Healthmonix Advisor

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).

Health systems face a unique challenge when navigating the CMS Quality Payment Program (QPP). All currently available options to comply with the QPP require the submission of some form of clinical quality measures. With multiple specialties and often multiple sources for tracking billing and clinical data, aggregating all available data in a coherent, efficient, and centralized way can seem nearly impossible for the average health system. This case study demonstrates how MIPSPRO assisted one of their health system clients by streamlining their quality reporting process.

Patients want to be treated with dignity and respect. And when they are, as the American College of Physicians (ACP) points out in a recent position paper on patient engagement, they are more likely to interpret their experience as a quality care encounter. Organizations can improve outcomes and adherence to care plans by helping patients and families feel central to their own care experience, and research even suggests that patient experience is a more important factor in patient loyalty than standard marketing efforts.

In today’s quality-focused healthcare environment, patient satisfaction is commonly used as a metric for success—which means that it can affect your bottom line. But what if a patient becomes dissatisfied before the appointment even begins? Unfortunately, this happens daily in practices across the nation, as patients grow frustrated from long and unpredictable wait times.

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.

Hospital readmissions can be bad news for patients, but they can also be bad news for a hospital’s bottom line. Readmissions cost $41.3 billion overall, a majority of which—about $26 billion annually—is paid by Medicare. Moreover, as much as $17 billion of Medicare-paid readmissions are considered to be avoidable.

With the beginning of June came the half-way point for the first year of MIPS reporting. While many providers haven't started reporting yet, a good number of clinicians have started early. We interviewed clinicians and practice administrators who have reported PQRS in the past via registry, are currently reporting through the MIPSPRO registry, and that represent a diverse demographic of MIPS eligible clinicians.