Posted on June 13, 2023
In our 5-part blog series, "Mastering MIPS," Part 1 offers effective strategies to improve scores for the Merit-Based Incentive Payment System (MIPS) in 2023. With many clinicians preparing to report for the first time in several years due to the end of the public health emergency (PHE) for the COVID-19 pandemic, this series aims to provide guidance on successfully navigating the reporting requirements of the traditional MIPS program. First, let's explore steps you can take to optimize your performance and achieve better scores within the program.
Strategies to Help Maximize Your MIPS Score
Stay updated on MIPS requirements.
- Reviewing the MIPS program's guidelines, performance measures, and reporting requirements each year will ensure you are aware of any changes for the specific performance year. MDinteractive regularly posts MIPS updates on our website and communicates important changes in our blogs.
Start early, regularly monitor your MIPS performance, and make adjustments throughout the year.
- Developing and implementing a reporting plan at an early stage is a crucial step that will support your MIPS success. We recommend developing a reporting plan for each MIPS category you intend to report (Quality, Improvement Activities, and/or Promoting Interoperability). MIPS plans should be added to your MDinteractive account by clicking the “Add Plans” button on your dashboard and selecting the categories and measures you plan to report with MDinteractive.
- Once you begin entering your data into your MDinteractive account you will be able to closely monitor your performance and estimated scores. Your MDinteractive account has effective tools that will help you keep track of your progress throughout the year. The sooner you start, the more time you will have to address any areas that need improvement. We recommend reviewing your data on a regular basis (at least quarterly) to ensure you’re on track to meeting your MIPS scoring goals.
Consider group reporting.
- Clinicians who are part of a group or eligible virtual group (MIPS APM participants) can explore the option of reporting as a group. Group reporting allows for the aggregation of data, which may lead to higher performance scores and increased eligibility for incentive payments.
Choose high-scoring measures.
- Identify the measures that align with your practice's strengths and focus on those that carry higher point values. It is important to prioritize measures that have a higher likelihood of achieving the performance thresholds.
- There are several scoring changes that will impact the number of points you can earn for Quality measures this year. In 2023, a Quality measure that has a national benchmark can generally earn between 1 - 10 points if you meet both the case minimum and the data completeness requirements. This means:
- At least 20 patients are reported (case minimum); and
- At least 70% of eligible encounters, for all insurances, are reported for the full 12-month reporting period (data completeness).
- Large practices that don’t meet these requirements will earn 0 points (small practices will continue to earn 3 points).
- Some measures don’t have a benchmark. If there is not enough performance data from the prior MIPS reporting year to establish a reliable benchmark for a measure, or if the measure specifications went through significant changes, CMS will attempt to establish a benchmark retroactively after the 2023 submission period closes. Measures with no benchmark will receive 0 points (small practices will continue to earn 3 points) until after submission. Note that this does not apply to new measures in the first 2 performance periods available for reporting or to administrative claims measures.
- “Topped out” measures have scoring limitations due to high performance rates. Topped out measures require a perfect performance rate to achieve the maximum amount of points. Certain topped out measures are also capped at 7 points. Once a quality benchmark has been "topped out" for two years, it becomes subject to a cap of 7 points.
Consider reporting new Quality measures in 2023.
- New measures (like #487 Screening for Social Drivers of Health and #493 Adult Immunization Status) will receive a minimum of 7 points in their first performance year, even if they cannot be scored against a national benchmark. These measures will receive a minimum of 5 points in the second performance year.
- A full list of new Quality measures in 2023 can be found here.
Enhance care coordination.
- Care coordination is an essential aspect of MIPS. Clinicians can improve their scores by implementing efficient communication systems and workflows among healthcare providers. This may involve using electronic health records (EHRs) to exchange patient information, participating in health information exchange networks, or engaging in care coordination activities with other providers.
Optimize the use of technology.
- Utilize certified EHR systems to their full potential, including functionalities that assist in MIPS reporting and performance improvement. This may involve ensuring accurate and complete documentation, implementing clinical decision support tools, using e-prescribing capabilities, and promoting patient engagement through secure messaging or patient portals.
Implement quality improvement initiatives.
- Focus on improving the quality of care provided to patients. Clinicians can establish quality improvement projects within their practice to address specific areas that need enhancement. Regularly analyze performance data, identify areas for improvement, and implement evidence-based interventions to drive better patient outcomes.
Promote patient engagement.
- Engaging patients in their healthcare can positively impact MIPS scores. Encourage patients to actively participate in their care by providing educational resources, involving them in shared decision-making, and leveraging patient portals for secure messaging, appointment scheduling, and access to health information.
Remember that MIPS is a performance-based program, so consistent effort, ongoing evaluation, and continuous improvement are key to achieving higher scores. In the next four parts of this blog series, we will delve into the specific MIPS performance categories, exploring Quality, Improvement Activities, Promoting Interoperability, and Cost, to provide you with a comprehensive understanding of how each aspect contributes to enhancing your MIPS scores and overall performance. Stay tuned for valuable insights and strategies to excel in these areas!
2023 MIPS Reporting Improving your 2023 MIPS Score; Mastering MIPS