Healthmonix Advisor

I was intrigued by a recent Becker’s article which outlines the results of Mount Sinai’s use of the “Hospital at Home” model for acute care. According to the article, patient experience showed improvement and readmission rates were noticeably lower. I had to know more, so I decided to do some research into exactly what this model of care looks like.

Healthmonix has just announced several types of increased functionality in the MIPSPRO measure engine, including new options to input the outcome of a measure for a visit using an “English” code. In this post, we’ll outline exactly what that entails, and what it means for our users and the future of interoperability.

Our measure status upload functionality will soon provide you with the ability to “tell” MIPSPRO the outcome of a measure for a visit using an English code, such as “Met”, “Not Met”, or “Exception”. Plain English expressions can be used in either spreadsheet or manual entry situations. This new feature will especially save time and energy for users whose EMR already tracks data in this or a similar format.

Through my work with MIPSPRO, I’m given daily opportunities to watch people reporting from the outside looking in. As a result, I’ve uncovered a few truths in reporting that providers might not notice if they’ve only ever reported through their EHRs or Claims submission. Today I want to share some of those insights with you.

Here at Healthmonix, we’re always looking for ways to make it easier for our customers to navigate complicated Medicare reporting requirements and optimize their Quality outcomes. In the spirit of that mission, I am pleased to announce the following new and upcoming improvements to our MIPSPRO reporting system, which enable our customers to make even better use of the data they already have and provide a more seamless, less burdensome reporting experience.

Primaris and Healthmonix have joined forces to help healthcare providers meet and exceed new regulations that tie the quality of patient care to the payment for that care.

In 2018, CMS is pushing even harder for the shift toward value based care. The minimum MIPS reporting score has increased from 3/100 to 15/100, and failing to report results in an automatic 5% reimbursement penalty. But if your practice or organization isn’t in a position to invest the kind of time, money, and resources that it takes to really go all in on VBC, you might be wondering: “what’s the minimum I can do to avoid the penalty?”

There is no one answer to this question, but the good news is that your practice has several options for how to report to earn a score of at least 15/100.

For many practices, one of the biggest differences between MIPS reporting for 2017 and 2018 is the amount of information that needs to be reported to achieve a high score. Gone is the test option that allowed clinicians to simply report on 90 days worth of patient visit information for the Quality performance category—now clinicians need to report on 60% of eligible patient visits per measure for all payers. This is typically a phrase I repeat a few times when discussing MIPS with practices who reported minimally for 2017.

As we make our way through year two of the Quality Payment Program (QPP), it’s clearer than ever that simply reporting quality data is no longer enough. CMS penalties and incentives reach 5% in 2018, and in future years payment adjustments will continue to increase along with the percentage of patients you will be required to report on. Meeting quality standards and cutting costs are also increasingly important as measures are assessed against benchmarks and peers. Choosing the best reporting method for your practice is therefore an increasingly important step toward reporting efficiency and ultimately reporting success.

This past Sunday, I was fortunate enough to attend the Philadelphia Take Steps Walk. Sponsored by the Crohn’s and Colitis Foundation and organized by members of the local community, this event raised $388,000 to fight inflammatory bowel diseases (IBD). Hundred of patients, providers, and organizations met at Citizen’s Bank Park here in Philadelphia to enjoy an educational festival, celebrate loved ones fighting IBD, and walk through the stadium and field as a show of solidarity to anyone suffering from these diseases.

We get a lot of questions from multi-specialty practices about how to get started with MIPS reporting. Measure selection can be confusing, and there are many common misconceptions, such as the assumption that different specialties cannot report together. Reporting MIPS can even seem entirely hopeless, due to the size, services, and systems used by your practice. That’s why this week we’re sharing our advice about the most significant steps your multi-specialty practice can take to set itself up for MIPS success!