MIPS stands for Merit-Based Incentive Payment System, and managing this system is essential to the functioning of your healthcare practice. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), and the CMS (Centers for Medicare and Medicaid Services), use a Quality Payment Program to promote higher-quality and lower-cost healthcare across the United States of America.
The (MIPS) is the dominant quality reporting program for providers. Medicare reimburses incentives for high-performing clinicians and imposes financial penalties on low-performing clinicians.
Each year the Centers for Medicare and Medicaid Services (CMS) revise requirements for MIPS. CMS recently finalized requirements for the calendar year 2023. The Centers for Medicare and Medicaid Services (CMS) proposed changes to the Quality Payment Program (QPP) for 2023. The proposed rule provides policy updates to the traditional Merit-based Incentive Payment System( MIPS).
Proposed Changes to Traditional MIPS
The proposed rule would use the mean final score from the 2017 performance year to establish the performance threshold for the 2023 performance year of 75 MIPS points. This means clinicians and groups would need to reach 75 MIPS points again in 2023 to avoid a negative adjustment in the 2025 payment year.
How To Maximize Payments and Bonuses?
A score of above 85 makes you eligible for the exceptional performance bonus. There are specific performance categories to build the MIPS score.
Quality
This category covers the quality of the care you deliver, based on performance measures created by CMS, medical professionals, and stakeholder groups. Providers can pick a minimum of the six measures of performance that best fit their practice to increase scores. Partnering with EHR experts guides you in selecting the ideal ones to earn the highest score.
Promoting Interoperability
Your score on this segment depends on patient engagement and the electronic exchange of health information using certified electronic health record technology (CEHRT).
This may include: sharing test results, visit summaries, and therapeutic plans with the patient and other facilities to coordinate care. Ensure that the data are conveyed to patients promptly to score well.
Improvement Activity
This category measures how innovative your practice has been. It includes activities that assess how you improve your care processes, enhance patient engagement in care, and increase access to care. The category allows you to choose the activities appropriate to your practice from categories such as improving care coordination, patient and clinician shared decision-making, and expanding practice access. Consistent participation in qualifying improvement activities is essential to maintaining a high MIPS score.
Cost
MIPS uses cost measures to gauge the total cost of care during the year. The Medicare Spending Per Beneficiary (MSPB) and Total Per Capita Cost (TPCC) calculates the cost score over each performance year. Charging reasonable fees for service can improve your score here.
How Doctorsoft Make MIPS Reporting Easier for Practices?
Ophthalmic EHR systems make MIPS data collection and reporting less of a manual process, helping to take the burden off your clinical and administrative staff. Here are some of the MIPS-related features you should look for from an EHR vendor:
- MIPS Dashboard: The dashboard reflects your performance in many MIPS categories.
- Automated Ophthalmology MIPS Measure Collection: When you enter information into your EHR, your EHR is automatically collecting the measures you need to report to CMS.
- Ophthalmology-Specific Quality Measures
Doctorsoft facilitates you to report to most specialty-specific quality measures, which involve:
- Age-Related Macular Degeneration (AMD): Dilated Macular Examination
- Cataract Surgery: Difference Between Planned and Final Refraction
- Diabetes: Eye Examination
- Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
- Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation
- Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP)
MIPS Qualified Registry
- Doctorsoft sends Quality data to the registry monthly, and it processes it to post the final data in its portal.
- Doctorsoft has its qualified registry, which makes submission simple.
Modern Features
CMS gives points for the activities you resort to upgrading your practice. The more updated your system is, the more scores you stand to achieve.
Are you struggling with a score? Doctorsoft is the patent-approved ophthalmic EHR software. Contact us to implement, learn and use free training to streamline your workflow and can help you process MIPS submission to CMS.