The Healthmonix Advisor

Top Takeaways From The MGMA Annual Conference

Posted by Lauren Patrick on October 29, 2019

 

It felt as if the Medical Group Management Association (MGMA) Annual Conference, which we have attended for years, was smaller this year. The hall was down 10 percent, and the foot traffic was slower. Regardless, we left with plenty of insights into the state of the industry. Here are some of the highlights of what we learned:

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Topics: MACRA & MIPS, Industry insights, ROI

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 NPI level) or as a group (at the TIN level).

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

MIPS Scores Impact More Than Medicare Revenue, Commercial Payers Are Following Suit

Posted by Shannon Scott on August 8, 2019

Since 2017, the Centers for Medicaid and Medicare Services (CMS) Merit-Based Incentive Payment System (MIPS) has provided eligible clinicians a score of zero -100 annually based on the clinician’s efforts and data collection in four program categories: Quality, Improvement Activities, Promoting Interoperability, and Cost. A clinician’s final score for each year’s MIPS performance ultimately dictates a payment adjustment that is applied to his or her Medicare Part B reimbursement rate two years later. In practical terms, this means that a clinician’s 2017 performance impacts all of his or her Medicare claims that are filed in the 2019 calendar year.

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Topics: PRO Tips, MACRA & MIPS, Industry insights, VBC, 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.

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

A Summary of the 2020 MIPS Proposed Rule

Posted by Christina Zink on July 29, 2019

Today, CMS posted CY 2020 Updates to the Quality Payment Program to the Federal Register. Many clinicians are still trying to wrap their heads around how to report MIPS in 2019, but the release of the 2020 proposed rule is advantageous in deciding what to conquer both this year and in the future. As the title suggests, this document also covers other Quality Payment Program tracks, like Advanced APMs; however, for now we will just focus on the MIPS component of the proposed rule.

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Topics: MACRA & MIPS, Policy

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.

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

Everything You Need To Know About MIPS Cost in 2019

Posted by Christina Zink on July 18, 2019

The CY 2019 Medicare Physician Fee Schedule Final Rule involves a slew of regulatory changes that will apply to the 2019 performance year. Of course, wading through the final rule to find and understand the most important features of the policy can be grueling; but you’re in luck, because we’ve already done it so you don’t have to! In today’s blog, we’re focusing on the MIPS Cost category.

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Topics: MACRA & MIPS, Policy, Cost Performance Category

Three Reasons MACRA and MIPS Are Here To Stay

Posted by Christie Hicks on June 13, 2019

Look, we understand, we really do. MACRA is frustrating for doctors who want to spend more time talking to patients than checking boxes, and it’s often hard to recognize what, if anything, its requirements are actually doing to move practices toward value-based care. So of course it’s tempting to believe all those rumors (you know, the ones that have been flying around since the law was passed in 2015) about how MACRA and MIPS are on their way out, how CMS will be repealing the law any minute, how maybe it is an option to cover your ears and whistle until it goes away.

But we’ve been paying close attention to the shifting landscape of CMS policy since we released MIPSPRO in 2009, and in our expert opinion, the law isn’t going anywhere any time soon. Here are three reasons why.

 

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Topics: MACRA & MIPS, Industry insights

Everything You Need To Know About MIPS Improvement Activities In 2019

Posted by Christina Zink on June 6, 2019

The CY 2019 Medicare Physician Fee Schedule Final Rule involves a slew of regulatory changes that will apply to the 2019 performance year. Of course, wading through the final rule to find and understand the most important features of the policy can be grueling; but you’re in luck, because we’ve already done it so you don’t have to! In today’s blog, we’re focusing on the MIPS Improvement Activities (IA) category.

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Topics: MACRA & MIPS, Policy, IA Performance Category

Everything You Need To Know About MIPS Quality in 2019 Part 2: Scoring

Posted by Christina Zink on May 30, 2019

In our last blog we gave an overview of the MIPS Quality Performance Category and discussed its reporting requirements. This week, we'll look more in-depth at how this category will be scored for the 2019 performance year.

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Topics: MACRA & MIPS, Policy, Quality Performance Category