IT Practice Consulting – Health IT Report – April 2016
“Incentive Program Changes in 2017 – What Meaningful Use Providers Should Know About MIPS”
Last April, Congress approved of the Medicare and CHIP Reauthorization Act (MACRA) 2015, a federal health bill awaiting its nationwide integration in 2019. The legislation terminated the Sustainable Growth Rate (SGR) method utilized in government incentive programs, due to payment controversies and substantial negative feedback. Current participants of Meaningful Use should understand the full impact of MACRA on medical programs moving forward, with a focus on the newest system: MIPS.
What is MIPS?
Titled Merit-Based Incentives Payment System, MIPS is defined by the Centers for Medicare and Medicaid Services’ as, “a new program that combines parts of the Physician Quality Reporting System (PQRS), the Value Modifier (VM or Value-based Payment Modifier), and the Medicare Electronic Health Record (EHR) incentive program into one single program.” This all-encompassing system initiates its first performance year in 2017, with adjusted reimbursements to commence in 2019. Furthermore, MIPS’ aggregated program will rate physician and practice performance with a 0-100 scale measuring Quality, Resource Use, Clinical Practice Improvement, and Meaningful Use of Certified EHRs. Although the mandatory transition requires reorganization on the health benefactor’s part, the American College of Surgeons’ assures the medical community that, “[MIPS] is designed to give certainty for providers, reward those who meet performance thresholds, and improve care for seniors.”
How will MIPS affect my ongoing/upcoming Meaning Use program?
Mentioned earlier, MIPS is a collective system which strives to efficiently integrate quality reporting with health IT incentive programs. A WellCentive article by Liz Preece, “10 Things to Know About MIPS Today,” confirms that “separate MU payment adjustments will stop in 2019, when the incentive/penalty structure under MIPS will start.” However, according to the American College of Surgeons’ “Frequently Asked Questions about MIPS,” performance valuation will not deviate far from past programs. “The quality measures will consist of those currently used in the existing quality performance programs,” says the American College of Surgeons; these measures include the Physician Quality Reporting System and Meaningful Use. Moreover, while existing programs have begun penalizing surgeons for non-compliance in 2016, MIPS will combine all further incentives and penalties in 2019, nullifying individual consequences.
Read more about MIPS from the American College of Surgeons here:
Frequently Asked Questions about MIPS
What benefits will arise from this collaboration?
MIPS’ innovative development from multiple incentive programs to one effective quality assurance system centers on the medical community’s movement towards interoperability. Participating health providers are expected to benefit through MIPs’ improved incentives and continuous approach. For example, WellCentive’s “10 Things You Need to Know About MIPS Today” reports that PCMH (Patient Centered Medical Home) recognized organizations “automatically qualify for the highest possible score in the Clinical Practice Improvement category.” WellCentive also finds that Eligible Professionals (Eps) who exceed the 25th percentile of positive scores will receive additional payment adjustments up to 10%. Most significantly, the federal government has allocated $20 million annually (from 2016-2020) for technological assistance for health care providers with 15 or fewer professionals to improve their MIPS performance.
Read more on WellCentives’ article here:
10 Things to Know About MIPS Today
Final Thoughts
Transitioning from an ongoing Meaningful Use incentive program to MIPS doesn’t have to be a complicated process. Implemented through the New York State Department of Health, the New York eHealth Collaborative lobbies for Eligible Professionals state-wide to receive federal grants and ensure practices remain meaningful users advancing towards interoperability. Furthermore, IT Practice Consulting supports local health providers in their selections of federal incentive programs, as well as seamless technological incorporation of EHRs.
Is your practice prepared for the upcoming transition to the Merit-Based Incentives Payment System? Contact IT Practice Consulting today!
Coming Next Month – HIPAA
Read our update on how the new HIPAA audit rules may affect your practice!