Maximizing MIPS Score with Health eFilings

targeting a better MIPS scoreThere 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 misperception 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.

MIPS score comparison graph

“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 the 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 maximize 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
  • Proprietary algorithm evaluates 9 million combinations to select best quality measures to optimize 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 written by Sarah Reiter, Vice President of Strategic Partnerships with Health eFilings ].

The Importance of Selecting the Right Reporting Methodology

2019 MIPS Reporting2019 MIPS Reporting

2019 MIPS Reporting – Guest Author: Sarah Reiter of Health eFilings

The Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law on April 16, 2015, and is driving the transition in healthcare from a volume to a value-based care model. CMS programs such as MIPS require providers to transition to a value-based care model or else face significant financial risks and even reputational harm. The stakes have been raised every year and it is even more complex than it has been in the past, further increasing the stress, burden and financial risk to providers. For a provider, it is critical to understand the impact that the reporting methodology has on one’s MIPS score and to choose the best methodology and reporting partner.

Within this new framework of the MIPS program, all healthcare practices regardless of size or specialty must evolve their approach to reporting to assure their financial viability. However, most 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. This misperception and general lack of awareness of the other reporting methodology is detrimental to the financial interests of any practice. And, furthermore, for the 2019 Reporting Period, it is likely the first time that traditional, legacy reporting systems (registry or EHR) may be unable to fulfill enough of the reporting criteria to avoid the minimum score penalty.

The other reporting methodology, known as a Certified EHR Technology or CEHRT, has emerged as the superior reporting methodology. Reporting through a CEHRT dramatically improves the efficiency and effectiveness of the MIPS reporting process especially when done using ONC certified software. Also, a CEHRT utilizes eCQMs (electronic Clinical Quality Measures), which are a better way to optimize the points that can be earned.  When the process utilizes ONC certified software and is, therefore, an end-to-end electronic solution, CMS awards significant bonus points toward the provider’s MIPS score.

Health eFilings, a CEHRT, is the best choice for a reporting partner. Our cloud-based ONC certified software fully automates the process and does all the work with no IT resources, administrative support, and workflow changes. 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.

And, finally, an important and timely addendum: While the 2019 reporting period is quickly coming to a close, Health eFilings can support you with reporting for 2019 so that you will avoid the automatic 7% penalty for not complying. But, time is of the essence, reach out NOW to connect with Health eFilings.

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