MIPS -Merit-Based Incentive Payment System – Medicare’s new program that determines payment adjustments.
Based on a composite performance score, eligible clinicians will receive a positive or negative adjustment on future reimbursements.
The Composite Performance Score is based on four performance categories:
- Quality Measures – Formerly PQRS
- Advancing Care Information (ACI) – Formerly Meaningful Use
- Clinical practice improvement activities
- Resource use (starting in 2018)
MIPS started on January 1, 2017 and annually measures eligible clinician’s performance in four performance categories to derive a “MIPS score” (1 to 100).
The MIPS score will determine the clinician’s Medicare reimbursement adjustment from -9% to +27% by 2022.
The clinician’s MIPS score will be published online.
MIPS is the largest change in medical reimbursement in over a generation.
The MIPS program changes every year and the ruling is constantly being reinterpreted and fine-tuned.
A well informed coach will help you take advantage of this huge opportunity to enhance patient care while significantly increasing your income.
Having a Coach allows you to focus on what you do best—Care for your Patients!
Having an experienced MIPS Coach will eliminate confusion and help keep you on track.
Our goal is to Help you qualify for the largest bonus and eliminate penalties with the least amount of effort by you and your staff.
Let us put you on the right track today and then keep you there!
The MIPS score will determine the clinician’s Medicare reimbursement adjustment from -9% to +27% by 2022. The clinician’s MIPS score will be published online.
Quality measure reporting makes up 60% of the final MIPS score for 2017. Over 250 available quality measures cover a broad range of health care providers and conditions.
Clinicians must select 6 quality measures including 1 outcome measure. Measures are selected based on the clinician’s specialty and are designed as preventative care measures.
Clinicians report for each quality measure for a minimum of 90 days. Quality measures have the largest effect on Medicare reimbursement penalties/bonus!
Selecting the right measures for your office is CRITICAL for MIPS success!
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Many Healthcare providers are asking if they should be participating in the MIPS program this year?
Unless you are exempt you have no choice: You are in the MIPS program.
The better question is “Should I enjoy the benefits from MIPS or just take the penalties?” --- Without Question “Take the Benefits!” it is not that hard.
This is the first year for MIPS and the requirements have been reduced.
Start now and be prepared for 2018 when the there is no “Pick your Pace” option.
Access1 will help you avoid penalties and qualify for the largest bonus with the least amount of work on your part.
Created by the MACRA legislation of 2015 to pay participating clinicians based on performance rather than fee for service.
There are two ways to participate in the QPP:
- Advanced APMs
- Merit-Based Incentive Payment System (MIPS)
QPP is a cost neutral program – every dollar collected through penalties must be paid out in bonuses.
2019 Medicare reimbursement will be based on MIPS performance in 2017.
Clinicians who do not report in 2017 will incur a 4% penalty on all Medicare reimbursement in 2019.
Clinicians with a high MIPS score will earn up to a 4% bonus on all Medicare reimbursement.
It’s not too late to start participation in the MIPS program.
Required annually as part of the HIPAA Act of 1996 and ARRA Act of 2009.
Reporting of Risk Analysis required as part of MIPS Advancing Care Initiatives attestation.
Attesting completion of a risk analysis is required as part of the MIPS Advancing Care Initiatives.
Without proper HIPAA risk analysis documentation clinicians do not meet the standards to qualify for a full MIPS positive payment adjustment.
Review of your reported Risk Analysis is commonly the first item chosen during an audit.
Access1 has years of experience completing HIPAA compliant risk analysis.
We will complete the physical and electronic components at a reasonable cost and help you complete this required MIPS component.
ACI replaces the Medicare EHR incentive program previously known as Meaningful Use.
Advancing Care Initiatives makes up 25% of the Total MIPS score.
There are two measure sets based on EHR certification.
To get any ACI credit Providers must report for all required measures in the appropriate measure set.
Bonus points can be earned for completing additional, non-required measures.
Submitting all ACI measures will count for minimum participation for 2017.
Data can be submitted through attestation, QCDR, Qualified Registry, or an EHR Vendor.
Who stays on top of all the Medicare Reimbursement changes in your office?
- The Doctors? No!
- Office Manager? No!
- Staff? No!
Most offices do not have a Medicare Programs Specialist – can you afford to lose up to a 25% difference in Medicare reimbursement?
What will a MIPS coach do for you?
- Select Quality Measures and track reporting
- Ensure you are meeting appropriate ACI measures
- Pick an Improvement activities that fit your practice
- Keep you up to date on changes to the MIPS/QPP/MACRA program
- Walk you through successful completion at the end of the reporting period
- Support you through any potential audits
Working with a MIPS coach that can:
- Help you avoid all penalties.
- Help you maximize your bonus.
- With the Least amount of work.
By now the bonuses and penalties associated with the MIPS program should be well known.
However, receiving a bonus in 2019 is not the only upside. There are further long-term benefits that can be gained by successfully participating in the MIPS program.
For the first-time providers will be graded on a standardized scale and MIPS scoring can be used to market your practice.
MIPS scores will be made public and providers with high MIPS scores should advertise these figures.
Many private insurance companies are looking at MIPS for the future. High MIPS scores could result in preferred provider status.
Practices with more than one provider can choose to report either individually or as a group.
Quality data can be submitted through several different methods:
- Registry
- EHR
- QCDR
- Claims
Selecting the best method of data submission for Quality Measures could result in a large difference in your final MIPS score.
Each MIPS category requires a different form of data submission or attestation.
What should you do?
Work with an Access1 MIPS coach to determine what is best for you and your practice.
