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QPP Elevating the Bar of Value-Based Healthcare

The Quality Payment Program (QPP) shifts the Medicare payment model from a volume to value-based paradigm, promoting a care delivery culture that prioritizes patients, their health, and safety with technological innovation. One example is MIPS reporting services program.

This program revamps the previous SGR formula (Sustainable Growth Rate) to a new P4P (Pay-for-Performance). Thus, CMS tried to modernize outdated services and regulations that seem to do nothing better but confuse clinicians.

Quality Payment Programs for Physicians Rescue

You spend hours and hours treating and caring for your patients. Then why not get incentives for it via the MIPS reporting services program?

Why P3Care?

We are a trusted MIPS Qualified Registry known for delivering outcomes as per CMS requirements.

01 Experienced MIPS Consultant Services

Our years of experience reflect our reliable and data-driven incentive payment solutions that benefit the revenue cycle.

02 Streamlined & Accurate Workflow

P3Care’s consultancy includes a seamless approach right from data collection to MIPS quality measures submission.

03 Proactive Approach for Timely Reporting

We analyze every measure via a proactive approach to ensure the accuracy of your data before it reaches the CMS door.

04 Reliable and Dedicated Client Support

From the eligibility check to MIPS quality measures selection to the data submission, we are with you at every step.

What Payment Options Do QPP Addresses?

The two pathways for the QPP reporting are:

MIPS

(Merit-Based Incentive Payment System)

MIPS has streamlined the previously existing quality Medicare reporting programs as:

Value-Based Payment Modifier (VM)
Medicare EHR Incentive Program (MU)
Physician Quality Reporting Program (PQRS)

Most clinicians did qualify for the MIPS reporting in its first year, 2017. However, as the years progressed, CMS established some eligibility rules and performance parameters to enhance quality care and reward satisfaction.

APM

(Advanced Alternative Payment Model)

This framework provides an alternative payment strategy for eligible clinicians to register their high-quality and cost-efficient care to authorities to receive incentives. It focuses on the following aspects:

Special Clinical Conditions
Care Episodes or Population

MIPS-eligible clinicians participating in an APM are also subject to MIPS reporting services. It includes demonstration programs such as Accountable Care Organizations (ACO), Bundled Payments Models, Medicare Shared Savings Program (MSSP), and Patient-Centered Medical Homes (PCMH).

Who Is Eligible For MIPS Reporting Participation?

To meet the eligibility criteria for MIPS quality measures submission, you must:

Offer professional healthcare services to more than 200 Medicare beneficiaries
Provide more than 200 covered professional services to Part B patients
Bill more than $90,000 per year for covered professional services under the Medicare Physician Fee Schedule (PFS)

Who Is Exempted From MIPS Participation?

The following clinician types are exempted from MIPS reporting.

Qualifying APM participants
Healthcare providers in their first enrollment year with Medicare Part B
Healthcare providers with a minimum volume threshold of patients or payments

Who Can Attest as the “Eligible Clinician”?

To meet the eligibility criteria for MIPS quality measures submission, you must:

Physicians (including doctors of medicine, osteopathy, dental surgery, dental medicine, podiatric medicine, and optometry)
Chiropractors
Nurse practitioners
Physical therapists

Physician assistants
Qualified audiologists
Clinical psychologists
Occupational therapists
Clinical nurse specialists

Osteopathic practitioners
Qualified speech-language pathologist
Certified registered nurse anesthetists
Registered dietitians/Nutrition professionals
Clinical social workers
Certified nurse midwives

HOW DOES CMS MEASURE PERFORMANCE?

The process goes like this: Eligible clinicians participate either as an individual or in a group/virtual group against different combinations of NPI/TIN. No matter what data submission method they choose via MIPS consultant services, they receive a score by CMS over a composite score of 100 points based on their performance. The final score decides if they will be receiving incentives or not.

MIPS 2023 Is Here! Are You Ready For Its Participation?

You can avoid up to a 9% penalty in 2023 and we are here to assist you.

Perks Of MIPS 2023 Reporting

Eligible clinicians can target up to 9% of MIPS incentives with successful participation.

Cons Of Not Participating In MIPS

If you’re eligible for participation and choose not to, you may receive up to 9% of negative payment.

Payment Adjustment Ratios Over The Years!

With each passing year, CMS updates incentives to motivate eligible clinicians. This year, the ratio is up to 9%.

An Overview of Payment Adjustments Over the Years!

Ready to Get Assistance with MIPS Reporting Services for Your Medical Practice?

Ensure QPP compliance with MIPS reporting services and report MIPS data in a timely manner to improve services for your patients and your practice’s reputation.

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