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 Medicare reimbursements; 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 and Improvement 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
EZClaim is a leading medical billing and scheduling software provider that combines a best-in-class product, with correspondingly exceptional service and support. For more inforatmion, schedule a consultation today, email our experts, or call at 877.650.0904.
This FREE Medicare reimbursements webinar will help healthcare providers with the financial challenges they are facing this year, and it’s critical not to ignore the impact MIPS compliance has on their bottom line.
There are many commonly misunderstood aspects of MIPS (Merit-based Incentive Payment System), and many nuances of how and when actions need to be taken to be able to earn points—and points significantly impact reimbursements!
To help bring clarity to MIPS, Health eFilings is holding a FREE 30-minute Medicare reimbursements webinar to help you understand key deadlines for this reporting period, what reporting methods will optimize your MIPS score, and how to increase the financial payouts from the MIPS program.
• Date: TUESDAY, DECEMBER 8, 2020, 1:00 – 1:30 pm EST
• Presenter: SARAH REITER, SVP Strategic Partnership of Health eFilings
• Register Here: https://healthefilings.com/ezclaim
The 2020 reporting period is quickly coming to a close, but there is still time to comply and avoid penalties. However, you must act quickly, so Health eFilings is here to help: https://healthefilings.com/ezclaim
Health eFilings is a ‘partner’ of EZClaim, a medical billing and scheduling software solution. For more details about their software, visit their website: ezclaim.com/features-pricing/
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 ].