Quality Payment Program 2020

Under MACRA’S Quality Payment Program (QPP), MIPS 2020 is well underway for clinicians to participate in. Another year of performance, outcomes, and incentives is here, not only for them but for us too because we, as their business associates, are in this together.

This page is created in view of the information released by CMS. Anything you find on this page is in accordance with the MIPS 2020 final rule; we want it to be a guide for clinicians to make informed decisions in the future. Eventually, it materializes our devotion, dedication, and commitment to healthcare purpose.

MIPS 2020 Quality Reporting

Since we are talking about MIPS CQMs (Clinical Quality Measures), previously registry measures, a MIPS Qualified Registry is an answer to your MIPS-MACRA objectives. In the end, it is a combined effort of both the registry and the provider that converts into the final MIPS score. The incentives, bonuses are the reward for MIPS quality reporting.

Thorough submission is key here. Due to a consistent knowledge base, our consultants are aware of all the ins and outs of how to submit MIPS 2020 data.

Performance Period

2020

Performance Year

Clinicians care for patients and record data during the year
Closes December 31, 2020
Performance period opens January 1, 2020

Submit

Mar 31,2021*

Data Submission

Deadline for submitting data is March 31, 2021
Clinicians are encouraged to submit data early via p3care
*Data differs for CMS web interface and claims-based data submission

Feedback Available

July 2021

Feedback

CMS provides performance feedback after the data is submitted
Clinicians will receive feedback before the start of the payment year

Adjustment

Jan 1,2022

Payment Adjustment

MIPS payment adjustments are prospectively applied to each claim beginning January 1, 2022

MIPS 2020 Data Submission Methods

EHR

1
Registry/QCDR

2
Claims

3
CMS Web Interface

4
CAHPS for MIPS Survey

5
Attestation

6

P3 ascertains the most suitable Quality measures, specialty-measure sets, and submission methods for you.

Submit Now

The 2020 Category Weight Distribution

The announced weights – same as the previous year – for each performance category are:

45% for Quality
15% for Cost
25% for Promoting Interoperability (PI)
15% for Improvement Activities (IA)

MIPS 2020 Category Weights

MIPS 2020 reporting is not as easy as it appears. It takes the skills of professional third-party intermediaries such as us to do the job.

Each of the MACRA-MIPS categories has measures that fulfill a specific purpose. With more than 200 MIPS Quality measures, each with the sole purpose of gauging your performance on clinical activities and patient outcomes, their accurate submission helps you achieve a higher MIPS final score.

Similarly, Improvement Activities category monitors your performance, as a clinician, in terms of patient engagement, care coordination, and patient safety. In total, there are over 200 Improvement Activities to choose from; select ones that best suit your practice or specialty.

The third category, Promoting Interoperability, previously known as Meaningful Use caters to the 2015 version of Certified Electronic Health Record Technology (CEHRT) to gauge the performance of clinicians. It does so through a wide range of measures. Our job is to help clinicians select, understand, and submit 2020 MIPS promoting interoperability measures for positive payment adjustments.

Finally, we have the Cost category that addresses the quality of claims filed against services rendered. It analyses a clinician’s performance in providing the needed care to patients, keeping the overall expenses to a minimum.

How Do I Know If I Am Eligible for MIPS 2020?

For clinicians who are interested but do not know whether they are eligible or not, we bring the right data for them into the limelight. There are zero changes to this section of the program from before in 2019.

Fall in one of the eligible clinician types on Medicare Part B claims

Be above the low-volume threshold

Be enrolled in Medicare before 2020

Not be a Qualifying Alternative Payment Model Participant (QP)

If you choose to report as a group and not as an individual clinician, the final score and payment adjustment are based on collective reporting.

To confirm your eligibility status for MIPS 2020

Check Eligibility

The Types of Clinicians Who Are Eligible

Physician

Physician Assistant

Nurse Practitioner (NP)

Clinical Nurse Specialist

Certified Registered Nurse Anesthetist

Physical Therapist (PT)

Occupational Therapist (OT)

Speech-language Pathologist

Audiologist

Clinical Psychologist

Registered Dietitian or Nutrition Professionals

Straight Up 2020 MIPS Eligibility Requirements

To be reporting MIPS 2020, clinicians must fall on the following requirements:

Bill Medicare an amount of $90,000 or more
Provide care to 200 or more Medicare patients
Provide 200 or more cover professional services to Medicare patients

If you don’t meet one of the above requirements, consider yourself excluded from MIPS in 2020.

Opt-in Clinicians

The option to report MIPS through the Opt-in doorway does not require you to regularly participate and report. You may elect to opt-in to MIPS even if you don’t meet the requirements except one of them.

Diagnostic QPP MIPS Quality Measures 2020 for Radiologists

The field of radiology is not new in the healthcare industry, and incentive payment programs as QPP MIPS also cater to it.
When we talk about MIPS solutions, like all other healthcare service providers, radiologists also worry about submitting the right MIPS Quality measures to CMS in an attempt to get payment adjustments and incentives.
Overview of QPP MIPS Incentive Program
Eligible clinicians under QPP (Quality Payment Program) can participate in two incentive payment programs.
• MIPS (Merit-based Incentive Payment System)
• APM (Advanced Alternative Payment Model)
Clinicians can receive payment adjustments of up to 9%, based on the performance of QPP MIPS 2020. To succeed in MIPS, radiologists have to compile MIPS data as per the following performance categories.

Quality

It holds a percentage of 45%. Radiologists should submit 6 quality measures based on the performance of the whole year with an outcome measure.

Promoting Interoperability (PI)

It holds a percentage of 25% out of the total MIPS score. Most radiologists might not receive credit for this category because of being non-patient-facing clinicians or hospital-based eligible clinicians.

Improvement Activities (IA)

It holds a percentage of 15%. For this category, radiologists should attest to four improvement activities. Small, rural, and shortage area practices and non-patient-facing MIPS physicians are required to submit data for only two activities. However, there must be one high-weighted activity.

Cost

It holds a percentage of 15%. It is measured as per the Medicare Spending per Beneficiary (MSPB) and Total Per Capita Cost (TPCC). This category does not require any QPP MIPS data submission, but the performance is evaluated based on submitted claims.

What Else Radiologists Need to Remember for QPP MIPS 2020 Reporting?

There are some points that radiologists need to remember if they want to score high in MIPS 2020.
1. The data for the MIPS quality category must be submitted for at least 12 months.
2. The minimum performance threshold is 45 points.
3. Against 85 or more MIPS points, eligible MIPS radiologists can earn a bonus from CMS.
4. At least 50% of the group participants must perform an improvement activity (IA) to receive credit for it.
5. There are no particular changes for QPP MIPS reporting for radiologists working in small, rural, or non-patient-facing participants.
Here’s the list of the QPP MIPS Quality Measures related to Radiology for diagnosis. However, if you choose to report through MIPS Qualified Registry, your work becomes easy.
You do not have to worry about finding the most relevant specialty-specific measures, but a team of experts will take up the administrative load efficiently.

How to Report MIPS Data?

P3 Healthcare Solutions simplifies MIPS data submission from the get-go. In fact, we submit data on your behalf, so you get to focus more on your patients – no more looking after compliance obligations on your own. The process executes in a step-by-step fashion, beginning from step 1 and ending on step 5.

Step 1

One of our health IT analysts spends a few minutes with you on the phone to understand your clinical workflow and practice requirements.

Step 2

Next is shortlisting of measures for each performance category and communicating the reporting activity with the practice manager.

Step 3

The cost category is auto-responsive because we take care of it for you – dealing with episode-based measures and claims filed with CMS.

Step 4

Self-educating and adding to client’s knowledge through feedback based on TIN level QRUR reports.

Step 5

In case of any MIPS reporting 2020 updates, we inform you of the regulatory changes and CMS MIPS submission criteria.

What is MIPS?

MIPS – the Merit-based Incentive Payment System – is a government program that judges the quality of care by care professionals. There are many ways in which an eligible clinician can submit measures through MIPS. However, submission of MIPS CQMs (clinical quality measures) previously referred to as “Registry measures” through a third-party intermediary, is an effective way of reporting. In this, clinicians can score high and handsome based on the accuracy of data. Contact us to report to CMS.

Why should I choose MIPS Quality measures?

QPP divides into two programs, of which MIPS is the popular version by far. Specialties can connect with MIPS consulting services such as ours to select the most suitable CMS MIPS Quality measures to their practice and submit them. In fact, CMS resource library has all the measures in detail you need as a provider. As for their purpose, it is to improve quality of care and reduce healthcare expenses.

MIPS Quality measures 2020 refer to measures across the Quality performance category. Ordinarily, ECs have four performance categories including Quality, Promoting Interoperability (PI), Improvement Activities (IA), and Cost to report. Moreover, accurate and meticulous MIPS submission depict high scores, incentives, and bonuses.

What is data completeness? Data completeness factor holds crucial place in Quality reporting. Clinicians with MIPS eligibility have to submit measures with 70% data completeness, which means they have to report performance or exception data for at least 70% of patients that are eligible for the particular measure’s denominator

What do the MIPS 2020 quality measures stand for?

MIPS 2020 Quality measures reflect the Quality category in the complete sense. Once you get to know them, reporting for the performance year only gets easier.

CMS MIPS 2020 is another year of transition out of the 5. We are transitioning to MIPS in a gradual process year after year with this transition phase ending in 2021. It will be the year 2021 that this program will have finalized requirements set for the Quality performance category.

The category holds a 45% weight of the total score, similar to what it did in 2019. ECs must collect data for 12 months for Quality – starting from Jan 1 to Dec 31, 2020.

For the 2020 Quality measures list, CMS’ official website contains the most accurate data for clinicians to read and understand; furthermore, the Quality measure specifications for 2020 are part of the MIPS section at qpp.mips.gov. The Quality measures, program specifications, hardship exception rules for MIPS 2020 are all there alongside data about Alternative Payment Models.

What is the MIPS 2020 submission deadline?

As the deadline for MIPS 2019 was extended from March 31 to April 30, 2020, 8 pm EDT due to the pandemic, we may expect submissions on a large scale once COVID-19 subsides. More doctors and healthcare professionals are expected to participate in it.

MIPS 2020 is currently underway; to make the most of it, we suggest you report MIPS before the year ends. As the deadline gets nearer, haste could get in the way of selection and submission of the right measures. Therefore, reporting them as early as possible is indeed fruitful for your practice in the long run.

MIPS 2020 deadline is most probably going to be March 31, 2021, 8 p.m. EDT by which ECs must report MIPS 2020 measures completely.

How Does P3 Help?

We only require 5 minutes of your time in which our analysts examine your case in light of your area of expertise. Reporting begins once the measures are finalized through mutual understanding. Besides the meticulous approach and attention to detail, we hold transparency as the distinguishing factor in our submissions. Give us a call or simply email your NPIs, contact person’s name, and practice’s name to get started.

What is a good MIPS score?

MIPS 2020 performance criteria include a score above 85 for bonuses from the $500 million pool. In 2019, they were allowed on a score of 75 and above, so that’s changed in 2020. This 10-number increase is proof of the government’s continued commitment to quality care.