A New Strategy for a New Year of MIPS

What a difference a year makes! An adage that could be applied to anything and in the case of MACRA, the QPP, and MIPS it means everything. Twelve months ago, Medicare providers were just learning about their eligibility and had months to figure out what they wanted to do about it MIPS.

Fast forward to 2018 and those providers that submitted MIPS data are waiting to learn how much of a bonus they will earn in 2019. Those that didn’t are trying to justify the looming penalties and the fact that they are again playing catch-up. Provider frustration with added burden and a plea for a reprieve resulted in an increased the eligibility threshold. Some hoped that MIPS would go away but the new eligibility requirements have only excluded a large number of providers from earning a bonus in 2018.

What we’ve learned is that MIPS can’t be ignored, it’s not going away. Not only is it still here, it’s bigger, its more complex, the benefits are greater, and it requires a great effort for success. All providers, regardless of eligibility should embrace the MIPS program as an opportunity and should apply maximum effort to earning a full MIPS score.

In a few months CMS will publicize a comprehensive list of MIPS scores including all the providers that did not earn a score. Patients will have access to this list and will use it when choosing a provider. You can also expect to see private insures take notice of these scores, and we believe that they will soon adopt a similar pay for performance plan.

We believe that the raised eligibility requirements are not an ease of burden but are an exclusion. No one likes to be excluded from anything, especially when it comes to making more money! The take away is that participating in MIPS is of greater importance than avoiding a 5% penalty, it goes beyond the possible 15% bonus. Published MIPS scores will soon have an effect on how many new patients you see and will also have an impact on your non-Medicare payments. Physicians, especially small practices cannot afford to pass on MIPS this year.

The quality reporting period started January 1st of this year. You can’t wait any longer to get started. Call Access1 today to speak with a MIPS coach. We will confirm your status and establish a plan to help you stay competitive in a new MIPS market.