{"id":6182,"date":"2018-06-26T11:36:20","date_gmt":"2018-06-26T15:36:20","guid":{"rendered":"https:\/\/systems4pt.com\/staging\/?p=6182"},"modified":"2018-08-31T11:22:44","modified_gmt":"2018-08-31T15:22:44","slug":"will-mips-help-or-hurt-your-practice-installment-2-of-10","status":"publish","type":"post","link":"https:\/\/systems4pt.com\/staging\/will-mips-help-or-hurt-your-practice-installment-2-of-10\/","title":{"rendered":"Will MIPS Help or Hurt Your Practice? Installment 2 of 10"},"content":{"rendered":"

Installment 2 of 10: Will MIPS Help or Hurt Your Practice?<\/u><\/strong><\/h3>\n

Most practice owners aren\u2019t thinking much about MIPS, because the CMS doesn\u2019t release their final rule until November 2018. That\u2019s a mistake. The program is well established, as other segments of healthcare have been participating in MIPS for years. Expecting substantial changes vs. the current approach (thinking that the CMS is going to revamp its MIPS program for outpatient rehab, which is less than 0.5% of healthcare), is not advised. Be Aware:<\/strong> Most of the changes that practice owners must make in preparation for MIPS have longer lead times than the 2 months available from the CMS announcement in November until New Year\u2019s Day, when MIPS begins.<\/p>\n

Will MIPS help or hurt your practice? \u00a0The answer is directly related to when you begin preparing.<\/p>\n

MIPS is a composite program, made of various parts that are scored in complex algorithms.<\/p>\n

PQRS is one of the components of MIPS. Expected to be very similar to the PQRS program you worked with in 2016, submission will now be required through a certified registry.<\/p>\n

While PQRS is not the major influence in MIPS scoring, if you want to avoid takebacks and benefit from the 7% (increasing to 9%) bonus payments, your practice must ace PQRS coding and defense. 40% of outpatient rehab practices did not fully comply with PQRS in 2016, either because of error or because they opted out. \u00a0These practices are at a distinct disadvantage when MIPS begins on January 1st.<\/p>\n

Quality is 50% of the MIPS composite score \u2013 the single largest influence. \u00a0At the 10,000-foot level (we\u2019ll take the deep dive with each topic in future installments), the \u201cquality\u201d that MIPS measures is patient progression and outcomes. Hence the terminology \u201cPay for Progression,\u201d which is often used when describing the MIPS program.<\/p>\n

The topic of \u201cQuality,\u201d will be the bane of thousands of practice owners as MIPS sets us all up to compete against each other. You will not be judged (and paid) based on whether your outcomes are good or great. You will be judged (and paid) based on how your patients\u2019 progression compares to the patient progression in other practices.<\/p>\n

Most practice owners downplay quality, thinking: \u201cMy patients leave here smiling, and very, very functional \u2013 My quality is superb.\u201d \u00a0\u201cSuperb\u201d is not the benchmark. The benchmark is how your practice outcomes compare to the outcomes of other practices. YOU MUST KNOW YOUR OUTCOMES, by therapist and by body region, AND YOU MUST KNOW THE BENCHMARK AVERAGE that you\u2019re compared against.<\/strong><\/p>\n

Again, quality is 50% of the MIPS composite score. \u00a0Practice owners who aren\u2019t paying attention to this topic today will be the ones suffering 7% to 9% takebacks, which will then be given, as bonuses, to the practice owners who were paying attention.<\/p>\n

Advancing Care Information (ACI) requirements consist of topics such as Security Risk Analysis, Electronic Prescribing, Electronic Patient Access, Digital Summary of Care, etc. \u00a0<\/strong>In a nutshell, this is all about interoperability, which is the ability to share data with patients and other providers. <\/strong><\/p>\n

MIPS deliberately pushes electronic transfer of medical records from concept to reality. For example, North Carolina has already notified EMR providers that in 2019, health records will be electronically submitted to NC HealthConnex, or providers will be unable to participate in Medicaid, including the state health plan (Northern Blue Cross Blue Shield State Health Plan). Your state will do the same.<\/p>\n

It goes without saying that paper practices will not thrive in the world of MIPS. Note our video, \u201c10 Reasons Why MIPS Will Put Paper Practices Out of Business\u201d Link<\/u><\/a><\/p>\n

Clinical Practice Improved Requirements are services, topics, and reporting that are required by MIPS. Again, participation is included in MIPS scoring.<\/p>\n

And scoring will be complex. Here\u2019s a look at one segment (the minority) of MIPS scoring: Total points for high-weight activities + total points for medium-weight activities = Total Clinical Practice Improvement Activity Points.<\/p>\n

Total Clinic Practice Improvement Activity Points \/ Total possible Clinic Practice Improvement Activity Points = The Clinic Practice Improvement Activity Performance Category Score.<\/p>\n

TAKEAWAYS, TODAY\u2019S LIST:<\/u><\/strong><\/p>\n

Waiting until November to think about MIPS will position your practice to fail.<\/p>\n

Right now, today<\/em>:<\/strong><\/p>\n

If you are a paper practice<\/strong>, you need to find and install an EMR that is equipped to succeed with MIPS (see below).<\/p>\n

If you currently use an EMR:<\/strong><\/p>\n

You need to know:<\/p>\n