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VIDEO: Tips for improving MIPS score, avoiding penalties

NEW ORLEANS – A practice assessment of a practice’s documentation policies is an important step that may reveal some of the reporting requirements are already being performed, or can be easily added, Shari Erickson, MPH, vice president for governmental affairs and medical practice for the American College of Physicians, told Healio Internal Medicine.

The first step for a practice is to determine if they are required to participate in the merit-based incentive payment system (MIPS), as the Centers for Centers for Medicare & Medicaid Services (CMS) have raised the low volume thresholds to $90,000 in claims and a patient population of 200, she said. In addition, exceptions are available for practices who experienced extreme circumstances in the last year, such as a natural disaster.

Clinicians should consider which of the reporting requirements make the most sense for their practice, based on their patient population, which areas of improvement make sense for the practice and which criteria were rated as most useful by ACP, Erickson said. The improvement categories only require basic attestation that a practitioner is engaged in an activity, such as providing access to care outside business hours or has a certified electronic health records system. Some improvement categories are sufficient by themselves to meet the minimum MIPS score required to avoid a penalty, she said.

Although not required for reporting in 2018, cost is an area that CMS will be evaluating and providing feedback and will count as 10% of the MIPS score in 2018. This underscores the importance of being thorough in coding, particularly with hierarchical condition categories, which quantify patients with more significant illness to explain some costs any may be worth bonus points, Erickson said.

“It’s really worthwhile to take a look and see what you’re already doing, because a lot of things you [fulfill requirements], and see if there are ways to document that better if you haven’t before,” Erickson said “Then take a look at some of the other options that are available and you could easily take on initially or areas where you really want to jump in and so some more work in.”

For more information :

American College of Physicians. Merit-based Incentive Payment System. https://www.acponline.org/practice-resources/business-resources/payment/medicare/macra/mips.

Quality Payment Program. https://qpp.cms.gov/

Disclosure: Erickson is vice president for governmental affairs and medical practice for the American College of Physicians,