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MIPS 101: Finalizing Your MIPS Plan and Seven Steps for Success

In prior articles, we introduced the basic concepts of MIPS, discussed MIPS submission methods and financial incentives, and some of the practical implications in MIPS participation. 

Keys to Success

There is no doubt that MIPS is complex, and that for PTs and OTs, success in reporting Quality Measures is job number one, since quality reporting counts for 85% of their total MIPS score. But with some knowledge and strategic planning along with a well-designed system and proper implementation of a practical program for MIPS participation, it becomes easy to succeed in this Quality Payment Program (QPP).

Ask Yourself Some Questions

Before you even embark on implementing your MIPS strategy, you should ask yourself two questions:

  • Is the potential bonus or avoidance of a negative payment adjustment even worth the effort?
  • Even if it is obvious that the potential financial incentives are worth the effort, wouldn’t it be better if participation in MIPS actually achieved their goals of improved patient satisfaction, clinical outcomes and efficiency?

Clearly, the answer to the first question depends in part on how much of your caseload is Medicare, but the answer to the second question is clearly “Yes!”. 

MIPS Plus Strategy

Participating in MIPS could be a great benefit to your practice, even without the financial incentives. Routinely measuring and reporting risk adjusted outcomes, developing strategies and processes for tracking patient satisfaction, interacting with patients prior to their first visit, and following up on patients are all good practices, and all are incentivized by MIPS.

All too often, quality improvement programs are initiated without consideration of how the process affects clinical efficiency and patient convenience. And, more often still, programs are developed, valuable data is gathered, but the data is never really analyzed or utilized.

Aside from the financial incentives, analyzing and acting on the information you gain from outcomes analysis and patient engagement initiatives is a great long-term value. And, a well-designed MIPS strategy can improve service, clinical efficiency, and satisfaction of patients and staff.

Any MIPS strategy should have the following four goals:

  • Efficient clinical workflow
  • Patient convenience
  • Information utilization
  • Successful MIPS participation

We call the collection of data with an efficient workflow for your clinic, convenience for your patients, utilization of data to improve quality and processes along with successful MIPS participation as “MIPS Plus”.  

Delivering on MIPS Plus

It is easy to describe poorly designed processes to support MIPS that do not achieve the “MIPS Plus” goals:

  • Use of laborious paper outcomes surveys handed to the patient at the first visit
  • Manually scoring surveys and manually entering scores in multiple systems 
  • Outcomes survey data that is never utilized clinically
  • Patient satisfaction surveys that are mailed, or (worse yet) filled in by the patient in the clinic
  • Data that is manually plugged into a spreadsheet and never analyzed or utilized
  • Multiple, non-integrated systems

So, what does a well designed process for success in MIPS look like?

  • Use of an automated mobile patient engagement system
  • Automatic provisioning and scoring of patient reported outcomes surveys to appropriate patients
  • Automatic patient satisfaction tracking done very early in the process
  • Automatic distribution of appropriate patient education resources

MIPS Plus Workflow

In the workflow diagrammed below, a classification for the patient is entered as part of the patient registration process, and a patient engagement system is used to provision the appropriate outcomes survey. The survey data is exported to an outcomes analysis system and the results from individual surveys may be utilized in the patient’s clinical documentation. The outcomes system provides interim reporting that is used to monitor compliance and utilized as part of a continuous improvement process. In addition, the finalized MIPS scoring and data from CMS is utilized as part the improvement process. 

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Seven Next Steps for Success in MIPS

  1. Review the low threshold requirements and assess whether or not you are required to participate in MIPS. Take a look at this infographic for more information on determining your eligibility.
  2. If you are not eligible to report or participate in MIPS, stay tuned! MIPS is only an interim step on the journey from fee for service to value, so MIPS concepts are important to understand.
  3. If you are eligible, but not required to participate, analyze whether or not the effort required is worth the potential financial incentives. But remember, value-based payment is the future of healthcare. If you opt-out now, you are accepting you could be left behind in the transition.  
  4. If you exceed all three low threshold requirements, or you voluntarily elect to participate, start your “MIPS Plus” planning now.
  5. Familiarize yourself with MIPS, particularly the Quality Measures component. Use our MIPS resource center that will help you become more comfortable with MIPS.
  6. As you learn more about MIPS requirements, compare the advantages and disadvantages of different Quality Measure submission methods. We will be sharing more information needed to contrast and compare these methods in coming weeks.
  7. Begin browsing the Improvement Activity projects that are pertinent and useful for your practice. Try to identify the useful, high value improvement activities.

As we stated in the first article in this series, lack of preparation for MIPS will mark the end of life for some practices and a great opportunity for others. We are here to help you every step of the way to help you capitalize on a great opportunity and prepare yourselves for the continuing march toward value based payment.

Author

Jerry Henderson

Jerry Henderson

Jerry is a Physical Therapist and one of the founders of Clinicient and serves as the VP of Therapist Success. Prior to Clinicient, Jerry was a founding partner in a series of successful physical therapy clinics in the Seattle Area: Integrated Rehabilitation Group, Physical Therapy Clinics, Inc. PS, and Physiocare Corporation. He has a BS in Physical Therapy from the University of Utah.

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