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.
HealthEC Simplifies MIPS
HealthEC will help ensure your MIPS success with four easy steps:
- 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
- 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
- HealthEC can collaborate* with practice leaders to develop and execute a process improvement plan to improve
*One-time or year-round consulting is available
- All measure data is submitted by HealthEC on behalf of the practice
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
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:
*Please note: The measures identified in these specialty lists are not inclusive of the non-specialty measures. For a complete list of all measures, specialty or otherwise, please refer to:
Advancing Care Information (ACI)
You are required to use a certified (either 2014 or 2015) EHR technology; use this link to determine your EHR edition. You must report all base score measures (4 or 5, depending on your EHR) for a minimum of 90 days; to maximize your score, report on other measures.
The ACI score has three components, with a maximum of 100 points:
- Base score
- You must meet all 4 or 5 base score requirements to earn a base score of 50%; if you cannot report all 4 or 5, then your score for the entire ACI section is zero
- In order to meet the 4 or 5 base score requirements, you have to answer “yes” or have at least 1 in the numerator/denominator (depending on the measure)
- Performance score
- Measures are individually weighted
- Your score for each measure is based on your performance, e.g. if your performance rate is 50% for a measure, then you earn 5% of the possible 10% score for that measure
- Bonus score
- If you participate in at least one registry beyond the immunization registry, you qualify for a 5% bonus
- If you use a Certified Electronic Health Record Technology (CEHRT), you quality for a 10% bonus
HealthEC can supplement your ACI activities if you are having difficulty calculating numerators/denominators in your EMR, sending or receiving patient care summaries, etc.
View Advancing Care Measures
You are required to earn 40 points, and can choose any combination of high-weight and medium-weight activities to total 40 points.
View Improvement Activities
- High weight activities = 20 points
- Medium weight activities = 10 points
Learn more about HealthEC applications and services that support MIPS reporting and success:
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)
- Advanced APMs are a subset of APMs, and let practices earn more for taking on some risk related to their patients' outcomes.
- You may earn a 5% incentive payment by going further in improving patient care and taking on risk through an Advanced APM.
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:
|Quality (Formerly PQRS)
||-4% to +4%
||-5% to +5%
||-7% to +7%
|Advancing Care Information
|Clinical Practice Improvement
The first performance period opens January1, 2017 and closes December 31 2017. During 2017, record quality data and how you used technology to support your practice. If an Advanced APM fits your practice, then you can join and provide care during the year through that model.
Send in performance data:
To potentially earn a positive payment adjustment under MIPS, send in data about the care you provided and how your practice used technology in 2017 by the deadline, March 31, 2018. In order to earn the 5% incentive payment by significantly participating in an APM, send quality data through your Advanced APM.
Medcare gives you feedback about your performance after you send your data.
You may earn a positive MIPS payment adjustment for 2019 if you submit 2017 data by March 31, 2018.
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:
Not participating in
the Quality Payment
If you don’t send in any 2017 data, then you receive a negative 4% payment adjustment.
If you submit a minium amount of 2017 data to Medicare (for example, one quality measure or one improvement activity for any point in 2017), you can avoid a downward payment adjustment.
If you submit 90 days of 2017 data to Medicare, you may earn a neutral or positive payment adjustment and may even earn the max adjustment.
If you submit a full year of 2017 data to Medicare, you may earn a positive payment adjustment.
To learn more, read the Quality Payment System fact sheet.