Tips to Help You Avoid the 5% MIPS Penalty
The minimum reporting requirements for the Merit-Based Incentive Payment System have been raised somehow for the 2018 reporting year. Before, independent physicians had to just report on a single measure to satisfy the qualification. However, for 2018, physicians have to earn not less than 15 points in order to avoid penalty. Here are ways that you can avoid penalties.
Confirm whether you need to report under MACRA
From the start of 2018, medical practices or groups that see less than 200 Medicare patients or bill Medicare less than $90,000 annually are exempt from taking part in the program. Clinicians are also exempt if this is their first year of Medicare participation and if they are qualified participants in APM or eligible advanced alternative payment method (APM).
You can confirm whether you need to take part in the Merit-Based Incentive Payment System through Medicaid Services (CMS) online tool and updated Centers for Medicare. Status letters for group practices are not mailed by CMS, so it is crucial to confirm your status on the lookup tools.
Determine if you are eligible as a small practice
Practices that have less than 16 clinicians qualify as small practices. As a result, they get special benefits and reporting is much easier. The number of clinicians includes physicians, advanced practice nurses, and physician assistants. Some small practices can get an automatic five points bonus and double credit for improvement activities.
Additionally, they do not have to worry about data completeness for the quality measures category. You can get credit by just reporting some data for every quality measure.
Smaller practices
Smaller practices consisting of less than 16 clinicians can meet the performance threshold by reporting on one high-weighted improvement activity. They can also report on 1 quality measure and one medium weight improvement activity. They should also report six quality measures and reporting one quality measure and the advancing care information base score.
Larger practices
Big medical practices with over 16 clinicians can avoid payment penalties by reporting four quality measures and two medium-weighted improvement activities. They can also opt to report four medium-weighted improvement activities or two high-weighted improvement activities. Larger practices should also report two quality measures and the Advancing Care Information base score.
Avoid making hasty decisions
Most healthcare providers will feel overwhelmed by all the Merit-Based Incentive Payment Systems and quality payment programs requirements. However, you should never opt for the easy way out by just doing the bare minimum for Medicare quality reporting.
Bear in mind that the penalties and requirements will continue increasing. In 2017, the minimum score for avoiding the penalty was 3 points, but in 2018 it was increased to 15 points. This score may be increased to 30 points in 2019.
By fully participating in MIPS, you will avoid the 5% penalty, boost your chances of getting an incentive, and enhance your preparedness because there is more cash on the line.
Seek assistance if necessary
CMS has lots of resources that can help you like online courses and videos to assist in-person and desk assistance. You should not hesitate to reach out whenever you require assistance.
With the necessary assistance, you will increase your eligibility for payment and avoid any penalties. Experienced reporting specialists will discuss the reporting plans with you to ensure that you satisfy the 15 points and avoid any penalties.
There are fewer practices needed to take part in 2018 Merit-Based Incentive Payment System reporting. Larger medical practices will have to do more so that they can avoid penalties. However, if you keep these tips in mind, you can confidently avoid the 5% payment penalty in the year 2020.
