Planning for MIPS Success – Quality Measures

Check out Medicare’s new website: https://qpp.cms.gov/

Note there is a subscribe button at the bottom so you can sign up to receive updates from CMS.

Quality Reporting:

Quality Reporting can be one of the most confusing elements of MIPS but the site does a good job of making this as simple as possible too.  Check out:  https://qpp.cms.gov/mips/quality-measures

This portion of the site allows you to filter the possible Quality Measures by Data Transmission Method (select EHR) and by Specialty.  The specialty list is a suggested list, as you can submit any 6 report measures (one of which should be an “outcome measure”) that meet the requirements.

Planning is Key to Your Success:

  • Use the tool above to create a list of 9-12 reports that you think best fit your practice.
  • Review the MIPS report/dashboard in your EHR to see how you’re doing on the 9-12 reports.
  • Narrow it down to 6 reports including an outcome measure report.

Why Start with More than 6 Reports?

  • Your current EHR may not support all 6 of your “favorite” reports. In order to be certified EHRs do not need to support all measures.
  • Your current scores on your “favorite” reports may not be very good and/or it may require a great deal of additional work on your part to achieve better scores.

Make Your Plan:

  • Finalize your 6 reports
  • Review your EHR tools and practice workflows to ensure you’re making use of all resources to ensure great results on your 6 measures
  • Meet with your staff to review workflow or other changes
  • Schedule periodic reporting to check progress – share results with your staff
  • Consider some type of bonuses or incentives for achieving results

Last but not least, consider some type of bonus or incentive plan for achieving results.  The average Medicare provider receives nearly $200,000 in Medicare reimbursements annually.  A 4% penalty to a 4% reward is a $16,000 swing – and possibly much more if you have a lot of Medicare patients.