A recent webinar hosted by Studiomaca Medical-Surgical featured insights from physician practices that are participating in Medicare’s new (MIPS) just six months in the program’s transition year, which began January 1, 2017.
Full participation in MIPS isn’t mandatory for eligible providers until 2018, when they will be required to collect and report a full year of performance data to Medicare. But eligible providers can submit full or partial year data this year that Medicare will use to determine their payment adjustments in 2019. In fact, eligible providers must submit something this year to avoid a penalty in 2019. Practices waiting until 2018 might benefit from advice from practices that have decided to take advantage of the 2017 transition year to prepare for 2018 and the future of health care reimbursement.
The webinar, “After the transition from PQRS to MIPS: A case study of early adopters,” featured presenters from Healthmonix, a firm that provides technical support to providers to collect, analyze and report quality measures to CMS. Studiomaca Medical-Surgical and Healthmonix have a partnership that allows Studiomaca Medical-Surgical clients to access the Healthmonix reporting platform, MIPS Pro. The presenters for the webinar were Lauren Patrick, founder and CEO of Healthmonix, and Phillip Spence, a Healthmonix consultant who oversees the company’s partnership with Studiomaca Medical-Surgical and provides support to its customers.
1. Know what clinicians are eligible to participate and when
The first lesson for early MIPS adopters is to know what type of clinician is eligible for the program and when. Knowing this basic program information will help a practice determine what type of performance data needs to be collected and reported.
- Clinicians eligible to begin reporting performance data this year are: physicians; physician assistants; nurse practitioners; clinical nurse specialists; and certified registered nurse anesthetists. Medicare will adjust their reimbursement rates in 2019.
- Clinicians eligible to being reporting performance data in 2019 are: physical therapists; occupational therapists; speech-language pathologists; audiologists; nurse midwives; clinical social workers; clinical psychologists; and dieticians and other nutritional professionals. Medicare will adjust their reimbursement rates in 2021.
2. Successful program compliance requires practices to be organized
The second lesson for providers is to be organized. They recommended that physician practices build data collection, analysis and reporting into their daily routines. Advice from early adopters includes:
- Being organized is the key to success given the increasing reporting requirements and addition of new physicians to the practice.
- Assign the responsibility of keeping up to date on reporting requirements to a specific person or job title. Don’t leave it to chance or count on someone else to do it.
- Build a daily or weekly routine to check reporting requirements to stay current and avoid missing a new requirement.
3. Make data accuracy and timeliness a priority
The third lesson is to start early and don’t wait until the end of this year to get started. They said timeliness and accuracy count with reporting MIPS performance data and the only way to be proficient at both is practice and experience. Advice from early adopters includes:
- Manual data entry for large groups is impractical, and many EHR systems don’t support MIPS yet. Uploading data to a registry makes reporting much easier.
- Give physicians a printed patient encounter form for each patient visit to make it easier for them to capture the required information at the end of their day or week.
- Centralizing all MIPS reporting in one system improves compliance and helps ensure that the right data is being collected at the right time.
4. Get going as soon as possible to gain the competencies required to succeed
The fourth lesson is to use the transition year to plan and prepare for increased reporting requirements in 2018 and beyond. Advice from early adopters includes:
- Choose the participation rate that best matches the pace of the practice. Starting with the minimum and ramping up as the practice learns is an effective strategy.
- Doing the minimum to avoid the 4 percent penalty should be the practice’s first priority.
- Participating in PQRS will be an advantage when transitioning to MIPS. Clinicians who have experience reporting PQRS measures will find MIPS to be similar. The biggest change will be the increase in data that needs to be submitted. Still, participating as soon as possible is an important lesson as value-based reimbursement models will only increase over time.
Know who’s eligible, be organized, make data accuracy a priority and start as soon as possible. Following those four lessons from MIPS early adopters can help make the transition into the program by other physician practices as smooth and as successful as possible.
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