MIPS 2022 performance period has started, and for all we know, most clinicians are consulting their MIPS Qualified Registries for the data submission 2021. Moreover, they have also started to evaluate their options for this year.
It is certainly soon to say about what clinicians are thinking! But, the thing is, the better practitioners evaluate their options, the better strategies they can adopt for reporting.
The big question is Individual MIPS 2022 reporting vs. Group Participation, which is better?
In all fairness, both MIPS data submission methods 2022 offer certain ease, and we will be reviewing them one by one.
MIPS Participation as an Individual
An individual is a single clinician that can be identified with an individual NPI (National Provider Identifier) tied to a single TIN (Taxpayer Identification Number).
For this participation, a clinician has to surpass the reporting requirements of the individual level to opt-in to this participation status.
You will be sending your MIPS 2022 data as an individual to CMS (Centers for Medicare and Medicaid Services). Consequently, they will review, analyze, and score your data based on your performance.
The authority will analyze your performance independently based on your submitted MIPS Quality Measures. And the payment adjustments you receive will be rewarded against the final MIPS score.
Here are some of the requirements for individual MIPS 2022 performance evaluations.
Points to Remember for Eligible Individual MIPS Participation
If you manage a medical practice, you will be responsible to collect data for each individual. And they all will receive payment adjustments only for them based on their final MIPS score.
The same reporting process can also be handled by third-party vendors/MIPS Consultants such as MIPS Qualified Registry or a Clinical registry.
Participants Have the Option of Partake with Multiple Reporting Options
CMS allows its eligible physicians to submit 2022 quality data via a group and/or APM Entity alongside the individual reporting. And, they will reward payment adjustment based on the highest-scoring MIPS 2022 reporting method.
With virtual group participation, CMS will not voluntarily assess the other MIPS 2022 performance data even if one submits.
MIPS Participation as a Group
Two or more clinicians with a single TIN and identified by their NPI (reassigned their Medicare billing right to the respective single TIN) can participate as a group. And it is a must factor for at least one of them to be a MIPS reporting eligible clinician.
A medical practice can participate as a group when the practice TIN qualifies for the low-volume performance threshold, is eligible to report, and opt-in to report on a practice level. There are no certain group-level reporting requirements.
The group participants will collect and segment the aggregated data from the clinician submitted through the same TIN. After the data submission, CMS will access all MIPS 2022 performance data at the group level.
The payment adjustments will be based on the final score.
Here are a few things that one needs to take responsibility for before the group participation.
Points to Remember for Group MIPS Participation
If a medical practice does not go for group participation, each eligible clinician will have to participate as an individual. It can be done even though the APM Entity if the situation applies.
If the medical practice decides to report as a group, all clinicians of the group will receive payment adjustments even if any one of them is not eligible.
If medical practice takes help from a third-party vendor as a Clinical Registry or a MIPS Qualified Registry, they must ensure that they submit your data at a group level. Moreover, the clinicians of practice can have the option to participate even as a group and as individuals. They will receive payment adjustments based on the highest final score reporting method.
CMS allows clinicians to participate as individuals, groups, and/or APM entities; they will receive payment adjustments based on the highest scoring method.
If you report as a virtual group for MIPS 2022 reporting, CMS will only reward points and payment adjustments at the virtual group level. They will not be considering voluntary participation from the other reporting methods.
MIPS 2022 Reporting Methods
When you know your eligibility status and the reporting type, now is the time to learn about choosing the right data submission methods.
This decision is influenced by several factors such as:
- If you’re participating as a group
- The size of your medical practice
- The type of healthcare IT you use
- The performance category you want to report
Now, it is up to them to choose the right option that fits your practice the best.
All reporting methods apply to all reporting types (Individual, Group, Virtual Group, APM Entity). However, there are two exclusive cases, which we have to consider.
- Only Groups, Virtual Groups of at least 25 clinicians and ACOs (Accountable Care Organizations) can use CMS Web Interface.
- Only small medical practices can use claims to report their MIPS Quality Measures.
CMS has certainly given the flexibility to participate via the most suitable option. Now, it’s up to you to analyze your options and maximize MIPS 2022 performance score.