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MIPS incentives and
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categories
& their weightage
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Ready to Ace MIPS 2021 and Avoid 9% Penalty

The MIPS 2021 Final Rule is here to make reporting even less burdensome for clinicians. The Centers for Medicare and Medicaid Services (CMS) pays attention to policies that govern the Quality Payment Program (QPP). Under the QPP MIPS 2021 program, CMS puts the interests of physicians, nurses, dieticians, physical therapists, audiologists, and chiropractors ahead. Additionally, MIPS Value Pathways (MVPs) come in to grant maturity to the existing facets of the program. However, for MVPs to become fully part of MIPS, we will have to wait until 2022.

Step 1 – Am I MIPS Eligible?

How do I know if I am eligible for MIPS 2021? If that’s the question you are wanting to ask, you are in the right place. Not only do we explain to our reporting clinicians their eligibility status, but also tell them how to report MIPS data. As a third-party intermediary, we want our clients to know that their compliance status turns green with us regardless of the time of the year they decide to submit measures.

Step 2 – Why Do I Have to Report MIPS 2021?

Why is it crucial for clinicians to report MIPS 2021? Whether it is the MIPS quality measures or measures for other categories, the sole purpose of this program is to ensure quality and decrease the overall cost of healthcare. With almost 5 years into MIPS & MACRA program, we have managed to improve patient outcomes through the application of measures. That’s what the program does and that’s why you must keep up with it.  

What you have to do is obtain a score of a minimum of 60 out of 100 points to avoid a penalty as decided in the CY 2020 Quality Payment Program Final Rule. 

Back in MIPS 2020, the minimum points to avoid penalty stood at 45 points. 

Besides, the exceptional performance threshold for PY 2021 stands at 85 points similar to what it was back in 2020.

Stay up-to-date with MACRA and MIPS.

Step 3 - MIPS Incentives and Final Score Range

How many MIPS incentives does one receive as a result of reporting proactively? It depends on the accuracy of MIPS submission and measures you choose as an individual or group.

We have to find measures most suitable for your practice and submit them accurately. In case you have switched to a new EHR system, select and report accordingly for the best results.

The MIPS final score depends on selected measures and their scoring potential. On the whole, the trick to scoring big in MIPS Quality reporting is a mixture of quick intellect, experience, and accuracy all at once.

Step 4 – Performance categories and their weightage

Ask yourself which performance categories do I have to report?

As an eligible clinician or group, it is a no-brainer that you are supposed to attest to four performance categories: Quality, Cost, Improvement Activities, and Promoting Interoperability.

The four categories judge the performance of practices via measures. Each category, with a highlighted weight, has a specific role to play. The 2021 MIPS requirements include adequate reporting with accuracy for the time windows made mandatory by CMS.

Quality:

It holds a total of 209 measures upon which the fate of clinicians depends for the 2021 period. Quality measures encompass a critical portion of the overall MIPS 2021 measures. In case you are looking for a distinguished total score, you ought to score high and handsome in this category.

Improvement Activities:

Unfortunately, COVID enters with us into the new year, which calls for the continuation of COVID-19 clinical data reporting improvement activity. Eventually, we are going to find our way out of it. Therefore, ECs ought to perform this activity for MIPS 2021 payment adjustment. In addition, clinicians receive a modification of two of the existing improvement activities.

Promoting Interoperability:

Healthcare MIPS is a starting point for clinicians to reflect on their value-based care journey. MIPS billing results in incentives and bonuses out of the $500 million pool on exceptional performances. Rest assured, QPP MIPS as a MIPS consulting firm, reports on your behalf keeping in mind what might the future hold for you to the best of our ability.

  • A new Health Information Exchange (HIE) bi-directional exchange measure comes in as an alternative to the two existing measures of the HIE objective – it is optional.

Cost:

MACRA MIPS cost category involves additional telehealth services directly related to existing episode-based cost measures and TPCC measures. Moreover, CMS continues to assess, as before, this activity based on the filed Medicare Part B claims.

  • Like MIPS 2020, this year establishes a TPCC measure
  • MSPB Clinician measures unchanged from back in 2020
  • And, 18 prevailing episode-based Cost measures

Step 5 – Execute MIPS 2021 and Show Compliance

At this step, the actual reporting begins. You are about to submit MIPS full form in healthcare at this stage through your third-party intermediary unless you choose another method to report it. Collect maximum revenue out of your submission using our Registry, one of the recognized MIPS data submission methods. If done right, you are on your way to success both financially and reputationally. Here’s what you get:

  • Dedicated HIT analyst
  • Accurate submission
  • MIPS Quality, IA, PI, and Cost measures for all specialties
  • EHR interoperability measures reporting
  • Data validation and support
Execute-MIPS-2021-and-Show-Compliance