With the many requirements needed to be met within the Merit-based Incentive Payment System (MIPS) of MACRA, physicians and practices are looking to find ways to receive a neutral or positive payment adjustment through a high composite performance score.
But how does one do such a thing? Is there a way to meet many categories without needing to drastically change the way you currently work? It all starts with understanding the various MIPS categories and their measures.
As a refresher, MIPS has four performance categories to be met:
These four categories make up a composite performance score, including various subcategories and measures within each.
Some Quality Measures include Community, Population and Public Health, Person and Caregiver-Centered Experience Outcomes (formerly Patient and Family Engagement), Effective Clinical Care and Patient Safety.
CMS’ key changes to the Resource Use category include Medicare Spending per Beneficiary (MSPB), total per capita costs for all attributed beneficiaries, total per capita cost measures for the four condition-specific groups (chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease, and diabetes mellitus) and attribution to the group practice (TIN).
There are a total of nine Clinical Practice Improvement Activities, some of which include: Expanded Practice Access, Population Management, Care Coordination, and Beneficiary Engagement.
When it comes to Advancing Care Information, the base score 2017 Advancing Care Information transition measures are:
All of these categories are weighted differently, with some having less influence in the transition year (2017) than others.
With the transition year in full swing and physicians and practices gearing up for what’s to come, understanding the many measures and categories to fulfill can be a headache. What’s more, many don’t have the resources such as required staff or time to ensure all categories are met, proper paperwork is filled out, and quality of care is maintained.
Trying to do everything in-house, while still maintaining an already hectic workload is worrying for many. However, the good news is that there are ways to meet MIPS requirements without needing to change the way you currently work, without adding workload, and all the while adding revenue to your bottom line.
Outsourcing services such as Annual Wellness Visits allows physicians to offer their patients a wider variety of care offerings, without the added effort. Qualified Registered Nurses meet with your patients on a yearly basis, acting as an extension of your practice and providing personalized care to your patients according to your specifications.
As the Quality Measures portion of MIPS is worth 60% in the transition year of 2017, outsourcing Annual Wellness Visits can effortlessly help you meet many requirements such as:
Annual Wellness Visits meet 18 measures, including 6 high priority measures, across four out of the six Quality Measures domains. In addition, these services also meet three measures across two subcategories for Clinical Practice Improvement Activities (CPIA). Other services such as Chronic Care Management also add incremental revenue to a practice’s bottom line and meet many MIPS categories and measures.
These measures and other categories that AWV and CCM services meet can be found in this whitepaper. It discusses what providers need to understand about MACRA MIPS, potential Medicare payment adjustments, and how Chronic Care Management programs can help transition to a value-based care model.