The COVID-19 pandemic has bolstered the transition from volume-based to value-based care. This transition has attracted more attention to the Quality Payment Program (QPP), which seeks to reward high-value, high-quality Medicare clinicians with payment increases – while at the same time reducing payments to those clinicians who aren’t meeting performance standards. One of the ways to participate in QPP is through the Merit-based Incentive Payment System (MIPS).
Through its traditional framework, MIPS ties payments to quality of care, improvements activities, improved use of healthcare information system and the cost reduction initiatives. MIPS-eligible clinicians will receive payment adjustments based on their MIPS final score following successful and complete reporting of MIPS requirements. For MIPS-participants in 2019, the maximum adjustment will be 7% for payment year 2021.
While MIPS reporting will directly impact payments and deliver an opportunity for bonuses, many clinicians are dissuaded by the amount of work and manual tasks involved in collecting data and reporting those measures. The good news is we have the answer. The following best practices will make your MIPS reporting streamlined.
1. Determine eligibility and select target quality measures early on.
The first step in successful reporting for MIPS is to determine your eligibility and identify target quality measures that you want to report on. You can determine your eligibility here.
QPP requires that practices and clinicians report on at least 6 measures, including 1 outcome measure or high-priority measure, or a complete specialty set. However, it’s best to select and collect data for more than the required number to have options at the end of the year and ensure you submit your best-performing measures and maximum payment adjustments.
Consider your benchmarks and specifications when selecting your target measures since they will also impact your result and eventually payment adjustment. Not all benchmarks are created equal. Since each benchmark is presented in terms of deciles, points will be awarded within each decile, the minimum score for Decile 10 is different across benchmarks.
2. Leverage the power of integrated technology to reduce manual efforts and optimize your workflow
A big obstacle for many clinicians in participating in MIPS is the comprehensive reporting frameworks. A large part of inefficiency in MIPS reporting came from data entry and consolidation. Performance data reside in multiple disparate systems from billing to EHRs and scheduling. Without a direct communication and integration between your technology systems and the registry, the data entry tasks fall back on the clinicians.
When choosing a CMS-qualified registry for your MIPS reporting, make sure that the registry enables automated data submission from the EHR to minimize manual effort. Even better is a complete technology platform for PALTC practices with built-in MIPS reporting capability like TheSNFist™ suite of products and services. With the combined power of the PacEHR™ electronic health record and billEHR point of care charge capture, our platform provides a fast and easy navigation through the reporting requirements.
Based on the ICD code, demographic, and other applicable criteria, PacEHR™ electronic health record can suggest appropriate performance measurements. All you have to do is to check a box and we will submit a report on your behalf at the end of the year. Don’t worry about mistakes – our gap reports allow clinicians to cross check and verify any data entered!
3. Fully utilize your EHR for efficient data mining and quality improvements.
Utilizing a certified EHR software help you streamline your data flow, improve consistency and improve overall care quality. If your EHR can trigger quality codes like PacEHR™ electronic health record, you have one less thing to worry about. Focus on interpreting and translating that data into quality-driven insights.
Quality data capture is a year-round activity, so you need constant and reliable access to your complete performance data around the year to course-correct when necessary. Beat the year-end rush with routine reviews of your performance data with key stakeholders to address any problems before they escalate.