MIPS is a point-based program and understanding how to earn MIPS points is critical to avoid a 9% penalty. The MIPS program continues to change and evolve each year as it meets the goals laid out in the MACRA law and carried out by CMS. Since the program was implemented in 2017 the points threshold to avoid a penalty has grown from 3 to 60 out of a possible 100 MIPS points; the penalty has increased from 3% to 9% of annual Medicarereimbursements; and, the number of patients required to be reported on has increased from 20 patients to all patients for all payors. With the rules changing every year, the strategy you previously used to score MIPS points and report may no longer be optimal. If you want to avoid the 9% penalty in 2021 and beyond, you must think differently and evolve your strategy for MIPS.
With all the complexities and nuances of the program, it’s challenging to know what you can do to impact your MIPS score. Here are three critical considerations that provide guidance on ensuring you have the right MIPS strategy to optimize your ability to earn MIPS points for the 2021 reporting period.
The Quality Category, worth the most points, is the category to focus most of your effort. Because the Quality category is worth anywhere from 40 to 85 MIPS points, focusing on this category throughout the year is critical. You need to submit a full year’s worth of data so now is the time to ensure that you are capturing all relevant data in your EHR and or billing system so that it can be properly extracted and reported on for your submission.
40% of the MIPS points require you meet stringent timeframe requirements. Two of the MIPS categories, Promoting Interoperability andImprovement Activities, have timeframe requirements where you must perform and document activities for a minimum of 90 continuous days. These are not easy categories in which to be successful and so if you wait too long you will find it impossible to put the right actions in place to complete the activities necessary to earn any of the MIPS points in these categories.
The reporting methodology you choose impacts the points you can earn. Not all reporting methodologies are the same and the reporting methodology you select has a significant impact on the MIPS points you could earn. Unless you select a reporting partner that will help you earn the most points available by leveraging technology to facilitate the ease, accuracy, and completeness of tracking and reporting to maximize your score, you risk leaving MIPS points on the table and significantly sub-optimizing your score. Reporting via a CEHRT, like Health eFilings, is the best approach because it optimizes the MIPS points that could be earned and therefore, maximizes Medicare reimbursements.
Health eFilings’, a CEHRT, is the national leader in automated MIPS reporting and our cloud-based ONC certified software fully automates the MIPS reporting process. And because Health eFilings’ service is an end-to-end electronic solution that doesn’t require any IT resources, administrative support, or workflow changes, you will save significant time while maximizing your financial upside.
Contact Sarah Reiter, email@example.com, or 608.841.1866 to find out how to maximize your reimbursements and protect your bottom line.
About Health eFilings:
Health eFilings, a CEHRT, is the national leader in automated MIPS compliance and quality data analytics. Its services drive improved patient outcomes, optimized quality measures, and stronger financial results for healthcare practices. Their proprietary cloud-based ONC certified software is significantly more efficient and effective than any registry as it does all the work to extract, calculate, benchmark, format, and electronically submit MIPS data to CMS so clients avoid significant penalties and earn maximum reimbursements. And, you can have peace of mind knowing you are working with the best partner because CMS has accepted 100% of Health eFilings’ submissions. Learn more here: https://healthefilings.com/ezclaim
ABOUT EZCLAIM: As a medical billing expert, EZClaim can help the medical practice improve its revenues since it is a medical billing and scheduling software company. EZClaim provides a best-in-class product, with correspondingly exceptional service and support. Combined, EZClaim helps improve medical billing revenues. To learn more, visit EZClaim’s website, email them, or call them today at 877.650.0904.
[ Contribution from the marketing team at Health eFilings’ ]
The 2020 MIPS reporting is already half done, and given that MIPS (Merit-based Incentive Payment System) is a points-based program, the goal is to earn as many points as possible to avoid this year’s 9% penalty and potentially even earn a positive payment adjustment. However, earning the 45 points necessary to avoid the penalty for the 2020 reporting period will be no easy feat. With over half of the reporting period already behind us, it is imperative you ACT NOW so you don’t find yourself in a position later in the year that you can’t recover from in terms of earning points.
With all the complexities and nuances of the program, it’s challenging to know what you can do to impact your score. Here are three critical actions to take right now so that you will still optimize your ability to earn points for the 2020 reporting period:
1. Focus on the Quality Category
There are various points available within each of the categories and the Quality Category has the most points associated with it. Based on a number of factors, the category is worth anywhere from 45 to 85 points. This is a critical category to be focused on throughout the year, so now is the time to ensure that you are tracking all relevant data so that it can be properly reported on within your submission.
2. Understand the Timeframe Requirements
Two of these categories, Promoting Interoperability and Improvement Activities, have timeframe requirementswhere you must perform for a minimum of 90 continuous days. These are not easy categories in which to be successful and so if you wait too long in the year you will find it impossible to put the right actions in place in order to complete the activities necessary to earn any of the points in these categories.
3. Choose the Right Reporting Methodology
Not all reporting methodologies are the same and the reporting methodology you select has a significant impact on the points you could earn. Additionally, there is strategic maneuvering that can be done throughout the reporting period with exemptions and reweighting of points that can set you up to optimize your performance and your score. Therefore, you must select a reporting partner that will help you earn the most points available and leverages technology to facilitate the ease, accuracy, and completeness of tracking and reporting to maximize your score. Reporting via a CEHRT, like Health eFilings, is the best approach because it optimizes the points that could be earned and therefore, maximizes Medicare reimbursements.
Health eFilings is a certified EHR technology (CEHRT) and the national leader in automated MIPS reporting. Their cloud-based ONC-certified software fully automates the reporting process. Because Health eFilings’ service is an end-to-end electronic solution that doesn’t require any IT resources, administrative support, or workflow changes from you, the practice will save significant time while maximizing its financial upside.
To learn more about how to properly perform your 2020 MIPS reporting, contact EZClaim’s partner, Health eFilings, so they can help before it’s too late!
For details and features about EZClaim’s medical billing software, or general information about the company, visit their website.
[ Written by Sarah Reiter, SVP Strategic Partnerships, Health eFilings ]
There WILL NOT be any changes to the MIPS Program in 2020, so all payers must be submitted and a minimum of 45 points must be earned to avoid the 9% penalty.
On March 23, 2020, CMS made it perfectly clear that MIPS Program is not going away in 2020. It also reiterated that the data requirements and thresholds in place for the 2020 program have not changed. Additionally, Promoting Interoperability and Improvement Activities must be done for the required durations, or no points will be earned for those categories.
To put this in context, while the stakes have been raised every year, the final ruling for the 2020 reporting period is the most complex to-date, further increasing the stress, burden, and financial risk for over 900,000 clinicians who bill Medicare Part B. Failure to comply or earn enough points for the 2020 reporting period will result in an automatic 9% penalty on every Medicare Part B claim paid for an entire year. This equates to a minimum of a $8,100 per provider hit to the bottom line.
Given the unprecedented time when everyone’s bottom line is at risk, now is the time to get a handle on what’s at risk with the MIPS program and proactively engage to ensure your bottom line is not further jeopardized by being assessed a 9% penalty. It can be challenging to know exactly what you need to do to earn points, optimize your score, and protect your Medicare reimbursements, as there are many commonly misunderstood aspects and nuances with the MIPS program.
So, with what is at stake and the inherent complexity in earning points, it is critical that you select the right methodology and partner who can help you maximize reimbursements and protect your bottom line. Not all reporting methodologies are the same.
Health eFilings‘ CEHRT is the best choice for a reporting partner. Their cloud-based ONC-certified software fully automates the process and does all the work without any IT resources, administrative support, and workflow changes from the practice. Health eFilings service is an end-to-end electronic solution that will save significant time, be a turn-key submission process, and maximize the financial upside for providers.
As more than 25% of the 2020 reporting period is behind us, now is the time to act while there is still plenty of time to positively impact your results and points earned.
Health eFiling provides the nation’s only fully automated solution for MIPS compliance and is integrated with EZclaim’s billing solution. Click on the following link for more details: https://healthefilings.com/ezclaim
[Contribution by Sarah Reiter with the Senior VP of Strategic Partnerships]
There are many commonly misunderstood aspects and nuances with the MIPS program, particularly in how points are earned. For a healthcare practice, it can be challenging to know exactly what to do to earn points, optimize the score, and protect their Medicare reimbursements. But, at the same time, the stakes have been raised every year and the final ruling of the program is even more complex than it has been in the past, further increasing the stress, burden, and financial risk for a healthcare practice.
The approach a practice takes to report for MIPS will greatly impact the results. Many do not understand or have awareness of, the different reporting methods available to them. Many Providers erroneously still think that a registry is the only reporting option available to them or that they are required to use a registry. Or, they think that their EHR covers their reporting obligation or that an EHR’s reports satisfy the MIPS requirements. These misperceptions and erroneous assumptions are detrimental to the financial interests of any practice.
There is a third reporting methodology that has been established and authorized by CMS, called CEHRT, or Certified EHR Technology (software). The CEHRT methodology assists CMS with their need for more valid data submitted through technology and to refocus Providers from merely using technology towards Providers leveraging technology to improve outcomes. Reporting via a CEHRT using software that has been certified by the ONC is a superior approach because it optimizes the points that could be earned and therefore, maximizes Medicare reimbursements for the practice.
Recently an RCM company CEO approached us at Health eFilings with the decision to use six of her clients to conduct a side-by-side comparison of the registry and Health eFilings (CEHRT) methodologies for reporting. In this manner, she intended to validate for herself whether a CEHRT or registry would generate the greatest ROI for her clients. The results of using Health eFilings’ MIPS Accelerator service, on average earned almost triple the points versus a registry for the same year for the same clients.
“Due to limited understanding and guidance, we weren’t aware of the differences of the reporting methodologies available for my clients. We believed there was greater opportunity, but the current registry methodology we had chosen didn’t demonstrate that for our clients.”
Katy, RCM Company CEO
This side-by-side comparison highlights not only that a CEHRT is a superior method of reporting as Health eFilings was able to leverage technology to facilitate the ease, accuracy, and completeness of tracking and reporting, but it also maximizes a Provider’s MIPS score. Additionally, given the levels of Medicare reimbursements for these practices, the higher score resulted in their earning a positive payment adjustment, which significantly improved their bottom line. And, take note that if the Registry were to perform the reporting for the 2019 reporting period, these practices would not earn enough points to avoid the penalty of negative 7%.
Health eFilings with its proprietary ONC certified software has many advantages over any type of registry:
Automatically extracts data from any EHR or billing system
No staff or IT time required to comply
Benchmarks performance versus peers based on CMS standards
The proprietary algorithm evaluates 9 million combinations to select the best quality measures to optimize the score
Earn 10% in bonus points for the Quality category
eCQM deciles earn more points than registry deciles
Almost all eCQM’s have a CMS benchmark versus less than 25% of registry measures
Electronically submits the data to CMS
And, important to note that it’s NOT too late to comply for the 2019 reporting period as Health eFilings is able to support new clients, but time is of the essence. Reach out NOW if you or your client hasn’t reported for 2019—there is NO REASON to accept the 7% revenue hit.
Now EZClaim and Health eFilings want to ensure you can partner with the only complete, end-to-end MIPS compliance solution that saves you significant time and money. To learn more, click the following link: https://healthefilings.com/ezclaim
[ Article was written by Sarah Reiter, Vice President of Strategic Partnerships with Health eFilings ].
The Medicare Access and CHIP Reauthorization Act (MACRA) and the program designed to implement the law, Merit-based Incentive Payments Systems (MIPS), have raised the financial stakes and the complexity of regulatory compliance for all healthcare systems. Simply put, healthcare organizations, like yours, have no choice but to engage and embrace the shift to value-based care to improve outcomes and therefore maximize your reimbursements.
And the method of reporting for the MIPS program can have a significant impact on your ability to earn points. Not all reporting methodologies are the same. There are BIG differences between MIPS reporting methods and what you don’t know could result in a 7% penalty increasing to 9% penalty for the 2020 Reporting Period, not to mention lost bonuses! The most effective, and most efficient, reporting methodology is known as Certified EHR Technology or CEHRT.
But why is CEHRT reporting the superior method? In this post, we will address the comparison of CEHRT reporting with the legacy “Registry” reporting method. Here are the top three reasons that working with a CEHRT, like Health eFilings, is the superior approach:
1. The software does all the work
Health eFilings’ ONC certified software is an “end to end electronic solution”. The software will extract, analyze and prepare the data in the most complete and accurate manner without requiring any administrative or IT support from you, the practice.
In contrast, registry reporting is fully a manual process and simply is a combination of purchased forms and a submittal vehicle. With a registry, the burden of all the administrative work is placed on staff and requires manual measure calculation and measure selection, all with no visibility to the measure benchmarks.
2. eCQMs earn more points
Health eFilings uses eCQMs (electronic Clinical Quality Measures) for purposes of reporting, and eCQMS offer more and better measures to optimize the points that can be earned. Almost all eCQMs have benchmarks that provide a clearer and more concise way to determine your performance and earn more points. As a point of insight, think of how points are earned as grading on a curve, where your actual performance percentage is irrelevant but what is relevant is the way that percentage compares to your peers, and my peers, it means all providers, regardless of specialty or geographic location, who submit data for that measure.
As a point of comparison, almost half of registry measures don’t have benchmarks which mean no matter how well you do on that measure, your score (or points earned) will be significantly limited, resulting in few overall points.
3. End-to-end electronic solution and earns bonus points
CMS has determined that the data submitted via technology is more complete and accurate, and because of this, CMS is incentivizing clinicians and practices by awarding them bonus points toward their MIPS score when they use a CEHRT like Health eFilings.
However, a registry is not a CEHRT and does not meet CMS’s definition of technology and as such does not provide verified accurate and complete data. Therefore, a registry provides no opportunity for any bonus points for the practice.
So, when complying with MIPS, it’s critical to utilize the reporting method that optimizes the points that could be earned and leverages technology to facilitate the ease, accuracy, and completeness of tracking and reporting to maximize the score. Reporting via a CEHRT like Health eFilings is the best approach because it optimizes the points that could be earned and therefore, maximizes Medicare reimbursements.
Beyond the inherent benefits of leveraging technology, working with Health eFilings has many advantages versus any other reporting methodology:
Seamless integration with any EHR or billing system
No IT or Administrative resources needed from the practice
Tracks and reports for all MIPS categories
Earn bonus points because Health eFilings is an “end to end electronic solution”
A proprietary algorithm evaluates 9 million combinations to select the best quality measures to optimize the score
Electronically submits all data to CMS
Is there anything I can still do for 2019 reporting?
Even though the end of the 2019 reporting period is quickly approaching, you do not need to accept that you must take the automatic penalty for this year. Health eFilings can support you with reporting for the 2019 reporting period and also advise you on your situation to set you up to be ready for the start of the 2020 reporting so you are able to optimize your score.
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