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Step 1- Are You an Eligible Clinician?

Since 2020 has begun, some of our valuable clinician time must be spent over 2020 compliance standards set for MIPS 2020. Back in 2017 and 2018, not everyone was eligible that were previously included in Medicare quality reporting programs such as PQRS and MU.

Moving forward in 2019, and, now in 2020, the pool of eligible clinicians expanded to contain some of the previously ignored specialties. Such specialties include Physical/Occupational Therapists, Speech-Language Pathologists, Audiologists, Dietitians/Nutritionists and Clinical Psychologists.

So, if you are any of the above or come from another field, you can make use of our MIPS consulting services. Staring in 2019, the otherwise eligible clinicians, clinician groups, APM entities can choose to opt-in to MIPS if they are above 1 or 2, but not all, provisions of the low-volume threshold

Step 2 – Why MIPS?

As measures are submitted for each performance category, MIPS 2020 determines the payment adjustment based on how each of the participating clinicians performs against their peers. The score that cumulates to the total score is the Composite Performance Score (CPS) or the MIPS Final Score. The final score is calculated as a composite score of each category and attributed on a scale of 0 to 100.

Unlike past quality programs, MIPS will stay with the clinicians even after they are done with the reporting activity. Because along with the financial element comes the reputational element.

Physician Compare

It is a site that is managed by CMS where MIPS Final Scores are posted. Hence, highlighting the reputation element of eligible clinicians and clinician groups. Scores are published online to the Physician Compare portal as soon as the informal review period is over with after the performance year.

Stay up-to-date with MACRA and MIPS.

Step 3 - Transition Efficiently

Since moving on to MIPS occurs in phases, this gradual transition allows clinicians to get ready and adjust to the new system. Each year the reporting criterion intensifies. For clinicians reporting MIPS in 2020, they are eligible for 9% positive payment incentives and -9% in case of non-compliance.

Sign up with us for improved results as suggested in the following packages.

MIPS Essential

MIPS Final Score of 45 plus to avoid 9% penalty
Affordable one-time charges
No contracts
Reports on all four categories: Quality, IA, PI, and Cost

MIPS Budget-Neutral

MIPS Final Score of 46 to 84 for 9% incentives
Guaranteed 9% penalty avoidance + 9x incentive payments
Analysis of the reporting activity in progress and after completion
Report on all categories: Quality, IA, PI

Benchmark MIPS

MIPS Final Score from 85 to 100 for incentives and bonuses
Guaranteed 9% penalty avoidance + 9x incentive payments
Become eligible for bonuses up to 10x
Report on all categories: Quality, IA, PI, and Cost

Step 4 – MIPS Performance Categories

Quality:

Quality replaces the Physician Quality Reporting System (PQRS) of the earlier days. To get a positive outcome from this performance category, clinicians must report at least 6 Quality measures (one of them is an outcome measure) over 12 months for at least 70% of their designated patient visits.

 

Improvement Activities:

This particular category judges clinicians on a set of predetermined activities targeted at improving the quality of care. Clinicians, groups, and virtual groups ought to participate in activities most relevant to their practice and patient population.

Promoting Interoperability:

The Promoting Interoperability category stresses the use of the 2015 edition of Certified Electronic Health Record Technology (CEHRT) for e-prescribing, Health Information Exchange (HIE), patient engagement, public health, and clinical data availability. For 2020, similar to 2019, clinicians have to submit one set of PI measures to stay in line with the 2015 edition of CEHRT. The measures remain the same for 2020 as well.

Cost:

2020 marks the third performance year in which Cost will be weighted to calculate the MIPS Final Score. Briefly, it will be the average score for the Medicare Spending Per Beneficiary (MSPB) measure, the Total Per Capita Cost measure, and 18 episode-based measures. The episode-based measures include 10 new measures. However, they undergo automatic submission as CMS captures them through administrative claims.

Step 5 – Get Started with QPP MIPS

Under MIPS, the performance of clinicians matters. It’s no longer enough to report just the MIPS Quality measures and get it over with. You have to report measures for each category according to the submission guidelines to avail positive payment adjustments up to 9%. In case of negligence, it will cost you a hefty amount in the form of a -9% penalty on your total Medicare reimbursement.

Our intuitive and efficient health IT team will guide you at each step making the process a lot less challenging.

With us, success is inevitable.

No Burden of Contracts
Timely Reporting
CMS MIPS Qualified Registry
Dedicated Accounts Manager
Virtual support at odd hours
Healthy MIPS record of accomplishment for ECs

Being the MIPS Qualified Registry, we offer a systematic and consistent way to report data without getting overwhelmed.
The performance and penalty threshold reaches up to 7% – three points more than the last year. But, you don’t have to worry.

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