MIPS: Will it Help or Hurt Your Practice?
Most practice owners think MIPS is “just another big change that we’ll all get used to.” Agreed, we’ve all survived G-codes, PQRS, and Eval Complexity codes. In fact, Systems 4PT’s average collections per claim are higher today than they were in 2012, prior to G-codes.
But, with each of these former changes, everyone was able to win. That is if 100% of practices submitted perfect G-codes, PQRS, and Eval Complexity Codes, 100% of practices would enjoy full reimbursement and even bonus payments with PQRS.
MIPS will be different.
The CMS designed MIPS as a “self-funding” program. This means that while one practice will receive a payment bonus of 7% (which is expected to increase to 9%), that incremental reimbursement will be funded by some other practice that will be penalized the same 7% to 9%.
Get it? With PQRS, theoretically, 100% of practices could have received the bonus.
MIPS will be different.
Outpatient rehab is about to be stratified into winners and losers.
MIPS will require changes in how your practice operates, major changes in your EMR, changes in therapist documentation and coding, and fundamentally new approaches to how you submit data. And many of these changes have significantly longer lead times than the 8 weeks afforded by the CMS’s announcement of the final 2019 MIPS rules, disclosed in November 2018.
The practices that will succeed with MIPS in 2019 are already planning today.
It’s a complicated topic with a lot of moving parts. Systems 4PT will be providing a 10-part communication series explaining what MIPS is, what new requirements will exist, and what changes will be necessary to enjoy the reimbursement bonus of 7% to 9%, rather than suffering the penalty.
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MIPS will prove the truth in Jack Welch’s popular quote: “Control your own destiny, or someone else will.”