Maximizing MIPS Score with Health eFilings

by Dan Loch | Mar 10, 2020 | Health eFilings, Partner

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 ].