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A Brief Overview: Looking Back at MIPS 2019

MIPS cost measure, MIPS healthcare, MIPS quality measure, MIPS solutions, MIPS Submission Methods, QPP MIPS program

MIPS 2019 performance year is about to end. Only a little time is left until eligible clinicians can report for MIPS healthcare.

MIPS put forwards the opportunity to get incentives and bonuses aside from the regular payment model. The revenue cycle runs smoothly, and also if a clinician performs well in all MIPS performance categories, he/she can earn a reputation in the healthcare industry among fellow physicians.

Although, P3 Healthcare Solutions has published an overview of MIPS 2019 changes. But, we know it’s difficult to stay updated all the time. So, here’s a summary of everything happening in the 3rd MIPS year.

Go through them, and if you are missing on something, make sure to report according to the guidelines.

More Eligible Clinicians Can Report for MIPS 2019

The list of eligible clinicians is expanded to include more clinicians. Now, the following physicians can also report to CMS - The Centers for Medicare & Medicaid Services.

·         Physical therapists
·         Qualified audiologists
·         Clinical psychologists
·         Occupational therapists
·         Qualified speech-language pathologists
·         Registered dietitian/nutrition professionals

What’s the New Threshold for Penalty Prevention?

As more and more physicians are participating in the QPP MIPS program, the competition is getting tougher. Consequently, the MIPS performance threshold is also doubled.
To avoid a penalty, clinicians are required to score at least 30 points. Additionally, to achieve the top score, one has to score 75 points. The payment adjustment threshold is from -7% to +7%.

Information about the Low-Volume Threshold

Clinicians and groups who meet the following requirements are excluded from this program.

·         Physicians offering  healthcare services to 200 or lesser beneficiaries
·         Physicians having $90,000 or lesser in Medicare Part B allowed fees for healthcare services

MIPS Performance Categories – Modified

·         The percentage of quality and cost categories are changed in the total score
·         The percentage of quality category drops down to 45% from 50%
·         The percentage of the cost category is increased to 15% of the total score
·         The percentages for Improvement Activities (AI) 15% and Promoting Interoperability (PI) 25% remain the same

The reporting criteria are the same. There are no major changes.

Eligible clinicians can report for 6 quality measures with 1 outcome measure or a high-priority measure.

It is compulsory to report data for at least 60% of the cases in the whole performance year.

What’s New for Small Practices?

Small medical practices with TIN 15 or lower, will receive a bonus included in the Quality performance category.

If the eligible clinician report for at least 1 Quality measure, he gets a bonus of 6 points in the total MIPS score.

There is relaxation for small practices. If they report with uncompleted data on performance categories, they still get 3 points.

MIPS Submission Methods

There are multiple MIPS submission methods or submission mechanisms allowed for eligible clinicians.

If the clinician submits data to CMS via multiple methods (exclude CMS web-interface), the method having the highest points will be recorded.

Conclusion

The highlights of the QPP MIPS program are mentioned above.

There is nothing to afraid of MIPS 2019, and of course, it offers many revenue-generating chances for physicians. There is hard work required, but in the end, it’s all worth it.

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