Approximately 90% of eligible clinicians will be subject to MIPS.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) creates two payment tracks for Medicare Part B services – Advanced Alternative Payment Models (APMs) and the Merit-Based Incentive Payment System (MIPS). Under MIPS, eligible clinicians will receive a composite performance score based on four categories:
Eligible clinicians will be scored and ranked against each other nationally, and scores will be publicly available. Clinician scores during calendar year 2017 will determine payment adjustments in 2019, and so on. MIPS is required to be budget neutral, making the program a zero sum game where performance bonuses are funded by penalties levied against other providers. The payment bonuses and penalties progressively increase each year as outlined in the graph to the right.
Under MIPS, eligible clinicians are now in a race against their peers. And like any
race, those who get off the starting block first and are able to maintain momentum
will outperform those who wait. With cost and quality equating to 60% of the MIPS score, these categories will undoubtedly differentiate top performers. Not surprisingly, care coordination and electronic document exchange are components of all four categories.
Infina Connect’s Intelligent Care Coordinator helps clinicians optimize MIPS scores by:
Impact cost/utilization and quality measure performance.
Ensure high value care is maintained as patients move across the care continuum.
Expedite the referral process & prevent avoidable hospital admissions.
Manage cost by referring to high value partners.
Regardless of the consulting providers EHR.
Electronically exchange C-CDA’s or other clinical documents.
Manage quality with ongoing visibility into patient care.
Coordinate care community wide.
Receive clinical summary & results electronically.