Check out these top 5 tips for starting your 2018 MIPS reporting on the right foot!
- Focus on Quality! – 2018 requires full-year reporting. With quality being the highest valued category (50% of your MIPS score), now is the time to review your quality-reporting plan and make sure you are capturing all the necessary data to report successfully. Furthermore, this is the category where providers can really distinguish themselves. It is anticipated that ACI scores will generally be high due to MU experience, and that most providers will earn the full score in the Improvement Activities category.
- Understand Your Cost Position – In a change from the original proposal, the cost category will contribute up to 10% of your overall MIPS score. Look for CMS reports later in 2018 to help you understand how cost is assessed and consider ways to reduce the cost of care you provide.
- Plan your ACI Reporting Strategy – CMS is allowing the use of 2014-certified software in 2018. Here are your options:
- Your EHR is 2014 Certified – report the 2017 Transitional Measure Set.
- Your EHR is 2014 and 2015 Certified – report either 2017 Transitional Measure Set, the ACI Measure Set, or a combination of both.
- Your EHR is 2015 Certified – report the ACI Measure Set.
Compare the two measure sets and evaluate which set will likely earn you higher performance scores.
- Pick Your Improvement Activities – CMS has included some additional Improvement Activities for 2018. Review the list and make sure you will be able to attest to completing them for at least 90 days in 2018.
- Strive for Better Performance – Improvement in the Quality (and Cost) category for 2018 over last year will earn you bonus points this year. Review your CQMs and readjust workflows as necessary to support higher performance.
There are many factors that contribute to achieving “value-based care,” some of which your practice may already be targeting—patient engagement, interoperability, outcomes, and efficiency, just to name a few! The reality is that the shift to value-based care has been underway for some time, but the change-over is accelerating with the implementation of MACRA. Whether through Alternative Payment Models or the Merit-Based Incentive Payment System (MIPS), the emphasis is now on improving quality and reducing cost.
For most doctors, of course, delivering quality care has always been a priority, so the question really is how to document that while maintaining practice efficiency, containing costs, and continuing to provide excellent patient care. Let’s look at some of the components of Value-Based Care:
Whether you focus on all or some of these components, there will likely be a shift in how you use your EHR. To be effective in your pursuit of value-based care, you need your HIT vendor to be a true partner. Here are some questions to consider as you determine your goals and your technology needs:
- What am I doing to drive value-based care, and how are my partners supporting me?
- Where do I need more assistance?
And more specifically:
- Do I have the capability to effectively engage and maintain communication with my patients—both pre- and post-visit—to better manage their care?
- Can I track outcomes and set standards of care/protocols?
- Can my current technology improve my practice efficiency?
Don’t settle for only what is imposed by regulatory requirements—decide what is truly valuable for the care of your patients and then implement it. The right technology partners will help you to develop a strategy for achieving your patient-care goals. Remember: How to efficiently deliver the highest quality patient care is an ongoing conversation—make sure your technology partners are holding up their end of it.
Let’s continue the conversation – tell us what you are doing to drive value-based care.
Remember the days when the provider-patient relationship was centered primarily on the interactions that occurred during a visit? Whether it was in the exam room, over the phone or at the hospital, these were the places where the provider-patient relationship was built. Now, patient care encompasses more than just the traditional office visit and a physician’s bedside manner. A lot more emphasis is being placed on the patients—engaging and empowering them to partner in the healthcare process.
Patient Engagement is a hot topic in healthcare – a quick google search and you’ll come up with countless references to infographics, successful approaches, and tools to help build a patient engagement strategy. You will also find articles that discuss how patient engagement can have positive effects on improved quality of care and patient outcomes. The frameworks vary from simplistic to more complex, but the common theme is partnering with your patients and building ownership of their health and healthcare. Some examples of an effective PE strategy include: providing patient-specific education, making patients’ health information available online, including the patient in developing care plans and coordinating with other caregivers.
With an increased focus on patient engagement and interoperability incorporated in Meaningful Use Stage 2, many of these suggested practices can be accomplished using your EHR. Although many providers are anxiously awaiting the Final Rule Modifying MU Stage 2 in 2015 – 2017 and hoping for lower thresholds on the patient engagement measures like Patient Electronic Access and Secure Messaging, it is safe to say these measures are here to stay and will have increasing threshold(s) over the next few years.
So if there was ever a time to start building or improving upon your engagement strategy – the time is now! Whether you go at it on your own or use your EHR to help accomplish these goals the resources are abundant. What will your strategy include? Maybe you’ve been actively engaging patients for years and have some best practices to share. What helps to empower your patients?
With summer now in full swing, I’m going through my summer attire and have found myself questioning my fashion style. I feel like it’s time to trade in my classic look for something more stylish!
I see a similar trend when I talk with clients about PQRS reporting—they are looking to revamp their reporting style. With more providers subject to penalties under both the Physician Quality Reporting System (PQRS) and the Value-Based Payment Modifier (V-BPM) programs, there is more riding on quality reporting—so it is important to ensure you are dressed for success.
Why building the right quality reporting “wardrobe” is important to your revenue:
If not reporting PQRS in 2015:
- All PQRS-eligible providers are subject to a 2% PQRS penalty in 2017 and
- An additional Value-Based Payment Modifier penalty based on group size:
- 2% for Solo practitioners and groups of 2-9 providers
- 4% for groups of 10 or more providers
If reporting PQRS in 2015, practices will be evaluated on quality and cost:
- Solo practitioners and groups of 2-9 PQRS-eligible providers could see a potential increase of up to 2% in 2017
- Groups of 10 or more providers could receive between a 4% penalty and a 4% incentive
Select the option that’s the best style and fit for you from the list below:
This chart summarizes the PQRS reporting options. The definitive source of requirements is: www.cms.gov/pqrs.
Are you dressed for quality reporting success? Let us know what ensemble fits you the best!