Outrunning the MIPS Bear (Article 1 of 5)

Article #1 of 5

I have always loved this saying, because you can’t really outrun The Bear: no, what you really want to do, is be a little bit faster than the next slowest guy who is also trying to outrun The Bear.  You don’t want to be the fastest guy in the group running from The Bear – that takes too much energy, and you can’t keep that up for long. What you want is to be in the middle group of folks who are comfortably ahead of the slower guys running from Da MIPs Bear.

Why make sure you’re not the slowest guy? Good question! Because if you are, you’ll pay the penalty even though you’re being a good compliant doctor, participating in MIPS whether you like it or not. Da Bear is after you regardless: first he’s going to penalize those who don’t participate in MIPs at all, and then he’s going to go after those who bother to meet only minimum thresholds. They’re too slow – don’t be too slow.

There are 4 categories to consider while running this race:

  1. Quality
  2. Promoting Interoperability
  3. Improvement Activities (IA)
  4. Cost

Let’s get an overview of each one, figure out what you have to do to keep ahead of the slowest guy running from Da Bear (MIPS). In the next 4 articles I’ll dive into details of each category.

Quality: 50% of your final score

This used to be PQRS. Just like PQRS, you’ve got to figure out which Clinical Quality Measures (CQM) you’re going to focus on: you need 6 that best fit your practice.

Promoting Interoperability (PI): 25% of your final score

Last year, this was Advancing Care Information which used to be Meaningful Use, but The Bear wants you to think about how to proactively share patient health information (PHI), such as results, electronically via Patient Portal and Direct email, so The Bear renamed it to PI.

The more acronyms, the merrier!

You’ve got to submit 4 or 5 Base Score measures over 90 days or more.

Improvement Activities: 15% of your final score

This is a new category that assess how you improve your care processes, enhance patient engagement in care, and increase access to care.

You’ve got 3 options on this one:

  • 2 high-weighted activities
  • 1 high-weighted activity, 2 medium-weighted activities
  • 4 medium-weighted activities.

Cost Measure: 10% of your final score

The good news: Cost measures are evaluated automatically via claims data and are based on Medicare Spending per Beneficiary and Total per Capita Cost.

Conclusion

There you have it – MIPS is designed to push you towards ever more meaningful use of your EMR. There’s no minimum qualifying threshold that’ll remove you as bear bait. Adopt the workflows in your EMR to constantly improve your scores – that’s the best way to go!

I will be diving deeper in to each of the 4 categories in my next 4 articles.

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Brad Sclar has founded several successful Healthcare IT companies within the last 20 years in the Denver area — PRS Network, Phasis Group, and MD-IT. In addition to multiple IT certifications he supports voice recognition software into multiple EMR environments nationwide, serves as the CIO of the PRS IT Division, overseeing template development, maintenance of client LAN installations, custom software development, HL7 interfaces between EMRs, and the installation of the Health Record portion of the EMR software packages that PRS represents. Currently, he is involved in launching a Urology focused MSO.