Value-Based Care is not a destination it’s a journey MIPS

Value-based Care is not a destination, it’s a journey and it’s picking up momentum with Medicare’s 2017 MIPS/APM Reporting now in full motion!

The gazillion dollar question … Who is embracing this transition?

  • Providers who received the letter from CMS indicating they must report MIPS for 2017 and are currently collecting MIPS data have embraced the Value-based Care journey.
  • Physicians who signed up with ACOs and their participation in 2017 qualified them for the APM track of MACRA have embraced the Value-based Care journey.
  • On the flip side, providers who have not embraced the journey have chosen to simply take the penalties along with the ZERO performance score. They may simply be unaware that MIPS/APM is all part of the Value-based Care journey every physician must embrace.

Significant considerations

If you are an approved Medicare provider and must report MIPS, you must take an action now! Your patients, referring providers and affiliated facilities will appreciate you have embraced the Value-based Care journey.

  • The window to avoid penalties and a ZERO performance score is closing in!
    • Penalties increase every year. 2017 is 4%, 2018 is 5% and so on and a ZERO performance score is damaging and visible to all; your patients, referring physicians, affiliated hospital etc. … must act NOW!
  • Opportunities to improve outcomes and increase revenues!
    • The Value-based World requires a certified EHR; however, the fundamental driving reason for implementing an EHR should never be regulation-centric but rather patient-centric. Thinking “Outcome”, the EHR is a tool that assists physicians in mining vast amounts of data to make informed medical decisions, not for a single patient, but for the thousands of patients and across the thousands of combinations of diagnoses and diseases a single provider cares for on a yearly basis.
    • Maximizing the EHR gives patients secure on-line access to their medical information encouraging the patient to be more engaged with the provider’s care.
    • Capitalize on reimbursement bonuses and add new revenue streams with clinical improvement activities.
  • 2017 is the transition year and 2018 raises the bar!
    • Yes, 2018 is the real thing and all physicians must be ramping up now. The final ruling for 2018 is due in November so this is the time to start putting together your plan.
    • There is no TEST option in 2018 and some categories may require a full year of data collection.
    • There is a laundry list of action items, such as obtaining a new EIDM account, registration for attestation, participation in virtual-groups and much, much more.
  • Protect your public reputation … a huge game changer!
    • Patient referrals will incorporate a new level of scrutiny with the on-line publication of MIPS performance for all Medicare approved providers. This is why a ZERO performance score is so damaging!!!
    • The Physician Compare Website will be available to patients, providers, hospitals, affiliates and healthcare facilities searching for Medicare providers. Scheduled for 2018.
    • Users can also view primary and secondary specialties, practice locations, phone numbers, board certifications, education, residency, Medicare assignment status, group affiliations, ACO affiliations, hospital affiliations and much more. Most information comes from PECOS.

Leave a Reply