5 takeaways for your 2018 MIPS reporting

Quality Patient Care is in the forefront of every medical practitioner … but is reporting Quality Measures even on their radar?

The transition to Value-Based Care includes the reporting of Quality Measures, Improvements Activities, patient engagement and more via MIPS or APM for Medicare and other Payment Models for private insurances.

Practice Advisor is your resource to stay on top of this transformation and make informed and strategic decisions about your Quality Patient Care.

5 takeaways for your 2018 MIPS reporting  

  • COST category effective in 2018 – Major change!

The COST category will be 10% of the final MIPS score. CMS will use the Medicare Spending per Beneficiary (MSPB) and total cost per capita to score the COST category.

The total composite score breakdown: Cost 10%; Quality 50%, ACI 25% and IA 15%.

The reporting period for Quality and Costs is from Jan 1st – Dec 31 while the Advancing Care Information and Improvement Activities remain at a continues 90-day period.

 Key action item: engage providers and staff in learning the 2018 Rule and develop and implement a strategy.

The reporting period for 2018 starts in just a few weeks!!!

  • More demanding performance scores, thresholds and higher penalties!  

Penalty increases to 5%; Threshold exception up to 90K or 200 patients; Data completeness up to 60%; bare minimum score to avoid the 5% penalty went up to 15 points.  

Key action item: Set performance score targets and monitor throughout the reporting period.

  • Relief for practices affected by disasters & bonus for small practices!

Evaluated on a case-by-case basis via hardship application for providers in areas declared an emergency or major disaster by the Federal Emergency Management Agency.

Complex patient bonus: CMS will award five bonus points in the MIPS program for treatment of complex patients.

Small practice bonus: CMS will award five bonus points on their MIPS final scores to small practices having 15 or fewer eligible clinicians. The bonus is awarded as long as the eligible physician (or group) submits data for at least one performance category.

Key action item: Contact us if you were affected by Irma, Harvey, Maria or other natural disaster.

  • Leverage Virtual Groups to maximize your participation!

For solo practitioners and groups of 10 or fewer eligible clinicians. These professionals can partner with at least one other group to report MIPS quality metrics, regardless of location or specialty. Can help track and share best and most cost-effective methods of clinical care to benefit all members of the virtual group.

 Key action item: Contact us now because Virtual Groups are being formed right now. Deadline to join a Virtual Group is Nov 30 !!!

  • Easier Alternative Payment Models participation and All-Payer Payment Models!

CMS fosters APM participation in 2018 by extending nominal risk of 2017. Participation in APM is expected to double and the preparation for the All-Payer Payment Model begins.   

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