MIPS, part 1

MIPS came to stay with us January 1st,  which made the customarily cheery "Happy New Year" salutation ring a little hollow for our EHR clients.

However, not to worry. CMS has published a 962 page proposed rule with the rather unwieldy name "Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive under the Physician Fee Schedule, and Criteria for Physician-Focused Models" or MBIPSAPMIUPFSCPFM for short.

If reading 962 pages of government-speak (a guaranteed cure for insomnia, by the way) seems daunting, never fear, Practice Alternatives is here. We are the lucky sods that had to read all 962 pages of the proposed rule and accordingly, will make the required software changes.

MIPS has several areas in the program: Quality, Improvement Activities, Advancing Care (replacing Meaningful Use), and Cost (will not be implemented in 2017). Today, we are going to talk about the Quality aspects of MIPS.

Before we get into the Quality stuff, let's cover a few basics about MIPS. The level of participation in MIPS is up to each practice but there are consequences to the level of participation or lack thereof:

1. Do nothing and receive a negative 4% adjustment in 2019
2. Submit some data and receive a minimum or zero payment in 2019
3. Participate for 90+ days and receive a small positive payment adjustment in 2019
4. Participate for a full calendar year with high scores (>= 70 points) to qualify as an "exceptional performer"; doing so could result in a significant payment bonus

The Quality Measures are very similar to PQRS, so this part of MIPS shouldn't be too daunting. Each practice should visit the CMS Quality Measures web page (Click on this link to access the page) and review the Specialty Measure Set list. See below for the screenshot:

Select the specialty that pertains to your practice and the website will display a list of applicable measures:

 Click on a measure, and the criteria for the measurement will be displayed:

You need to pick six measures or qualify for exceptions.

If you are a practice which uses AuroraEHR, contact us and let us know which measures you are planning on using. We will then customize your screens and implement the data tracking as required by the measurement criteria.

That's it for now, and Happy MIPSing!