{"id":6209,"date":"2018-07-17T12:22:48","date_gmt":"2018-07-17T16:22:48","guid":{"rendered":"https:\/\/systems4pt.com\/staging\/?p=6209"},"modified":"2018-08-31T11:20:57","modified_gmt":"2018-08-31T15:20:57","slug":"july-12th-cms-mips-announcement-will-mips-help-or-hurt-your-practice-part-3","status":"publish","type":"post","link":"https:\/\/systems4pt.com\/staging\/july-12th-cms-mips-announcement-will-mips-help-or-hurt-your-practice-part-3\/","title":{"rendered":"July 12th CMS MIPS Announcement – Will MIPS Help or Hurt Your Practice? Part 3"},"content":{"rendered":"

July 12th<\/sup> CMS MIPS Announcement – Will MIPS Help or Hurt Your Practice?\u00a0 Part 3<\/h3>\n

The latest CMS communication clarifies some topics but \u201cmuddies\u201d others.<\/p>\n

It\u2019s now official.\u00a0 Outpatient rehab will participate in MIPS in 2019.<\/strong><\/em><\/p>\n

The July 12, 2018, CMS announcement emphasized a new topic, \u201cPatients Over Paperwork,\u201d with the goal of lowering documentation time by 51 hours per year, per provider.<\/p>\n

One specific change that relates to outpatient rehab is, \u201cRemove burdensome and overly complex functional status reporting requirements for outpatient therapy.\u201d\u00a0 We\u2019re all familiar with the eval complexity codes.\u00a0 You may not be aware that therapists are currently expected to defend eval code complexity by following a CMS workflow that separates topics into four categories, and then scores each category individually.\u00a0 This is followed by 100-200 words of defensive documentation detailing each factor that impacts complexity.<\/p>\n

While Systems 4PT recommends this defensive documentation in a 10-second workflow, every other EMR requires the therapist to manually tabulate, score, and then type the defense (10-15 minutes of work).<\/p>\n

The APTA\u2019s interpretation of \u201cPatients Over Paperwork\u201d was, \u201cGoodbye Functional Limitation Reporting \u2013 Hello MIPS?\u201d<\/p>\n

This is the muddy part.<\/strong><\/h3>\n

EACH OF US wants to see documentation streamlined.\u00a0\u00a0 WE ALL want to treat more and type less.\u00a0\u00a0 But we need to keep two things in mind:<\/p>\n

    \n
  1. These topics are proposals. They may or may not happen.<\/li>\n<\/ol>\n
      \n
    1. If these changes do happen, what workflows will replace them? Remember, MIPS is a process of scoring numerous topics.\u00a0 \u201cQuality\u201d comprises 50% of the MIPS score.\u00a0 And patient progression\/outcomes comprise the majority of the \u201cQuality\u201d score.\n
        \n
      1. Like it or not, \u201cSeverity\u201d is interwoven with progression. For example, consider two patients with a sprained ankle.\u00a0 One patient is an obese, chain-smoking 78-year-old with a history of falls.\u00a0 The other patient is an 18-year-old high school cheerleader. Obviously, CMS needs some mechanism to recognize the first patient is more severe than the second.\u00a0 Plus, if \u201cSeverity\u201d is not defended, what then assures anyone that MIPS progression is being fairly reported?\u00a0\u00a0 What stops the practice across town from reporting inflated severity to improve their MIPS score?\u00a0\u00a0 Our expectation: If the necessity to defend eval code severity is eliminated, CMS will either institute some new workflow, or will adjust their scoring to protect from gaming, (which would likely discriminate against patients who truly are high-severity).<\/li>\n
      2. If we stopped reporting G-codes, how will CMS judge progression? Outcome submission via a registry could be the answer but realize:\u00a0 We would be trading an old workflow for a new workflow.<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n

        Like we said, \u201cmuddy.\u201d<\/h3>\n

        The CMS announcement included two other important topics for outpatient rehab:<\/p>\n

          \n
        1. \u201cAdvancing Virtual Care. Paying clinicians for virtual check-ins, (brief, non-face-to-face appointments via communications technology), paying clinicians for evaluation of patient-submitted photos, and expanding Medicare-covered telehealth services to include prolonged preventive services.\u201d\u00a0\u00a0 The implications are obvious.\u00a0 We\u2019ll all be watching this.<\/li>\n<\/ol>\n
            \n
          1. The announcement increases the emphasis on \u201cInteroperability, encouraging information sharing among healthcare providers electronically, so patients can see various medical professionals according to their needs while knowing that their updated medical records will follow them through the healthcare system.\u201d There is mention of increasing the emphasis (i.e., reward or penalty) for interoperability within MIPS.<\/li>\n<\/ol>\n

            The increased emphasis on interoperability may be the most significant news from the July 12th<\/sup> CMS announcement.\u00a0 To succeed with MIPS, your data must be interoperable, shareable with other healthcare entities.\u00a0\u00a0 While Systems 4PT is ready, most EMRs are not. \u00a0You should realize that the technology\/expense related to this topic will be beyond the capabilities of many EMR systems in our industry.\u00a0 Practice owners who aren\u2019t paying attention will be destined to suffer MIPS penalties, solely because of their low-tech EMR.<\/p>\n

            This Topic Deserves Attention, Right Now, Today.\u00a0 <\/strong><\/h3>\n

            If you\u2019re using an EMR, ask them to explain their interoperability plans.\u00a0\u00a0 When they answer, \u201cinterloper-what?\u201d you need to find a new EMR right away.\u00a0\u00a0 If your EMR is not fluent and passionate about this topic, they\u2019re in trouble.<\/p>\n

            If you document on paper, you are now faced with a decision:\u00a0 Install a modern, capable EMR or be prepared to pay the 7%-9% MIPS penalty that is then given to compliant practices as their MIPS bonus. \u00a0\u00a0Remember:\u00a0 The CMS is pressuring the major commercial payers to adopt these same rules.<\/em><\/p>\n

            As discussed, MIPS is a program designed to segregate outpatient rehab into winners and losers.\u00a0\u00a0 Your practice is your life\u2019s work.\u00a0 These topics deserve your full attention.<\/p>\n

            Systems 4PT is in front of healthcare reform.\u00a0 We are ready for MIPS with workflows that will cut your documentation time in half.\u00a0 We invite you to take a look.<\/p>\n<\/div><\/div><\/div>

            Sign up to Get More MIPS Info Or<\/h2>\n

            Get a Free, Hands-On\u00a0Demo<\/h2>\n<\/div>[contact-form-7 id=\"5393\" title=\"Free Demo_copy\"]<\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":6210,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[56],"tags":[47],"class_list":["post-6209","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general","tag-mips"],"yoast_head":"\nJuly 12th CMS MIPS Announcement - Will MIPS Help or Hurt Your Practice? Part 3 -<\/title>\n<meta name=\"description\" content=\"It\u2019s now official. Outpatient rehab will participate in MIPS in 2019. 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