The Healthmonix Advisor

Mike Lewis

Find me on:

Recent Posts

Reporting MIPS as Individuals or as a Group: Why Not Both?

Posted by Mike Lewis on September 26, 2019

The Merit-based Incentive Payment System (MIPS) can be rewarding for those who optimize their scores, and devastating for those who fall behind. 2019 is no longer considered a transition year, which means that the program is doing away with much of the leniency that made reporting easier in the past. The financial risk is now as high as 7%, while the performance threshold has increased to 30 points.

As the stakes continue to rise, it’s more important now than ever before that organizations strategize about their MIPS reporting process for 2019 and beyond. And in the course of that effort, one major decision they will need to weigh carefully is whether to report as individuals (at the TIN level) or as a group (at the NPI level).

Read More

Topics: PRO Tips, MACRA & MIPS, Healthmonix, Administrative Burden, Hospitals & Health Systems, ROI

MIPS Hacking for Psychologists: Turbo-boost your ROI With This One Simple Trick.

Posted by Mike Lewis on August 1, 2019

In last week’s blog I laid out the case for opting into MIPS, an option that allows clinicians and groups to still receive a MIPS payment adjustment if they exceed 1 or 2, but not all, elements of the low-volume threshold. Although this option can be beneficial for a wide range of clinician types depending on their situation, today I want to focus on psychologists in particular. Because in my experience, they provide some of the most striking examples of this “MIPS hack” in action.

Read More

Topics: PRO Tips, MACRA & MIPS, Eligibility, Small Practice, VBC, ROI

MIPS Hacking: Why the MIPS Opt-In Policy Could Seriously Boost Your Bottom Line.

Posted by Mike Lewis on July 25, 2019

Beginning in 2019, otherwise-eligible clinicians, groups, and APM entities can elect to opt-in to MIPS if they exceed 1 or 2, but not all, elements of the low-volume threshold. That means that for the first time, these previously ineligible clinicians have the opportunity to participate in the QPP and earn a payment adjustment.

Now maybe you haven’t had the time to pay close attention to policy minutiae, and this is the first you’re hearing of the opt-in option. Or maybe you’ve heard of it, but haven’t looked seriously at what it could mean for you or your organization. After all, on the surface it just sounds like work that isn’t required--and could it really make enough of a difference to your bottom line to be worth it?

Well, we highly recommend you do the math to find out. Because depending on your situation, you might be very, very glad you did.

Read More

Topics: PRO Tips, MACRA & MIPS, Eligibility, Small Practice, VBC, ROI

MIPS Hacking: Report as a Group to Maximize ROI

Posted by Mike Lewis on March 14, 2019

I speak with many organizations who are planning to report MIPS individually, only for their eligible providers. What they fail to realize is that they can achieve significant additional revenue by reporting as a group for all providers in their practices, even those that are deemed ineligible. In these cases I like to do a simple cost comparison to show what organizations are missing out on, and while each case is unique, the results are often striking.

Read More

Topics: PRO Tips, MACRA & MIPS, ROI

Chance Breakfast Dr. Barbara McAneny, President of the AMA

Posted by Mike Lewis on November 29, 2018

The early bird gets the worm.” 

I'm not sure when I heard this for the first time, but it became the guiding principle to my work ethic. Always show up first to any event whether personal or professional - that's the code.  This time it paid off!

Read More

Topics: Industry insights

How To Start With MIPS (If You've Been Avoiding It)

Posted by Mike Lewis on November 8, 2018

CMS reports that for 2017, just over 90% of eligible clinicians participated in the Quality Payment Program (QPP). That number is impressive, but what about the nearly 10% who declined to participate? Many adopted a “wait-and-see” approach, or were concerned that the required investment of time, money, and effort wasn’t worth the reward. But the QPP is here to stay, and some physicians may only now be wondering where to start, or even whether they can succeed at all after avoiding it for so long.

If you find yourself among that number, don’t worry, because it’s not too late! This week we’re laying out the first things you should know, and the first steps to take.

Read More

Topics: PRO Tips, MACRA & MIPS

Specialists: The Secret Key to CMS Success

Posted by Mike Lewis on October 18, 2018

 

  • I’m seeing a patient for dermatitis – Why do I need their BMI?
  • I’m seeing a patient for a colorectal screening – How is it going to help me if they got their flu shot?
  • I’m a Specialist. Why is it my job to ask these questions?

I encountered these questions all the time as a MIPS consultant within the specialty market. I spent the past 6 years working with providers who just want to provide better care to their patients. They didn’t mind participating in the programs, but they were not convinced there was much value.

Read More

Topics: PRO Tips, Small Practice

5 Ways to get Your Staff to Buy-In to MIPS

Posted by Mike Lewis on September 7, 2018

You have been dealing with the bureaucracy behind quality reporting for years - silly questions with no relevance to your field or specialty, EMRs changing the way measures are recorded, CMS changing requirements during the reporting period. It’s hard enough to get your fingers around the changes as a manager or provider, but imagine the confusion on your staff’s side! Plus, they don’t have the incentive of financial responsibility or a reputation to uphold.

So, how do we get their buy-in?

Read More

Topics: PRO Tips, MACRA & MIPS