Physician Practice

Adopt four changes to increase your success with MIPS

Physician Practice Insider, May 16, 2017

Be prepared to revise how your practice runs so that you can maximize your chances of earning an incentive payment under the new merit-based incentive payment system (MIPS).

Practices will need to make four operational changes to make MIPS work:

  • Learn your current quality metrics. A physician’s current quality resource use report (QRUR) will provide a good snapshot of how a physician compares with her peers for the quality and cost components to be reported and will go into the MIPS calculation, says Melinda Hancock, CFO, VCU Health in Richmond, Virginia. Having this information will help practices access quality and other gaps so they can improve going forward.
  • Revise your hospital contracts. Physicians who provide medical director services, on-call coverage, and other services to hospitals need to reassess those relationships to ensure that the hospital will assist in collecting and providing data the physician needs for MIPS reporting, such as process measures or the availability of physicians. Contracts may need to be revised to address MIPS reporting and how to protect the physician if the hospital fails to cooperate. Any changes in compensation would be subject to fair market value requirements as well as compliance with Stark and other laws, says Mark Herbers of AlixPartners consulting firm in Chicago, Illinois.
  • Have an adequate tool for data collections. Practices will need a method for collecting all of the measures required. Larger practices may invest in automated tools; others, particularly smaller practices, may engage a third-party vendor or reach out to a larger practice or hospital affiliate for navigation and reporting assistance, says Herbers.
  • Ensure your EHR capability. Practices will need to review their EHR systems to see whether they can capture the required quality measures. “This may be [hard], especially for specialists, since information may be in free form and not in a data element,” warns Herbers. Some practices may need to upgrade their systems.

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