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What's Intriguing in MIPS 2020 for Small or Medically Unprivileged Practices? by P3Healthcare Solutions

What's Intriguing in MIPS 2020 for Small or Medically Unprivileged Practices? by
Article Posted: 12/03/2020
Article Views: 376
Articles Written: 5
Word Count: 833
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What's Intriguing in MIPS 2020 for Small or Medically Unprivileged Practices?

An idea of a progressive US healthcare system will only become a reality by empowering small, rural, and medically underprivileged practices the same as the established healthcare organizations.

Under MIPS 2020, many eligible clinicians (ECs) who work in health shortage settings or areas can make use of flexibilities. This way, they get to make the most of value-based care too. The Centers for Medicare and Medicaid Services (CMS) encourages such physicians by simplifying MIPS reporting requirements and facilitating them through MIPS incentives.

In fact, eligible practitioners (EPs) have flexible options to participate in the Quality Payment Program. CMS helps them with free and personalized technical assistance.

Who Can Use These Facilities?

The assistance program is designed to aid practices with fifteen or fewer clinicians. Therefore, small practices are the ones cashing on its benefits.

High priority is for healthcare organizations located in rural areas, health professional shortage areas (HPSAs), and medically underprivileged regions.

CMS MIPS Quality Measures Reporting Initiative - Support Details

When clinicians of small practices take the initiative to report CMS MIPS quality measures, healthcare authorities appreciate their efforts, and, as a result, they are rewarded with the practice-level and program-level assistance.

What to Expect in Program-Level Assistance in MIPS 2020?

  • Comprehension of the general and must requirements of the Quality Payment Program
  • Checking of the eligibility status of the individual physicians or small groups
  • MIPS data submission with lesser requirements
  • Analysis and submission of the most-appropriate or specialty-specific MIPS performance measures. In simple words, it means optimized MIPS Quality reporting.

What to Expect in Practice-Level Assistance?

  • Performance analysis of the medical practice
  • Support in improving healthcare quality standards
  • Plan and develop strategies to implement Certified Electronic Health Records Technology (CEHRT)
  • Help in collaborating with peers, regional or local stakeholders

What Flexibilities Do CMS Offers in MIPS Reporting?

During MIPS 2019, clinicians enjoyed relaxation in certain areas. Moving onto MIPS 2020, the privileges, to some extent, remain the same. Individual medical practices or groups with ten or fewer clinicians have a choice to form a virtual group.

Clinicians in small practices can submit MIPS data for rendered professional services (both as individuals or groups) via the Medicare Part B claim submission method. On the whole, there are several MIPS data submission methods on which we have talked about on numerous occasions.

If you are looking to report healthcare MIPS most efficiently – a MIPS consulting firm could be the answer to that. It is a recognized third-party intermediary that reports on behalf of the eligible clinicians (ECs).

ECs or clinician groups are excused from MIPS 2020 submissions if any of the following conditions deem true for them:

  • Annual income is less or equal to $90,000 charges for covered professional services under Medicare PFS – Physician Fee Schedule
  • Care for less or equal to 200 Medicare Part B patients under Medicare PFS
  • Perform less or equal to 200 covered professional services under Medicare PFS

Quality Performance Category

Small, remote, or medically unequipped medical practices that don’t meet the data completeness requirement will be given three points in the final score. Moreover, a reward of six bonus points lies ahead.

Promoting Interoperability (PI) Category

This year too, ECs are required to report data for this category via 2015 Certified Electronic Health Records Technology (CEHRT). For the following reasons, medical practices can apply to reweigh this category to zero via applying for Hardship Exception by December 31, 2020.

  • Medical practice is a smaller one
  • Insufficient Internet connectivity
  • Uncontrollable and extreme situations
  • Limited or no access to CEHRT
  • Decertified EHR version

Improvement Activities (IA) Category

The reporting flexibilities in 2020 remain the same as in 2019.

  • Medium-weighted activities are worth twenty points for the IA category.
  • High-weighted activities are worth forty points in the total IA scorecard.

What’s New?

CMS revises its policies for Rural Health Clinics (RHCs), Critical Access Hospitals (CAHs), and Federally Qualified Health Centers (FQHCs).

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