The shift from a fee-for-service model of payment to value-based care is here. There’s no doubt we’re witnessing the largest initiative to build a model focused on wellness, patient experience, and prevention. Physicians need to be prepared and educated for a smooth transition as Meaningful Use (MU) evolves.
Now Is The Time To Be MIPS Ready
As a refresher, the new Medicare Access and CHIP Reauthorization Act (MACRA) established the Merit-Based Incentive Payment System (MIPS), along with Alternative Payment Models (APMs). MIPS streamlined reporting programs by combining the PQRS, the VPM, and the MU EHR Incentive program. Most eligible clinicians will participate in MIPS and receive bonuses or penalties based on their performance in four categories. These categories are:
- Quality (60%) – This refers to the quality of care and performance. The category replaces Physician Quality Reporting System (PQRS), and the quality component of Physician Value-based Payment Modifier (VPM).
- Improvement Activities (15%) – This is a new category focused on care coordinating, beneficiary engagement and patient safety.
- Advancing Care Information (25%) – This category replaces the Meaningful Use (MU) EHR incentive program and now places MU under the MIPS umbrella.
- Cost (0%) – The fourth category is added in 2018 and calculated with claims, not additional reporting.
Note that the percentages are defaults and can be adjusted in certain circumstances. For a more in-depth guide, download our white paper, MIPS: The New Meaningful Use.
2017 Reporting Coming To An End
MACRA will use 2017 data as the physician’s first performing year. If you chose MIPS, physicians will be measured in three of four MIPS categories for the first year. These are quality, advancing care information and improvement activities.
Physicians should leverage existing performance elements as they prepare for reporting data. MIPS enables clinicians the flexibility to report on activities that most accurately demonstrate the performance of their practice.
The calculated result will determine a Composite Performance Score. The 2017 score will influence future payment adjustments for 2018. The score will determine positive, neutral or negative adjustments to each provider’s annual Medicare reimbursement. A recent CMS presentation outlined the score threshold and impact on payment adjustments. Not submitting data may lead to penalties and missed bonuses.
Get Ready For 2018 MIPS Today
Providers will continue to be accountable for proactively managing the health of their patients and community. The need for advanced information technology solutions will increase as the expectation for quality care at a lower cost continues to grow. For MIPS reporting in 2018, providers must be using 2015 certified software in order to qualify. ChartLogic’s Connect Patient Portal has achieved Office of the National Coordinator for Health Information Technology (ONC-Health IT) 2015 Edition Health IT Module Certification via Drummond Group LLC as of August 18th, 2017.
Consider ChartLogic as the partner to help you navigate the MIPS transition in 2018 and the future of health care. For more information on our solutions, you can request a demo here. Together, we’ll improve the delivery of care across the continuum.