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November 15, 2019

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MIPS Data: The Finish Line is Crossed

 

The race is over, all the data is locked, and now we just wait for the results. The MIPS 2017 data submission period ended last week on April 3, 2018. The time for strategic planning and decision making is over. Submit on an individual or group basis? Choose this quality measure or that one? It simply doesn’t matter now. The window has closed on the opportunity to make those decisions. Now we just wait. Providers that submitted data through the Quality Payment Program can sign in now and view preliminary feedback. Just keep in mind this is not the final MIPS score or feedback. CMS tell us that a final MIPS score will be available for providers to view on July 1, 2018 and prior to that date changes could occur due to the following situations:

 

  • Special Status Scoring Considerations (ex. Hospital-based Clinicians)

  • All-Cause Readmission Measure for the Quality Category

  • Claims Measures to include the 60-day run out period

  • CAHPS for MIPS Survey Results

  • Advancing Care Information Hardship Application status

  • Improvement Study Participation and Results

  • Creation of performance period benchmarks for Quality measures that didn’t have a historical benchmark

 

The upcoming July 1st date will allow providers to get a preliminary peek at their MIPS report cards before they become public later this year on the CMS Physician Compare website. Those with high scores will be in good shape in terms of Medicare Part B reimbursement and professional reputation. Those with low scores will have to prepare responses along the lines of: “This is not reflective of quality”, “This is not fair”, etc. We all love “Top 10” lists and “Best of Category” information. We love rating systems whether they are reflective of what is real or not. Someone much smarter than me said, “Perception is reality”.

 

Beyond the reimbursement adjustments the ranking of providers based on quality will have a colossal impact on reputation. I’ve started calling the day that the MIPS scores become public “M-Day”. For years through shifting regulations and adjustments to the MACRA/MIPS program much has been going on behind the scenes. Now we are in a lock step with the approach of “M-Day” which this entire process has been about, the public release of a numeric provider scoring system that is easy to comprehend. Valid or not the score is simple and not based on a “star ranking” or anything that can be difficult to understand or misconstrued. 0 – 100 is a plain as it can be. Ready or not, the final exams have been completed and the report cards are coming.

 

This article was originally published on MIPS Consulting Blog.

 

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