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.

HealthEC Simplifies MIPS

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

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:

  • Allergy/Immunology
  • Diagnostic Radiology
  • Gastroenterology
  • General Surgery
  • Mental/Behavioral Health
  • Orthopedic Surgery
  • Physical Medicine
  • Rheumatology
  • Anesthesiology
  • Electrophysiology Cardiac Specialist
  • General Oncology
  • Hospitalists
  • Neurology
  • Otolaryngology
  • Plastic Surgery
  • Thoracic Surgery
  • Cardiology
  • General Practice/Family Medicine
  • Internal Medicine
  • Obstetrics/Gynecology
  • Pathology
  • Preventive Medicine
  • Urology
  • Dermatology
  • Emergency Medicine
  • Interventional Radiology
  • Opthalmology
  • Pediatrics
  • Radiation Oncology
  • Vascular Surgery
More »
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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.

Learn more about HealthEC applications and services that support MIPS reporting and success:

 

Data Aggregation

Create a unified view of clinical, financial and administrative data

Reporting Tools

Scorecards and exportable reports formatted for your quality reporting track

Advisory Services

A range of consultative services to help you reach your MIPS goals

Care Coordination

Promote high-priority care interventions and smarter resource utilization


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 $30,000 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:

  2017 2018 2019
Criteria Weighted Value Max Penalty/
Max Incentive
(Payment year
2019)
Weighted
Value
Max Penalty/
Max Incentive
(Payment year
2020)
Weighted
Value
Max Penalty/
Max Incentive
(Payment year
2021)
Quality (Formerly PQRS) 60% -4% to +4% 50% -5% to +5% 30% -7% to +7%
Advancing Care Information
(Formerly MU)
25% 25% 25%
Clinical Practice Improvement
Activities
15% 15% 15%
Resource Use 0% 10% 30%
Performance
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.
Feedback:
Medcare gives you feedback about your performance after you send your data.
Payment:
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 Program:
If you don’t send in any 2017 data, then you receive a negative 4% payment adjustment.
Test:
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.
Partial:
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.
Full:
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.

BECAUSE
SIMPLICITY MATTERS
Download the HealthEC MIPS Fact Sheet to learn more about simplifying your program and reporting goals.
View MIPS Webinar Recording
MIPS Made Easy: Strategies to Optimize Your Incentive Payments