June 12, 2021
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) continues to drive changes to the U.S. healthcare industry. The requirements associated with MACRA’s merit-based incentive program (MIPS) are ever-evolving since its launch in 2015. Providers have to stay up-to-date and focused on program compliance to receive incentives and avoid penalties.
The MIPS 2022 performance threshold is 75 points. It is the minimum requirement to succeed in the MACRA/MIPS in 2022 and avoid a downward payment adjustment to Medicare part B payment claims in 2024.
For those who want to leverage this transition year to get their practice ready for the MACRA/MIPS 2019 reporting requirements, we recommend you follow these three principles to help you navigate the compliance path.
From time to time, CMS and ONC upgrade the EHR certification criteria and practices have to follow them in order to be eligible for the incentive program. This makes it critical to verify that your current IT vendor is offering you the latest certified EHR software, one that is technologically capable of storing data in a structured format so healthcare providers can securely retrieve and transfer patient information for better patient care. Also, be sure that your select the right EHR software which is capable of capturing & submitting the wide array of MIPS measures and meeting the Meaningful Use criteria.
Leverage your CEHRT to uncover the underperforming areas of your practice and take appropriate actions based on data to rectify the situation. You can review the previous data of your practice through the advanced reporting modules of your EHR software to help identify loopholes and take necessary actions to rectify them. This strategy will help you improve your overall MIPS score and enable you to identify the MIPS measures in which you are performing well so you can submit them for MIPS reporting.
Although CEHRT plays a vital role in MIPS success, it doesn’t mean you can neglect the human role. Practices should have diligent staff to handle daily clinical and administrative tasks. Staff should regularly monitor the practice performance reports using the CEHRT to pinpoint the underperforming areas and they should take appropriate actions to improve the situation. Human staff can help you to identify the best measures to submit and ensure that the provider stays committed to MACRA/MIPS compliance.
CMS is gradually improving the MIPS program, and, by taking appropriate actions this year, you’ll be dutifully prepared for the upcoming years. Implement the 2015 edition CEHRT now and start using this technology to analyze the previous data and measures to understand the strengths of your practice and uncover the underperforming areas where you can make the easiest and most obvious improvements to ensure MACRA/MIPS success in 2019.
Q: What is the Difference between MACRA and MIPS?
A: MACRA combines parts of Medicare Electronic Health Record (EHR), Value-based Payment Modifier (VBM) and Physician Quality Reporting System (PQRS incentive program into one program known as MIPS (Merit-based Incentive Payment System).
Q: What are the 6 Quality Measures for MIPS?
A: CMS (Center of Medicare and Medicaid Services) asks for 6 high priority measure for MIPS to be reported. These include appropriate use, patient safety, care coordination, outcome, patient experience, and efficiency measures.
Q: Why Is MIPS Important in Healthcare?
A: It is designed to incentivized positive health outcomes, improve care processes, and promote cost-effective care. Moreover, it focuses on increasing the effective usage of healthcare information for better decision making.