Merit Based Incentive Payment System (MIPS)
CMS finalized MACRA’s Medicare Quality Payment Program (QPP) rule for 2018 on November 2, 2017. Year two of the QPP MIPS rule builds upon the new quality reporting initiative. Here are some of the highlights:
- There are four performance categories in 2018. Points can be earned in each category and are added together to give you a final MIPS score. The four MIPS categories are: Quality (50%); Cost (10%); Improvement Activities (15%) and Advancing Care Information (25%).
- There is no change in the types of clinicians who are eligible to participate. Eligible clinicians include: Doctors of Medicine • Doctors of Osteopathy (including Osteopathic Practitioners) • Doctors of Dental Surgery • Doctors of Dental Medicine • Doctors of Podiatric Medicine • Doctors of Optometry • Chiropractors
- The MIPS low-volume exclusion is increased to ≤ $90,000 in Medicare Part B Allowable charges or ≤ 200 individual Medicare patients.
- Avoidance of penalty now requires 15 points instead of only three.
- CMS has increased the data completeness requirement for Quality to 60% of eligible instances for each measure.
- For larger practices only 1 point is earned if the data completeness threshold is not met.
- Small practices can still earn a minimum of three (3) points per quality measure for submitting “some data” even if it falls below the data completeness threshold.
- Small practices can earn bonus points toward their final score based on being “small”.
Reference the fact sheets under the Covisint documents tab for more information on each of the MIPS categories. For a side by side comparison of the changes year-over-year reference the MIPS Year2 Fact Sheet.
Or visit the CMS QPP website for all available information.
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Covisint Enterprise Analysis Service
For organizations that need assistance aggregating their Quality Measure data Covisint offers an analysis service. The Covisint MIPS Enterprise service allows organizations to report MIPS Quality Measures as either individual eligible clinicians or as a group (GPRO) with data aggregated across the group TIN. By extracting your billing and clinical data from your source systems and uploading to Covisint via a secure file transport system Covisint can then analyze the data identifying measure eligible encounters and performance.
Results are provided via reports through a secure portal where they can be viewed and downloaded on demand as often as updated data is provided. The Covisint Dashboard provides the ability to track measures and performance throughout the year driving improved performance with actionable information. All reports use drilldown capabilities where appropriate and are designed to be immediately useful for quality improvement to either your data collection infrastructure or care delivery workflow.
Contact us at 866.823.3958 or firstname.lastname@example.org to learn more or sign up.