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As 2018 comes to a close, and we get ready to report, eligible clinicians need also be preparing for 2019 and the changes it will bring for their practice. Practices should be on the lookout for the following:

Weight:

Comprising 60 percent of the final score beginning in 2017, the quality category has understandably been the top priority for many practices and individual clinicians in this program. In 2019, quality will be worth 45 percent of the final score. [The cost category will absorb this 5 percent, bringing it to a final weight of 15 percent] At 45 percent, the Quality category remains the heaviest category of the MIPS program.

Benchmarks:

No surprise here: each year the MIPS program is getting harder and harder; the quality measure benchmarks will continue to shift higher. As practices learn their measures, the bar must continue to be raised as to remain an accurate measure of quality. Performing at the same level in 2019 will not bring you the same score—you must do more.

Measure Removal:

Certain measures will continue to be deemed ‘topped out’ and will eventually be removed from the program altogether. 26 quality measures will be finalized for removal. If you are a clinician who only collects data on the required 6 quality measures, make sure all 6 will be making a return in 2019. Otherwise, the time is now to select and implement a new measure into your clinical flow.

Claims Submission:

Only small practices will be able to report MIPS via claims. Because almost 70 percent of claims measures are now topped out, CMS is making an effort to phase this submission method out. If you have more than 15 clinicians at your practice, and you submitted via claims in 2018, you must choose a new submission method in 2019.

What isn’t changing?

Data completeness – Data completeness is still at 60% for 2019.

Reporting period – A full years’ worth of quality reporting will be required again starting January 1.

Be on the lookout for the next edition of MIPS Changes covering Promoting Interoperability!

About Alex Dighero



 

Alex is a consultant and account manager for MIPS-related matters, including pathology sales support, MIPS services sales, and delivery of MIPS services. She is a certified compliance technician with the American Association of Healthcare Administrative Management. She has an MBA in health care administration from Cleveland State University.

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