Healthmonix Advisor

Last Minute Hacks for Small Group MIPS 2019 Reporting


So, it’s now mid-December and you have put off MIPS reporting for any number of reasons including:

  • Incentives have been low
  • It doesn’t fit into your workflow
  • It’s not easy
  • You just don’t want to deal with it

If you are a small group (15 or fewer clinicians), 2019 is the last year that it will be easy to avoid the penalty.

What you need to know to meet minimum MIPS requirements to avoid a penalty:

1. You must report at least one patient that meets the quality action criteria for six quality measures.

2. It’s critical that you report 2 medium or 1 high weighted Improvement Activity that was completed for 90 days.

3. Signing up for MIPSPRO Standard will help you complete these tasks!

Your five hacks for achieving a MIPS score of at least 30%:

1. Verify your eligibility using the participation status look-up tool.

This tool produces a full eligibility report for any input NPI, enabling you to see if you have to report MIPS this year, which TINs you are (and are not) eligible to report under and whether or not those TINs qualify as a small practice.

2. Identify six quality measures that apply to at least one patient your practice.

An easy way to do this is to find a solution that supports both group reporting and filtering measures by specialty/ commonly used codes without unneeded features, like MIPSPRO Standard.

Easy Measures for Most Specialties:

47 – Advance Care Plan

110 – Preventive Care and Screening: Influenza

111 – Pneumococcal Vaccination Status for Older Adults

130 – Documentation of Current Medications in the Medical Record

226 – Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

431 - Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

3. Report one patient visit where you performed the quality action for each selected measure.

Let’s use the example of you reporting Measure #130: Documentation of Current Medications on the Medical Record. The quality action described in this measure requires that the clinician ensured the patient's current medication list was up-to-date on that date of service, and eligible patients on which to report this measure are 18 or older, with specified CPT or HCPCS codes that can be found in the measure description.

To complete this measure to avoid the penalty, simply find one date of service for patient where the clinician confirmed the list of medications was documented. The recommended quality action can be found in the measure description for each measure under the "numerator" section. 

4. Report either 2 medium or 1 high-weighted improvement activity that was completed for 90 Days.

 Select measures for activities that you have already completed for at least 90 days. Our MIPSPRO Standard package makes reporting your Improvement Activities very easy.

Most popular measures that you may already be completing:

IA_BMH_4 – Depression Screening

IA_PM_16 – Implementation of medication management practice improvements

IA_BE_4 – Engagement of patients through implementation of improvements in patient portal

IA_EPA_1 – Provide 24/7 Access to MIPS Eligible Clinicians or Groups who have real-time access to Patient’s Medical Record

IA_PSPA_21 – Implementation of fall screening and assessment programs

IA_PSPA_31 – Patient Medication Risk Education

5. You've now achieved a MIPS final score of at least 30 points, enough to avoid the 7% penalty in 2021.

The performance threshold that you need to achieve for the 2019 performance year is at least 30 points. This means achieving a score of 30 points or higher will guarantee penalty avoidance for the 2021 payment year. If you follow the steps described above, 30 points is a worst-case scenario score. In all likelihood, you will have a higher final score.



Topics: PRO Tips, Policy, Healthmonix, Eligibility