Coronavirus has struck all, but the healthcare industry is under its wrath the most. With double the power, physicians, medical billing outsourcing companies, and MIPS Qualified Registries are working together to undermine the effect.
MIPS 2019 performance year is behind our back, and now it’s time for 2020. Although given circumstances are tough, the planning for MIPS 2020 will get fruitful results in terms of revenue.
Physicians! Bear in mind that with each performance year, requirements change.
• Payment adjustment will be 9% in 2020.
• 45 MIPS points are required to stay penalty-free.
• An exceptional performance bonus will be awarded at 85 points.
The reporting burden is great, but, we can’t afford to stay idle. You are busy dealing with COVID cases and risking your life. We suggest don’t risk your future revenue with the current situation.
Here is a guide to get you through the MIPS 2020 details. MIPS reporting services can take notes and get started.
Check Your Eligibility Status. Review if you’re required to Report Data?
CMS has updated the eligibility tool. Now, physicians or MIPS Qualified Registries can check on their behalf that if they can report data or they will have to opt-in.
Even ineligible clinicians can voluntarily participate in MIPS.
Enter your NPI – National Provider Identification number into the tool to get updates about:
• The eligibility status
• Qualifying Alternative Payment Model (APM, (QP) or a Partial QP participation status
• If the physician is required to opt-in
• The special status designation, For Instance, Small Practice, Ambulatory Surgery Center (ASC)-based, Hospital-based, etc.
If a physician has switched places, checking the latest eligibility status is necessary.
Which Reporting Option to Choose: Individual or Group Participation?
Physicians can report data either individually or in a group. If chosen to report via a group, two or more clinicians can report via the same Tax Identification Number (TIN). All the participants of the group will get the same points in the end.
Group participation, of course, has some advantages. For Instance, Resources and time can be saved as it allows physicians a single MIPS submission on behalf of everybody.
• Group participants only have to report data for a similar set of patients.
• With more physicians on board, there are more chances to accurately submit data.
• However, there is a condition that at least 50% of participants should work upon the same activity for ninety days in order to report for Improvement Activities (IA).
Design Your Reporting Goals
Either you are submitting data via MIPS Qualified Registry or any other MIPS submission method, it's important to set goals beforehand. It gives time to analyze, and reflect the collected data for maximum revenue.
A Little Overview of MIPS Quality Measures
Quality
This category has a total of 45 points.
• Report 6 Quality measures, with at least 1 measure Outcome measure or a High Priority measure
• Reported data should comply with data completeness constraint, otherwise, the physician will receive 0 points. Small medical practices can earn 3 points for this.
• To score high, report each measure for 70% of the eligible patients.
Promoting Interoperability (PI)
This category has a total of 25 points.
• Data should be reported for 90 consecutive days.
• The use of a 2015 certified Electronic Health Record (EHR) is required.
• For extreme and uncontrollable situations, CMS weighs this category to 0 and credits in the quality category.
Improvement Activities (IA)
This category has a total of 15 points.
• Total data for 90 days is required.
• Groups with 16 or more clinicians: Attest to 2 high-weighted IAs or 1 high-weighted and 2 medium-weighted IAs or 4 medium-weighted IA measures
• Individual clinicians and groups with 15 or fewer clinicians: Attest to 1 high-weighted IA or 2 medium-weighted IA measures
Cost
This category has a total of 15 points.
There is no need to submit data for this category. CMS will itself calculate the performance based on the Medicare claim data.
Instructions for Small Medical Practices
• Report 6 Quality measures on 1 eligible patient each with at least 1 measure should be an Outcome or High Priority measure
• Submit 1 High-weighted or 2 Medium-weighted Improvement Activities
• Submit 1 High-weighted or 2 Medium-weighted Improvement Activities
QPP MIPS is a MIPS Qualified Registry ready to implement tried and tested strategies to increase physicians' score in MIPS performance. Whether you need assistance in submitting data to CMS or a full-proof plan to stay penalty-free, we got you covered in every need.
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