Just when you thought you had mastered CMS initiatives like Meaningful Use, the Physician Quality Reporting System, and the Value-Based Modifier program, along comes the Merit-Based Incentive Payment System (otherwise known as MIPS). While MIPS combines many facets of the various CMS programs listed above – facets which you may have mastered in your practice – there are some key things that are important to remember when preparing your Electronic Health Records systems, reporting, and internal workflows to address MIPS.
As the Curas team has worked with physicians and their staff in medical practices across the United States, we’ve identified five core areas where there is confusion, uncertainty or lack of knowledge around the details and impact of MIPS:
- MIPS will impact your finances.
There is no “maybe” about MIPS, nor is there the opportunity to ignore or opt out of the program. Of course there are a few exceptions to this statement, but the majority of medical practices in the United States will need to adapt to a MIPS world order for the foreseeable future. Fact is, if you accept Medicare Part B (and nearly 70% of doctors do), MIPS matters to your finances. Here’s why: if you do not adhere to the specified quality measures set forth in the program, you’ll begin facing penalties as early as 2019 for the 2017 performance year. At that time, your payment adjustment (which is the CMS euphemism for penalty), will be -4%. In 2020, that “adjustment” grows to -5%, then -7% in 2021 before capping out at -9% in 2022. The stakes are high, with a significant cut to your bottom line if you’re not prepared.
- Your MIPS score will become a part of your “permanent record”
Perhaps you haven’t been warned about your permanent record since high school, but it’s alive and well with MIPS. That’s because the primary goal of MIPS is to measure, track and record (in a permanent way) each physician’s scores on the various quality measures. It’s not just about the practice, it’s about the doctors, so it follows you around as you move to new practices, start your own, or join the staff of a hospital. That’s why it’s important to take MIPS seriously, if not just for the financial impact you’ll feel (as noted above), but potentially for the career impact it may have on your future.
- MIPS has already started – so you need to start too
The final MIPS ruling was released in October, 2016, and is in effect for the 2017 performance year. Have you started putting initiatives in place in your practice to track, measure and report on the various performance standards for MIPS? Have you examined how you’re currently using your EMR system, and whether it’s set up properly for what data you’ll need to access for MIPS? Considering that we’re well into 2017, it’s an urgent matter for your practice. Just like you experienced with previous CMS programs such as Meaningful Use and PQRS, you’ll likely need to make changes to how you’re leveraging your EMR system, what data you’re tracking, and how you’ll need to report that information to CMS.
- You can leverage what you experienced with previous CMS programs
MIPS combined many of the principals of MU, PQRS, and VBM into one program. While it may seem daunting to set forth on a new path with MIPS, there are many similarities and aspects of the program that you are likely already familiar with. It’s not completely foreign territory for you, so the great news is that you can set your fears and apprehension aside because the road to MIPS may not be quite as challenging as you may think.
- You can be successful with MIPS
Chances are, your practice may have successfully attested for Meaningful Use, and achieved the standards set forth in PQRS and VBM. That means you can do it with MIPS too. But as you experienced with the previous programs, you need a plan in place to get you there. You need to assess where your practice is now, and identify any gaps that may exist. You may even need to enlist a partner to help you through the process. In any case, MIPS is not an insurmountable obstacle, but rather an opportunity – an opportunity to not only receive incentives, but to also make improvements to your practice that can increase efficiency, enhance patient care, and implement processes that will add to your practice’s bottom line.
And if the whole world of these CMS programs is new to you, never fear. Although you may find yourself at a different starting line, you, too, can be successful with MIPS.
On the flip side, those who choose to participate in the MIPS program will experience the exact opposite – incentives! Those incentives begin at +4% in 2019 and grow annually to +9% by 2022. While you expose yourself to significant reductions in Medicare payments if you’re not meeting MIPS measures, you’re positioned to welcome incentives if you do. So whether it’s a positive or a negative impact for your practice, MIPS will impact your finances.
Regardless of where you find yourself and your practice in the CMS program scene, we all must acknowledge that MIPS has arrived to the party – and she’s a guest you’ll want to pay attention to because you will be impacted by her presence. So rather than hiding in the corner, get to know her, engage her in conversation, and share the information she’s looking for. Doing so is the difference between a positive experience, and one that could damage your practice and your reputation.
Want to learn more about MIPS and how your practice can get ready? Curas is hosting an informational seminar in St. Louis on Wednesday, June 14th to review the program and help put practices on the right path. Click here for more information.
Not in St. Louis, or can’t make the June 14th seminar? The Curas team will host a series of webinars to review MIPS. Check back for a complete schedule!
Curas, Inc. is a top reseller of eClinicalWorks, the leading cloud-based EHR solution for medical practices. Since 2004, Curas has served thousands of physicians in practices large and small, not only with successful implementations of eClinicalWorks and ongoing support services, but also with successful attestation for Meaningful Use, PQRS and VBM. Curas maintains a full support staff and call center in its St. Louis-based headquarters, and has been named a Gold Support Partner by eClinicalWorks.