April 1, 2019
The performance of physicians is measured in several ways, and now they are being rewarded for tangible benchmarks.
The Centers for Medicare and Medicaid Services (CMS) is required by law to implement a quality payment incentive program, referred to as the Quality Payment Program (QPP), which rewards practice value and outcomes. As such, the Merit-based Incentive Payment System (MIPS) was designed to tie payments to quality and cost-efficient care, drive improvement in care processes and health outcomes, increase the use of healthcare information and reduce the cost of care. Program participants must report data collected during the calendar year, beginning January 1st and ending December 31st, with data graded in several areas. Data collected in one year must be reported by March 31st of the following year to be eligible for a payment increase and avoid a payment reduction for the next year.
Recently, the CMS published the Quality Payment Program Reporting Experience report. Exceeding CMS’s goal of 90% physician participation, the results found that 95% of 1,057,824 eligible clinicians avoided a negative payment adjustment through the 2017 MIPS, with 93% earning a positive payment adjustment. This data is overwhelmingly promising considering 2017 was the first year CMS ran the QPP, making reporting in MIPS’ inaugural performance year an unequivocal successful.
It is essential that physicians continue to participate and report through 2019, as well as each year going forward. Making MIPS reporting habitual will benefit eligible physicians because as the years go by, both the incentives and penalties related to the process will only increase. The highest payment adjustment applied to participants in the 2019 payment year is 1.88%, according to Revcycle Intelligence. Although reporting may become increasingly difficult going forward, it is crucial that as many eligible participants report through MIPS in order to receive a more substantial payment adjustment. Further, reporting above the recommended threshold will pay immense dividends, not only this year but well into the future. CMS stated that in 2017, most participants did, in fact, report more than the minimum—a very positive sign.
To better understand how MIPS scores are calculated, the CMS grades physicians on four core performance categories:
Physicians that meaningfully participated in the program, began reporting early in the year and remained motivated in reporting throughout the entire calendar year experienced measurable success
At ChartLogic, our mission is to positively impact patient care by delivering award-winning healthcare IT solutions to providers of every size and budget. We offer an ambulatory EHR suite with access to practice management and revenue cycle management services with a system built on understanding workflow and preferences intuitively, facilitating faster note taking and much more. For 25 years, we have been driven by the desire to improve patient care, office efficiency, and profitability for the physician practice. We stay current with technology and legislation that affect our client practices, helping to educate them while encouraging participation in programs that can affect their success. ChartLogic is the physician practice’s true health care partner and we can help your practice become MIPS ready. To learn more about ChartLogic’s vast suite of products and services, you can view our solutions here.