For many years now, Healthmonix has supported clients who engage with the Merit-based Incentive Payment System (MIPS) on a variety of levels, in terms of the maturity of their process. At the lowest level—let’s call it Level 0—we have clients that come to us because they just want to report and avoid a penalty. Just beyond that, at Level 1, are those clients that seek an incentive.
Now, as we continue to settle into the brave new world of value based payments, we have noticed that our clients at Level 1 are starting to get comfortable. Clearly they are investing time and effort into the process, but with incentives still relatively small, MIPS can unfortunately seem more like an annoyance than an opportunity, and it can be hard to see beyond the immediate requirements.
But we’re thinking bigger, and we want you to do the same.
RELATED: Disillusioned About MIPS Incentives? Here’s Why You Shouldn’t Be.
So what does it look like to move up this ladder, and start thinking about quality in terms of the bigger picture? Well, to return to our concept of maturity levels, a client moving up to Level 2 might start to think about efficiency, strategizing the reporting process, and planning how to keep reporting going smoothly on an ongoing basis.
Table: Levels of Clinical Quality Management Maturity
| Maturity | Level | Goal | Suggested Supportive Resources |
| Improve Health | Level 6 | Analytics to assess movement into APMs | MIPS & APM Consulting |
| Level 5 | Clinical coaching to improve care and patient outcomes | Clinical Coaching | |
| Level 4 | CCM to increase scores and patient outcomes | Chronic Care Management | |
| Reduce Variation | Level 3 | Workflow optimization to increase scores | Workflow Consulting |
| Improve Efficiency | Level 2 | Reporting on continual basis to track and improve scores | MIPS patient reports Data Integrations / eCQMs |
| Maintain | Level 1 | Reporting to maximize incentive | MIPS performance reports |
| Level 0 | Reporting to avoid the penalty |
This kind of planning requires data integration, continual data pulls, etc. that help you maximize efficiency and ROI with your process—tools that are already available in our current MIPSPRO platform. And once we get that data into our system, we are also set up to work with various partners to optimize the data, and use it to help you manage your patients better.
If you have patients with chronic conditions, for example, we can help you figure out how to check in on them, how to get them the care they need, and how to help them take care of themselves. Clinical coaching is also a higher-level consideration: we can bring in expert coaches to assist you in improving care, and then use analytics to dig down through the static and understand where any issues may be. We are also working on optimizing cost of care, reducing burden through EHR integrations, building partnerships to close gaps in care, and addressing risk. All of these elements come together to give our Level 2 clients an unparalleled foundation on which to build their success.
Healthmonix has been working on performance improvement and quality measures since 2007, and has been one of the top qualified registries since 2009. We became a quasi-QE this year, so now we can get claims data to marry with our clinical data (and we’re the first to do so). We continue to forge this path because we have a vision: to bridge the gap between data and QI activities, in order to make a real difference in patient care in the United States. We know that’s a big goal—but we also know that we can reach it, that we can help you reach it, if we work together.
