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MACRA/MIPS

HealthEC Simplifies MIPS

The MIPS reporting period officially began on January 1, 2017, and HealthEC stands ready to simplify your MIPS program with a range of services to identify your baseline performance, establish plans to improve metrics, monitor the effects of change, and submit your data to CMS.

HealthEC’s data integration and analytics simplify your MIPS reporting process while helping you identify and address gaps in care delivery to drive better outcomes to maximize MIPS incentives.

HealthEC has the knowledge, experience and technology to help you succeed under the MACRA Quality Payment Program and MIPS reporting.

Four Easy Steps to MIPS Success

HealthEC will help ensure your MIPS success with four easy steps:

  1. The provider uploads* 837 billing summary files, Meaningful Use reports from their EMR, and CCDAs for all patients
    • *HealthEC can communicate directly with the billing service and EMR vendor to eliminate the need for IT assistance
  2. In 2-3 weeks, HealthEC provides a recommendation of best-performing measures to consider for submission, and the best approach: to avoid penalty, submit for likely bonus, or submit for full bonus potential
  3. HealthEC can collaborate* with practice leaders to develop and execute a process improvement plan to improve outlying measures
    • *One-time or year-round consulting is available
  4. All measure data is submitted by HealthEC on behalf of the practice
BECAUSE SIMPLICITY MATTERS

Download the HealthEC MIPS Fact Sheet to learn more about simplifying your program and reporting goals.

Benefits of Partnering with HealthEC

HealthEC has the knowledge, experience and technology to help you succeed under the MACRA Quality Payment Program:

  • Data aggregation expertise
  • Quick turn-around with program recommendations
  • Real-time monitoring of performance against measures, with feedback to address care gaps
  • Provider-level dashboards to reinforce program initiatives

Quality Measures

No matter what your specialty, HealthEC can help you report your quality measures. HealthEC has a long history and verified expertise in being able to access data from any system, any setting of care and in any format. All specialty measures are built into the HealthEC platform, including but not limited to the following:
  • Anesthesia
  • Allergy
  • Emergency Medicine
  • Cardiology
  • Gastroenterology
  • Hematology & Oncology
  • Immunology
  • Ophthalmology
  • Orthopedics
  • Pain Management
  • Pulmonary/Critical Care
  • Radiology

Clinical Practice Improvement Activities

HealthEC’s comprehensive population health management suite helps organizations realize remarkable year-over-year improvements in efficiency, quality of care, costs, and quality of life for the patient communities they serve. More precise identification and closure of care gaps, improved forecasting and impact analysis helps organizations manage patients across the care continuum, while meeting CPIA objectives.

Advancing Care Information

HealthEC can supplement your ACI activities if you are having difficulty calculating numerators/denominators in your EMR, sending or receiving patient care summaries, etc.

Background on MACRA/MIPS

The goals of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program are to help providers focus on quality and improve the health of patients. MACRA gives providers new tools, models, and resources to help deliver the best possible care.

Organizations/Providers can choose how they want to participate based on their practice size, specialty, location, or patient population:

  • The Merit-based Incentive Payment System (MIPS)
    • Most practitioners will be subject to MIPS, including Medicare Part B eligible clinicians (Physicians and Advanced Practice Nurses)
  • Advanced Alternative Payment Models (APMs)
    • Practitioners participating in Medicare Part B for the first year
    • Providers with Medicare billing less than $10,000 and provides care to less than 100 Medicare patients in one year

You can learn more and determine your need to participate in MIPS by entering your NPI on the Quality Payment program web site; exclusions for MIPS based on participation in APMs are also defined.

Financial Impact of MACRA/MIPS

MIPS assigns each eligible physician a Composite Performance Score (CPS) based on the following four criteria, and adjusts payment based on performance:



To read more, access the CMS Quality Payment Program web site.

Options for Timing of Participation

MIPS participants can choose their pace among three options:


To learn more, read the Quality Payment System fact sheet.