{"id":7457,"date":"2019-12-17T10:13:36","date_gmt":"2019-12-17T15:13:36","guid":{"rendered":"https:\/\/systems4pt.com\/staging\/?p=7457"},"modified":"2020-02-21T09:31:23","modified_gmt":"2020-02-21T14:31:23","slug":"the-2019-mips-debate-5-arguments-that-are-now-settled","status":"publish","type":"post","link":"https:\/\/systems4pt.com\/staging\/the-2019-mips-debate-5-arguments-that-are-now-settled\/","title":{"rendered":"The 2019 MIPS Debate.\u00a0 5 Arguments That Are Now Settled."},"content":{"rendered":"

The 2019 MIPS Debate.<\/h1>\n

5 Arguments That Are Now Settled<\/h1>\n

Throughout 2019, outpatient rehab\u2019s two leading EMRs debated about MIPS in a series of \u201cblog wars\u201d.\u00a0 The two companies had contrasting views about MIPS and the sparring between them was at times quite pointed, even accusatory.<\/p>\n

Now that we\u2019re through 2019, we thought it would be fun to revisit this debate. Which EMR got it right? And which was wrong?<\/p>\n

Debate #1: \u00a0MIPS Participation is a Necessity<\/strong><\/h3>\n

\u201cPractices need to take MIPS seriously. \u00a0MIPS will separate outpatient rehab into winners and losers. And the losers will pay the winners. Paper practices will be driven out as CMS rewards the practices who embrace technology and punishes those who don\u2019t.\u201d<\/p>\n

For the past 14 months, the above has been Systems 4PT\u2019s perspective.<\/p>\n

The other leading EMR labelled these words as \u201cfear mongering,\u201d recommending that the practice sit back and wait, \u201dAfter all, an incentive that small may not be worth the effort you put in\u2014or the amount you pay a vendor\u2014to collect and submit your data. When the data is not substantive enough to make a decision, go with your gut.\u201d<\/span><\/p>\n

The CMS settled this debate on August 14th<\/sup> when the 8% 2021 PT\/OT fee schedule reduction and 15% 2022 assistant reduction were announced. MIPS is the only way to offset these reimbursement cuts<\/u>.<\/p>\n

We\u2019re pleased that all Systems 4PT practices who are opting into MIPS for 2019 will enjoy rewards and bonuses in 2021.\u00a0 As the MIPS rules tighten up in 2020, these practices have a distinct scoring advantage over new participants who will be \u201ctrying to figure out how things work\u201d.<\/p>\n

Debate #2:\u00a0 Is MIPS Another \u201cHere Today, Gone Tomorrow\u201d Medicare Program or Part of Our Future?<\/strong><\/h3>\n

From the start, Systems 4PT saw MIPS as \u201ca necessary evil\u201d and we advised all practices to participate. 95% of our customers followed our advice and they\u2019re happy they did. \u00a0To us, it\u2019s obvious \u2013 the CMS is trying to transform healthcare into a paperless, integrated, interoperable \u201ccloud.\u201d MIPS penalties and rewards are \u201cthe stick and carrot\u201d being used.<\/p>\n

The other leading EMR provided this contrasting advice: \u201dMaybe the MIPS program will endure as a pillar of the transition to value-based care delivery; maybe not.\u00a0 We\u2019ve all seen what\u2019s happened to Medicare\u2019s previous reporting programs (hello, PQRS and FLR). And even if you end up having to report at some point, why not sit back and use this year to see what happens with the program\u201d<\/span><\/p>\n

Which perspective is correct?\u00a0\u00a0\u00a0 As with the previous point, this debate is settled as the other EMR is now recommending that their customers \u201cReconsider MIPS\u201d.\u00a0\u00a0 Unfortunately, it\u2019s too late for these practices to partially offset the 8% payment reductions with MIPS rewards in 2021.<\/p>\n

Debate #3:\u00a0 Qualified Clinical Data Registries. Necessary or Not?<\/strong><\/h3>\n

Systems 4PT made it clear that working with a QCDR (Qualified Clinical Data Registry) maximizes your options for success with MIPS. We believe that this is by design. Because of this, Systems 4PT has submitted data via our QCDR on a weekly basis throughout 2019.<\/p>\n

The other leading EMR included this topic in a blog entitled \u201c5 MIPS Lies You\u2019ve Been Told\u2014But Should Not Believe,\u201d<\/span> saying, \u201cif you are required to participate\u2014or if you choose to voluntarily report\u2014you can<\/em> submit your data using a Qualified Clinical Data Registry (QCDR), but you don\u2019t have<\/em> to. You can absolutely comply with MIPS reporting requirements with a certified registry, like [ours].\u201d<\/span><\/p>\n

Once again, we have a debate, and a testy one at that! \u00a0Who\u2019s right? Who\u2019s wrong?<\/p>\n

This difference of opinion was resolved recently when the other EMR proudly announced they\u2019re working with a QCDR for MIPS submission in 2020.<\/p>\n

Debate #4: \u00a0MIPS is Overly Complex and Requires Technology<\/strong><\/h3>\n

MIPS is a topic that very few EMR companies thoroughly understand.<\/p>\n

The common approach (used by the other leading EMR) is to enable therapists to select the appropriate MIPS codes and proceed with their documentation. Easy, right?<\/p>\n

With over 4,000,000 potential permutations of MIPS codes in each evaluation, Systems 4PT recognized that the opportunities for error were enormous. And with 7% takebacks (9% in 2020), we needed a zero-risk solution. Beyond complex coding, \u00a0MIPS requires 150 to 500 words of measure-specific defensive documentation in every eval. Complexities abound.\u00a0 For example, some MIPS measures require the additional of extra ICD-10\u2019s in the list of diagnosis codes. \u00a0With low-tech EMR \u201cit\u2019s all on the therapist\u201d to get things right.<\/p>\n

Systems 4PT initiated our solution with a unique perspective. Medicare is obviously judging you. But Medicare isn\u2019t judging you with an army of MIPS employees. They\u2019re judging you with a super-computer. \u00a0The way to win with MIPS is to create, comply, and submit MIPS data, using your own super-computer. That\u2019s exactly how our practices operate. Systems 4PT practices comply with the complexities outlined above with a 20-second workflow, covering both coding and defensive documentation<\/u>. Our QCDR recently finalized auditing our practices\u2019 coding and defensive documentation saying, \u201cIt\u2019s the most consistent, compliant, complete defensive documentation we\u2019ve ever seen.\u201d<\/p>\n

Compliant MIPS submission with the other leading EMR will add 5-7 minutes per eval. Our audit-tested approach takes 20 seconds, leaving you 5-6 more minutes for hands-on treatment in every evaluation.<\/p>\n

Debate #5:\u00a0 Is MIPS Scoring Feedback Important or Not?<\/strong><\/h3>\n

95% of Systems 4PT practices participated in MIPS though 2019. Our practices were updated with by-measure performance, and trending scores, at each quarter end. By-measure feedback is essential because it\u2019s the only way a practice \u201ccan see what isn\u2019t working\u201d and make necessary adjustments. \u00a0The results speak for themselves: Our practices\u2019 average trending MIPS score is 95.6 points, DEEP in the bonus territory. \u00a060% of our practices are trending toward 100 points! \u00a0Take a bow!<\/p>\n

And the debate from the other leading EMR? \u00a0Well, this is a debate of omission. To our knowledge, they haven\u2019t updated anyone on trending MIPS scores. Their practices are blind. And sadly, many of them will end up paying our 100-point performers.<\/p>\n

The Debate Continues: Who is a Trustworthy Business Partner? And Who is an Opportunist?<\/strong><\/h3>\n

After a year of giving bad advice to their practices, the other leading EMR is suddenly advising their customers \u201cto reconsider\u201d participating in MIPS. What caused the dramatic change of heart?\u00a0 Some people conclude that the EMR finally did their homework. Still, others feel that the bank owned EMR sees MIPS as an exciting new revenue stream and now recommends that you \u201creconsider\u201d opting into MIPS in 2020\u2026\u2026for a nominal fee.<\/p>\n

Here\u2019s what a trustworthy business partner looks like:<\/p>\n

    \n
  • In 2018, Systems 4PT invested hundreds of hours research by senior management to fully understand MIPS.<\/li>\n
  • We concluded that success with MIPS was one of many factors necessary to thrive in tomorrow\u2019s tightening environment<\/li>\n
  • As such we advised that all Systems 4PT practices opt into MIPS, and 95% of them did<\/li>\n
  • We innovated an audit-tested, 20-second therapist workflow<\/li>\n
  • We provided by-measure scoring trends at each quarter end, including what steps to take to improve scoring<\/li>\n
  • The result is audit-tested 95.6 average points, which is above the \u201cMIPS rewards\u201d status and DEEP in \u201cMIPS bonus\u201d territory<\/li>\n
  • All provided, at no additional charge<\/li>\n<\/ul>\n

    Who is the MIPS expert in outpatient rehab?<\/strong><\/h2>\n

    Which EMR is the most trustworthy business partner?<\/strong><\/h2>\n

    There is absolutely no debate.<\/strong><\/h2>\n<\/div>

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