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hiq services Mips compliance

MIPS

Impact of MIPS on Small Practices

 

  • Disproportionate negative impact on small practices
  • Masked by transitional scoring & temporary CMS accommodations
  • Root problem remains:
    • small practices lack the economy-of-scale of enterprise healthcare organizations to succeed with MIPS and Value-Based Care

MIPS Getting Harder Every Year

  • 2017 & 2018 MIPS transition years were trivially easy
  • CMS “simplifying” MIPS actually serves to reduce scores
    • Almost 21 point decrease due primarily to 2019 revised PI scoring
    • MIPS Value Pathways (MVPs) will similarly impact Quality, Cost & IAs scoring
  • 2022 MIPS & later will be challenging
    • Full MACRA scoring
    • Performance Threshold = nationwide median or mean MIPS Final Score
    • Half of providers nationwide will “fail” MIPS – receive a negative payment adjustment

MIPS Financial Impact Growing Every Year

 

  • MACRA fixed schedule for negative payment adjustment
  • Positive payment adjustments subject to scaling factors
    • More negative payment adjustments fund higher positive payment adjustments
    • Higher exceptional performance threshold also funds higher maximum positive payment adjustments

     

Overlooked and Misunderstood Aspects of MIPS

    • Performance data is a public record
      • may be published on Physician Compare
      • consider future Internet-shopping for healthcare providers
      • be careful what measures & information you submit
    • Security Risk Analysis is a critical mandatory requirement
      • not just a best practice, not just a form to fill out
      • also required for HIPAA compliance – critical in case of a HIPAA breach
      • sub-standard SRA is a huge risk estimated to affect the majority of small practices
    • Prevention of Information Blocking is a practice responsibility
      • not just a HIT vendor responsibility

How We Help

We help practices maximize revenue with expert MIPS optimization, minimize regulatory compliance risks and continue to maintain high quality patient care without distractions.

MIPS EssentialsTM

Learn More Free MIPS Assessment

 

 

We help increase organizational capabilities for measurable improvements and realization of strategic goals.

HiQ Quality Management Consulting

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