What Quality Measures Can Physicians Report for MIPS 2020 Reporting Services?

CMS revises MIPS reporting requirements every year. There is a high chance that the measures you reported last year may have been obsoleted this year.

2020 is particularly important as it is the year of some important updates.

You can rely on QPPMIPS.com to know about any MIPS update and get a solution to your reporting problem.

We have gathered all information about the topped-out measures and the updated measures for this year, so you submit data without any ambiguity.

What are the New Quality Measures?

A new update for MIPS Quality measures is that CMS (Centers for Medicare and Medicaid Services) requires at least 70% of the eligible cases (for both Medicare and non-Medicaid patients) for the whole performance year.

Groups with sixteen or more eligible clinicians will receive no points for this category, if they fail to meet the data completeness constraint.

However, eligible clinicians from small practices with groups of participants less than 16 can receive three points even if they submit data for less than 70% of the eligible cases.

Quality Measures to Report in MIPS 2020

There are approximately 216 quality measures to choose from and report this year (according to the final rule). Three new measures are added to the list along with seven new specialty measure sets.

New Quality Measures

For eCQM (Electronic Clinical Quality Measures)

#476 - International Prostate Symptom Score (IPSS) or American Urological Association-Symptom Index (AUA-SI) change 6 -12 months after Diagnosis of Benign Prostatic Hyperplasia

For CQM (Clinical Quality Measure)

#477 - Multimodal Pain Management

For CQM (Clinical Quality Measure)

#478 - Functional Status Change for Patients with Neck Impairments

Now, have a look at the list of new Specialty Measure Sets for MIPS 2020 Reporting.

Audiology Specialty Set
Pulmonology Specialty Set
Nutrition/Dietitian Specialty Set
Endocrinology Specialty Set
Chiropractic Medicine Specialty Set
Clinical Social Work Specialty Set*
Speech-Language Pathology Specialty Set

*Clinical social workers are exempt to report MIPS 2020. However, they can report data voluntarily.

We suggest all eligible clinicians check the CMS official documentation against each quality measure, so you report them as per their requirements.

What Quality Measures Have Been Removed from the List?

CMS removed almost 42 quality measures from the 2020 QPP MIPS Reporting list. The reason behind this is they no longer support the purpose of MIPS vision.

Given below is the list of topped out measures. We suggest going through all of these to avoid using inactive measures and lose points on them.

#046 - Medication Reconciliation Post-Discharge

#051 - Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation

#068 - Hematology: Myelodysplastic Syndrome (MDS): Documentation of Iron Stores in Patients Receiving Erythropoietin Therapy

#091 - Acute Otitis Externa (AOE): Topical Therapy

#109 - Osteoarthritis (OA): Function and Pain Assessment

#131 - Pain Assessment and Follow-Up

#160 - HIV/AIDS: Pneumocystis Jiroveci Pneumonia (PCP) Prophylaxis

#165 - Coronary Artery Bypass Graft (CABG): Deep Sternal Wound Infection Rate

#166 - Coronary Artery Bypass Graft (CABG): Stroke

#179 - Rheumatoid Arthritis (RA): Assessment and Classification of Disease Prognosis

#192 - Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures

#223 - Functional Deficit: Change in Risk-Adjusted Functional Status for Patients with Neck, Cranium, Mandible, Thoracic Spine, Ribs, or Other General Orthopedic Impairments

#255 - Rh Immunoglobulin (Rhogam) for Rh-Negative Pregnant Women at Risk of Fetal Blood Exposure

#262 - Image Confirmation of Successful Excision of Image-Localized Breast Lesion

#271 - Inflammatory Bowel Disease (IBD): Preventive Care: Corticosteroid Related Iatrogenic Injury

#325 - Adult Major Depressive Disorder (MDD): Coordination of Care of Patients with Specific Comorbid Conditions

#328 - Pediatric Kidney Disease: ESRD Patients Receiving Dialysis: Hemoglobin Level < 10g/dL

#329 - Adult Kidney Disease: Catheter Use at Initiation of Hemodialysis

#330 - Adult Kidney Disease: Catheter Use for Greater Than or Equal to 90 Days

#343- Screening Colonoscopy Adenoma Detection Rate

#345 - Rate of Asymptomatic Patients Undergoing Carotid Artery Stenting (CAS) (For patients who are Stroke Free or discharged alive)

#346 - Rate of Asymptomatic Patients Undergoing Carotid Endarterectomy (CEA) ((For patients who are Stroke Free or discharged alive)

#347 - Rate of Endovascular Aneurysm Repair (EVAR) of Small or Moderate Non-Ruptured Infrarenal Abdominal Aortic Aneurysms (AAA) (For patients who are discharged alive)

#352 - Total Knee Replacement: Preoperative Antibiotic Infusion with Proximal Tourniquet

#353 - Total Knee Replacement: Identification of Implanted Prosthesis in Operative Report

#361- Optimizing Patient Exposure to Ionizing Radiation: Reporting to a Radiation Dose Index Registry

#362 - Optimizing Patient Exposure to Ionizing Radiation: Computed Tomography (CT) Images Available for Patient Follow-up and Comparison Purposes

#371 - Depression Utilization of the PHQ-9 Tool

#372 - Maternal Depression Screening

#388 - Cataract Surgery with Intra-Operative Complications (Unplanned Rupture of Posterior Capsule Requiring Unplanned Vitrectomy)

#403 - Adult Kidney Disease: Referral to Hospice

#407 - Appropriate Treatment of MSSA Bacteremia

#411 - Depression Remission at Six Months

#417 - Rate of Open Repair of Small or Moderate Abdominal Aortic Aneurysms (AAA) Where Patients Are Discharged Alive

#428 - Pelvic Organ Prolapse: Preoperative Assessment of Occult Stress Urinary Incontinence

#442 - Persistence of Beta-Blocker Treatment After a Heart Attack

#446 - Operative Mortality Stratified by the Five STS-EACTS Mortality Categories

#449 - HER2 Negative or Undocumented Breast Cancer Patients Spared Treatment with HER2-Targeted Therapies

#454 - Proportion of Patients who died from Cancer with more than One Emergency Department Visit in the Last 30 Days of Life

#456 - Proportion Not Admitted To Hospice

#467 - Developmental Screening in the First Three Years of Life

#474 - Zoster (Shingles) vaccination

MIPS (Merit-based Incentive Payment System) has become a crucial part of how healthcare providers get reimbursed for their services. If you’re a physician, you might be wondering how to navigate the complexities of MIPS reporting, especially for the year 2020. This article dives into the quality measures you can report, the requirements, benefits, and some challenges you might face. So, buckle up and let’s get started!

Understanding MIPS

What is MIPS?

MIPS is a program initiated by the Centers for Medicare & Medicaid Services (CMS) to incentivize healthcare providers based on the quality of care they deliver. Instead of simply paying providers for the quantity of services, MIPS rewards them for improving patient outcomes and enhancing the overall care experience.

Importance of MIPS for Physicians

Why should you care about MIPS? Well, it directly impacts your payment rates! Providers who excel in MIPS can earn bonuses, while those who fail to meet the required standards may face penalties. It’s a way to promote higher quality healthcare and ensure that patients receive the best possible treatment.

Key Components of MIPS

MIPS consists of four main components:

Quality

This component measures how well you deliver care, focusing on specific areas such as patient outcomes and adherence to treatment protocols.

Cost

Cost measures evaluate the overall expense of the care provided, promoting efficiency without sacrificing quality.

Improvement Activities

This category encourages providers to engage in activities that enhance the quality of care, such as patient engagement strategies and care coordination.

Promoting Interoperability

This component ensures that healthcare providers are using certified electronic health record (EHR) technology to improve patient care and data sharing.

Quality Measures Explained

What Are Quality Measures?

Quality measures are specific criteria used to evaluate the performance of healthcare providers. These measures assess various aspects of care, such as clinical outcomes, patient safety, and patient experience.

Types of Quality Measures

Quality measures can be categorized into several types, including:

Outcome measures: Evaluate the end results of care (e.g., recovery rates).
Process measures: Focus on the methods of delivering care (e.g., screening rates).
Patient experience measures: Assess patient feedback and satisfaction.

Reporting Quality Measures for MIPS 2020

Eligible Providers

Most physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists are eligible to participate in MIPS.

Reporting Requirements

Individual Reporting

Providers can report quality measures as individuals, focusing on their performance metrics.

Group Reporting

Alternatively, groups of clinicians can submit their measures collectively. This method can help mitigate challenges individual providers may face, especially in smaller practices.

Performance Categories and Weights

For MIPS 2020, the performance categories and their corresponding weights were crucial:

Quality: 45%
Cost: 15%
Improvement Activities: 15%
Promoting Interoperability: 25%

Top Quality Measures for MIPS 2020

Specific Measures by Specialty

Quality measures often vary based on your medical specialty. Here’s a breakdown:

Primary Care

Preventive care measures (e.g., cancer screenings)
Chronic disease management (e.g., diabetes control)

Cardiology

Heart failure management
Statin therapy for patients with cardiovascular disease

Orthopedics

Postoperative care
Fracture management

High-Impact Measures

These are significant measures that have a broad impact on patient care and outcomes, such as:

Patient safety indicators
Readmission rates

Benefits of Reporting Quality Measures

Enhancing Patient Care

When you report quality measures, you actively contribute to enhancing the quality of care that patients receive. It's about creating a healthier community!

Financial Incentives

Meeting or exceeding MIPS standards can lead to financial rewards, making it worthwhile for your practice.

Improving Clinical Practice

The process of reporting encourages physicians to reflect on their practices, leading to improvements in care delivery.

Challenges in Reporting

Data Collection Issues

Collecting accurate data can be a struggle, especially for smaller practices that may lack the resources to manage this efficiently.

Keeping Up with Changes

MIPS regulations can change frequently, making it essential for physicians to stay updated and adapt accordingly.

Future of MIPS Reporting

Trends and Predictions

As healthcare continues to evolve, MIPS is likely to undergo further refinements, emphasizing value-based care and patient-centered approaches. Expect to see more focus on telehealth and integrating technology into care delivery.

Conclusion

Navigating MIPS 2020 can seem overwhelming, but understanding the quality measures you can report is crucial for your success. Not only do these measures enhance patient care, but they also benefit your practice financially and professionally. By staying informed and adapting to changes, you can thrive in this evolving healthcare landscape.

To succeed in the MIPS 2020, it is important to review every quality measure beforehand the reporting period. There is still a little time left, so if you have a lot of reporting work to do, contact us for a smooth data submission process aligned with the latest CMS requirements.

FAQs

What is the deadline for MIPS reporting?

The deadline for MIPS reporting typically falls at the end of the calendar year. For 2020 reporting, it was December 31, 2020.

How can I find quality measures specific to my specialty?

You can visit the CMS website or consult your specialty society for detailed information on quality measures relevant to your practice.

What happens if I don’t report MIPS quality measures?

Failing to report can result in penalties, including reduced reimbursement rates.

Are there penalties for low performance in MIPS?

Yes, providers who score below the minimum threshold may face penalties in their reimbursement rates.

How can I improve my MIPS score?

Improving your MIPS score involves regular monitoring of performance metrics, engaging in improvement activities, and ensuring accurate data collection.