Higher MIPS scores and positive CMS adjustments

Technology helps us do so much more than we used to be able to do on our own. If there’s anything we’ve learned in the last decade of technological innovation it’s that “there’s an app for that” when it comes to just about any goal you want to accomplish.

This absolutely includes the financial goals you’ve set for your practice, which you’ve probably had to re-evaluate recently due to the uncertainty surrounding CMS payment adjustments under MACRA.

Healthcare IT (HIT) will play a major role in your MACRA compliance efforts. In addition to automating some of the more tedious processes the new regulations require, HIT can help physicians score high under the Merit-based Incentive Payment System (MIPS), which is necessary to receive positive payment adjustments from CMS beginning in 2019.

Here’s how HIT, especially tools that enables efficient and timely care team collaboration, can boost scores in each of the four weighted MIPS performance categories:

Cost

The processes and treatment plans used by clinicians to deliver patient care are directly tied to costs. In the face of potentially negative payment adjustments, it’s more important than ever to realize cost savings, a feat that will be heavily impacted by providers’ ability to manage chronically ill populations. Success in population health management is highly dependent upon efficient communication, collaboration and care coordination across all care team members and care settings. Communication workflows and unified communication tools need to be assessed and implemented to improve the speed and efficiency with which disparate care team members can communicate with each other to coordinate care.

Quality

Clinicians have a lot of personal freedom when it comes to the quality of the care they deliver. One of the more manageable ways to improve the quality of healthcare is to overcome communication obstacles that have long degraded and delayed care. Obstacles such as not knowing who to contact for a given situation; searching for and struggling to find contact information and leaving messages with intermediaries; never knowing if the right message will be delivered to the right recipient, thus suspending and disrupting care, etc., are easily overcome with the help of intelligent communication routing and automatic escalation tools.

Advancing Care Information (ACI)

EHR functionality is a key component of ACI, but an EHR’s capabilities to support care coordination are limited. Care team members in a physician’s network may or may not share the same EHR, and the need to seamlessly communicate with them — and those outside of the network who are even less likely to have the same EHR — is equally important. There’s an increased need to implement a system of secure communications that transcend disparate EHRs to ensure timely bilateral exchange of patient information. Interoperability is an important factor for the ACI performance score.

Improvement Activities

Clinicians who utilize patient-centered approaches to achieve better, smarter and healthier care will perform well in this category. Implementing tools that enable patient-centric communications is one step toward achieving a high score in the Improvement Activities performance category.

More than 600,000 clinicians will be responsible for reporting MIPS performance criteria for at least 90 days this year. MIPS reporting is complicated, complex and extremely important to understand because it will impact CMS payment adjustments beginning in 2019.

The threshold to receive a positive payment adjustment has been set very low for 2017, so there’s less financial risk for eligible clinicians in the first year. The clinicians who want to cross the low composite score threshold to receive the maximum positive adjustment possible in 2019 need to score high in the performance measurement areas of Quality, Advancing Care Information and Improvement Activities. Reporting in the Cost category will begin in 2018.

Care team collaboration and communication platforms like PerfectServe® help clinicians decrease costs and improve quality by eliminating inefficient and time-consuming communication processes that delay treatment. Our cloud-based architecture allows clinicians to transcend the communication capabilities of the EHR and securely coordinate care with disparate interdisciplinary providers regardless of their location; and the patient-centered communication capabilities neatly fulfills all of the criteria for the Improvement Activities performance category.

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