SBMI’s Gulf Coast Regional Extension Center (GCREC) has spent the past two years assisting its healthcare provider clients as they navigate the Merit-based Incentive Payment System (MIPS) program. Based on newly released data, the GCREC client performance scores exceed the national average. MIPS, launched in 2017, ushers in a new era in which clinicians are responsible for providing value-based care.

In November, the Centers for Medicare & Medicaid Services (CMS) released an infographic to summarize 2017 MIPS Quality Payment Program Performance data. CMS reports that 71% of MIPS eligible clinicians across the nation earned a positive adjustment and an adjustment for exceptional performance. The GCREC has a performance score average of 91.97% for the non-Accountable Care Organizations (ACO) providers and 80.75% for the ACO providers it serves.

The quality-based MIPS program scores eligible clinicians in four categories: Quality, Promoting Interoperability (PI), Improvement Activities (IA), and Cost. Based on the 2017 MIPS scores, Medicare payments, which will be made in 2019, will be adjusted up or down by as much as 4%. However, for 2019 MIPS scores, providers can see payment adjustments of up to 7% when payments are made in 2021.

The GCREC, which provides Meaningful Use and electronic health record (EHR) technical assistance throughout south and southeastern Texas, has helped thousands of clinicians since its inception. With continual changes in MIPS requirements and necessary EHR upgrades, clinicians face challenges if they plan to participate in MIPS for 2019.

“We primarily work with underserved, primary care providers and in 2017 alone we successfully assisted 190 practices attest for MIPS and EHR incentive programs,” stated Susan Fenton, PhD, SBMI Associate Dean for Academic Affairs and Assistant Professor and GCREC Faculty Director. “Physicians don’t need to wait until the end of a year to consider MIPS reporting so our consultants work year-round to help our clients meet the quality measures and potentially earn financial incentives.”

The GCREC team aids their clients with MIPS by first evaluating the needs and goals of the practice. At that point, GCREC consultants help eligible clinicians meet the minimum PI requirements and assist in the selection of Quality and IA measures relevant to the practice specialty. By facilitating this process, the GCREC helps providers avoid penalties. While the MIPS program can be difficult to navigate, having outside assistance is a valuable resource.

LaSonya Knowles, MS is the Director at the GCREC. She says, “Each year the requirements become more stringent and the participation threshold to avoid a negative adjustment goes up.” Knowles continued, “By using the tools we provide, physicians and other eligible providers can maximize payment in this evolving environment without sacrificing time better spent on patient care.”

Clinicians interested in learning more about how the GCREC team can help them navigate the MIPS program, should visit the GCREC website.

published on 12/10/2018 at 09:26 a.m.