Feeling Overwhelmed By MIPS?

These 4 Strategies Will Help.


Most physicians have a general understanding of MIPS, but many are feeling overwhelmed by the intricacies of the new payment model. Yet physicians who are unsure of their approach to MIPS are at financial risk. According to the CMS final rule, the majority of eligible clinicians will enter the MIPS performance track under MACRA in 2017. Therefore, the strategies you employ today will have a financial impact on your medical practice in 2019 and beyond. Most importantly, your MIPS score will be made public with a direct impact on your reputation. There is no time to lose. Here are 4 strategies to keep pace with MIPS.

Make the Right Choice in MIPS

In 2017, the MIPS model will calculate a composite score based on these performance measures with varying importance:

  •      60 percent Quality
  •      25 percent Advancing Care Information
  •      15 percent Clinical Practice Improvement Activities
  •      0 percent Resource Use (Cost)

Making the right choice is critical. In this first test year of MIPS participation, you have four choices:

  •      Avoid participating and suffer a 4 percent negative adjustment in payment in 2019
  •      Meet minimum program requirements and report one quality measure and one CPIA or required ACI to avoid a negative adjustment in payment
  •      Submit more than one quality measure, CPIA, or ACI for a minimum of 90 days for a neutral or minor positive adjustment in payment
  •      Report MIPS data for the entire calendar year for a moderate adjustment in payment and a potential bonus for exceptional performance

Important Dates:

  •      Registration to participate in MIPS: June 30, 2017
  •      Collection of data (minimum 90 days reporting): October 2, 2017
  •      Submission of data collected for 2017: March 31, 2018

Strategy #1: Fine-Tune Quality Measures

For the participation year 2017 under MIPS, 60 percent of your composite score will come from quality measures. It makes sense then to fine-tune these measures by adopting evidence-based approaches with minimum variation in care and strong clinical outcomes with contained costs. For example, you could focus on discharge planning for a reduced rate of readmissions, which is a major indicator of quality.

Most eligible clinicians will report six quality measures (including one outcome measure) for at least 90 days for the performance year 2017. Full participation in MIPS will entail reporting 15 quality measures for the entire calendar year.

Strategy #2: Tweak CPIA Measures

CPIA measures include activities that support coordination of care, health equity, and engagement with patients. For example, can you use data at your practice to more effectively categorize your population of patients? Can you develop culturally relevant interventions that improve clinical outcomes and result in cost savings? What can you do to improve collaboration and communication with patients and families for better engagement? Examples of CPIAs include methods, such as mobile reminders, to improve medication adherence or reduce no-shows at appointments.

For the performance year 2017, eligible clinicians will complete four CPIAs for at least 90 days. The exceptions are medical groups in rural areas and practices with fewer than 15 providers who are permitted to report two CPIAs for at least 90 days.

Strategy #3: Use EHRs Effectively

Electronic health records (EHRs) are vital for the exchange of health information and patient engagement. Your practice can improve quality by leveraging EHRs to conduct an analysis of security risks and implement necessary updates. You can improve your score by using e-prescriptions and enabling drug query functionality through certified EHR technology. You can improve patient engagement by providing options to view, download, and share health information online. Certified EHR technology can also be employed for referrals and transfers to other providers.

Strategy #4: Contain Costs

Under the new payment model, CMS will compare costs for similar care episodes provided by physicians from different practices. In other words, your cost-effectiveness will be compared to your peers. Although for the performance year 2017, resource use (cost) has 0 percent weighting, it is a smart approach to prepare for this measure in 2018. For example, your practice could use predictive analysis to avoid scheduling unnecessary procedures or tests that have a limited benefit.

There’s no reason to be anxious about MIPS if you approach the new payment model with an in-depth understanding and a clear strategy. Your MIPS score will reflect the care you provide to your patients. This score will be particularly important for younger physicians. In light of the above, the importance of partnering with an expert EHR vendor in 2017 and beyond cannot be emphasized enough 

Contact us to find out how we can help your practice with MIPS.

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