 2018. Each performance measure has further subcategories in the form of medium and high-weighted activities. Obviously, the high-weighted activities carry more points and can get you closer to the maximum score.

How Do You Calculate Performance Categories?

The activities for the performance categories function around care coordination, population healthcare, beneficiary engagement, and health equity factors. To score in any category, eligible clinicians are required to collect and submit data for 90 consecutive days in 2018.

How to Submit MIPS to the CMS?

Healthcare providers can submit clinical data for MIPS 2018 via:

  • Quality payment program 2018 (QPP) data submission system
  • Electronic health record (EHR) system
  • MIPS qualified registry
  • The qualified clinical data registry (QCDR)

Improvement Activities – A Lucrative Offer for Small Practices

Reporting Improvement Activities (IAs) under MIPS 2018 can elevate the revenue cycle for small medical practices. MIPS reward small healthcare practices with double points as compared to well- established healthcare facilities.

Another advantage to smaller practices is a bonus of five extra points when they score a total of 15 points. It ranks them above the others on the MIPS scorecard with 20 points. Therefore, if you report for one high-weighted improvement activity, you are bound to earn more points.

For the same MIPS score, ECs working for large medical practices must submit data for two or more improvement activities to get up to the threshold limit of 15 points.

MIPS Quality Measures Shield You from Negative Payment Adjustments

Negative payment adjustments can be a big setback for your profit journey. Therefore, use quality measures wisely and in a timely manner.  To stay on top of your game, you must fully understand the performance measures to make to turn it into a lucrative opportunity.

There are 275 quality measures and clinicians can select from among them the most suitable measures to meet the MIPS 2018 threshold score.  Each Quality measure has further sub-categories as per the following factors:

  • Efficiency
  • Outcome
  • Patient engagement

Moreover, CMS has developed a specialized set of quality measures to help physicians identify appropriate quality measures. Clinicians can report data for 12 months on six quality measures. However, it is necessary that one of the quality measures should be an outcome measure or a high priority performance measure.

Clinicians participating in the form of virtual groups can use CMS Web interface or Consumer Assessment for Healthcare Providers and Systems (CAHPS) for MIPS survey.

Report for At Least Two Performance Categories

To stay away from negative payment adjustments, report for at least two performance categories. For instance –

  • Improvement Activities and Quality
  • Or, Promoting Interoperability and Quality

How to Score High and Handsome?

Ordinarily, we see small medical practitioners reporting one medium-weighted improvement activity and one quality measure. This reporting tactic earns you 10 points and with an extra 5 bonus points, you may achieve a total of 15 points.

The Territory of “Promoting Interoperability (PI)”

Another way to earn 50 out of 100 points is by reporting on the Promoting Interoperability performance category. It investigates the patient and physician engagement level and makes the patient information available to other clinicians via EHR technology. EPs are required to submit data for 90 days or more on the base score of four or five measures in this category. The base score measures take their value from the certified EHR edition.

Large medical facilities can achieve high scores by reporting on PI and quality categories. However, they must report on PI performance category to score 50 and two quality measures to get to 70 points and target the bonuses out of a $500 million pool.

EHR Technology – One Step Ahead

Each EHR edition has a different set of performance measures. For instance, the 2014 EHR edition allows reporting on the Promoting Interoperability Transition Objectives and measure set.

Important Tips to Score Higher

  • The data submitted on quality measures for at least 20 patients fulfill the data completeness requirement.
  • Two medium-weighted improvement activities and four quality measures can get you a score of 16 points in 2018.

It is only possible when the physicians earn 12 out of 70 points in the “Quality” performance category and score 20 out of 40 points in the Improvement Activities.

Vote for Better Healthcare

As 2018 is about to end, the evergreen slogan for the welfare of Americans is to vote for a better healthcare system. That truly goes in favor of the Americans.

If you still haven’t done anything to avoid the penalty in 2020, it is time to connect with a reliable MIPS registry for submissions. America needs you to come out as a winner and reputable practitioner.

Most of the performance categories require data for 90 days. Therefore, reach out to P3Care and report QPP measures efficiently and be free from the worries of non-reporting.

MIPS QUALITY MEASURES 2017 APPLICABLE TO LTPAC MEDICINE

The following article looks at CMS MIPS quality measures for LPTAC medicine. However, before we go towards the MIPS quality details, we need to look at the underlying purpose and objectives.

Purpose

CMS (Centers for Medicare and Medicaid Services) is always working on improving the policy to provide better healthcare facilities. Therefore, the new measures are aimed to help improve the overall care delivery and also reward clinicians who are better engaging patients, families, and caregivers.

Here is how CMS looks at MIPS.

“To these ends, and to ensure the Quality Payment Program works for all stakeholders, we further recognize that we must provide ongoing education, support, and technical assistance so that clinicians can understand requirements, use available tools to enhance their practices, and improve quality and progress toward participation in APMs, if that is the best choice for their practice.”

Key Strategic Objectives

Let us have a look at the strategic objectives set by CMS.

  • The engagement of patients and the improvement of beneficiary outcomes.
  • To further the clinical experiences that offer flexible yet transparent programs.
  • Ensure meeting of diverse needs of the physician practices typically those with small practices.
  • Further the capabilities of the IT systems that meet various data needs of the end user including reporting and submission.
  • Work on improving information and data sharing to ensure its timely availability.
  • Enable customized communication while keeping MIPS quality measures specifications into perspective.

Caveats for Individuals and Groups

The new MIPS quality measures take into consideration two LTPAC setting codes. These codes are the basis for the MIPS quality measures specifications. These MIPS quality measures are for application on individuals as well as groups.

Eligibility Criteria

Here are some considerations to undertake.

To qualify for the MIPS incentive payments you need to report on the following.

  • There are 6 measures with at least one of them as an outcome measure relating to poor diabetes control. The new quality measures mark high specialty and ambulatory practices.
  • Each measure’s applicability should be up to 90 days.
  • Around 50 percent of your patients have to qualify for one of those 6 measures.
  • The minimum number acceptable for the incentive payments stands at 20 patients.
  • The health practitioner can only report some measures after a specific diagnosis. Therefore, health clinicians have to be careful when selecting these measures.

Avenues for Submission

You can submit your measures to multiple avenues including EHR, claims, QCDR, and Registry. Registry seems to be the most suitable option for groups that aim to report when using the individual measures.

Why Consider Registry for Submission?

Here are the reasons why you must consider submission via Registry.

  • Since you can submit all 2017 QMs via Registry, you do not rely on any other methods.
  • Claims Reporting for 2017 QMs only supports a subset. Therefore, be careful to see the claims if the Claims Reporting offers support for it or you need to use Registry instead.
  • The group gets a measure of review or control when using Registry before you submit the data. Therefore, it gives a buffer, allowing you to remove any errors that you may find.

Avoiding Penalties is Critical

Make sure to always keep the benchmarks in perspective. By following them you can reduce your chances of getting a penalty. It will also help you satisfy base reporting requirements for MIPS.

Make sure that the data you submit for one patient satisfies that particular measure. If you are able to satisfy all six measures, the data would become a prime example for others to follow. In that case, you may be able to find your data published on CMS’s site for Physician Compare.

How 2017 MIPS Quality Measures Differ?

Previously, there was not much detail available. However, 2017 MIPS by CMS offers detailed benchmarking, relying upon the methodology which involves different performance points.

These individual performance points add to make a total score. Therefore, in 2017, you need to focus on performance as it is a critical year for it. Physicians should know the way they are graded to their performance, comparing it with the past year. It is vital to carefully select QMs which would help you score above average performance.

Here is how CMS elaborates this concept.

“By developing a program that is flexible instead of one-size-fits-all, we’re trying to meet clinicians where they are so that they can make the choice about how to participate in a way that is best for them, their practice, and their patients. Reducing burden, ensuring flexible program design, and improving how we measure cost and quality performance supports clinicians in doing what they do best – making their patients healthy.”