MIPS Reporting… Group or Individual?

Posted on Oct 16, 2017 by Lea Chatham

Avoid MIPS penaltiesSo, here we are in the last 90-day period for participating in the Merit-based Incentive Payment System (MIPS) in 2017. For the last few months, we’ve been talking about options to avoid a penalty and even get an incentive even if you can’t do a full year of reporting. We’ve reviewed the Quality Measures, Advancing Care Information, and Improvement Activities.

 

Hopefully, you have started working on your tracking for the last 90 days of the year so you can avoid a penalty.

You may still be unclear about how to report your data. Today, we’re giving you some highlights on reporting to help you when the reporting period comes in 2018. Remember you can always get all the details at qpp.cms.gov.

If you are an eligible clinician and plan to participate in MIPS, you’ll report your data in 2018 for the 2017 year. You’ll need to figure out if you are reporting as an individual or as a group. As a reminder, you’re an eligible clinician if you are:

  • Physicians (including doctors of medicine, doctors of osteopathy, osteopathic practitioners, doctors of dental surgery, doctors of dental medicine, doctors of podiatric medicine, doctors of optometry, and chiropractors)
  • Physician's assistants
  • Nurse practitioners
  • Clinical nurse specialists
  • Certified registered nurse anesthetists
  • In a groups that includes such clinicians
  • Billing more than $30,000 in Medicare Part B allowable charges and have more than 100 Part B-enrolled Medicare beneficiaries

Reporting as an Individual

When you report as an individual, your payment adjustment will be completely based on your MIPS reporting for individual or groups is different performance. When you report using a single National Provider Number (NPI) or Tax Identification Number (TIN), you’re considered an individual reporter.

You’ll submit your data for each of the MIPS categories—Quality, Advancing Care Information, and Improvement Activities—through your EHR or a registry. You can also submit quality data through the Medicare claims process. Here is the full list of reporting options. Your choice may vary based on the category you are reporting.

  • Qualified Clinical Data Registry (QCDR)
  • Qualified registry
  • Electronic Health Record (EHR)
  • Administrative claims
  • Attestation

Reporting as a Group

When a group reports together, their payment adjustment is based on the whole group’s performance. A group is two or more eligible clinicians who report using the same TIN. There are several reporting options for groups. However, to participate in MIPS via the CMS Web Interface or Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS survey, groups needed to register by June 30. The other reporting methods do not require registration. They are:

  • Qualified Clinical Data Registry (QCDR)
  • Qualified Registry
  • Electronic Health Record (EHR)
  • Administrative Claims
  • Attestation

For the MIPS 2017 performance year, you’ll do your reporting in 2018. The deadline to submit all of your data is March 31, 2018. At some point during the rest of 2018 Medicare will provide feedback on your performance. If you receive a payment adjustment—negative or positive—it will begin January 1, 2019. If you do not submit any data and choose not to participate, you will receive a -4% payment adjustment on your Medicare Part B claims. If you opt for the test pace, and complete just one quality measure or improvement activity at any point in 2017 you will get a neutral adjustment. In other words, things stay the same. For partial and full participation, your adjustment will be based on your score.

Looking for ways to save time and be more efficient at your practice so you can focus on projects like MIPS? Consider implementing automated reminders and recalls. Find out more about the benefits in this short guide.

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Lea Chatham

Lea Chatham

Lea Chatham is the Director of Content Marketing at Solutionreach and the editor of the Solutionreach blog. She is responsible for developing educational resources to help independent practices improve patient relationship management. She specializes in simplifying information about healthcare and healthcare technology for physicians, practice staff, and patients. Her work has been published in many leading journals including Physicians Practice, Medical Economics, Medical Practice Insider, and the PAHCOM Journal.

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