As most Eligible Clinicians (EC) definitely know, MIPS will start to produce results for Medicare doctor reimbursement in 2019, however, those payment changes will be measured by performance reported for 2017, which is being named a ‘transitional year’ for the program. The reporting time frame for 2017 has been brought down to at least 90 days as opposed to an entire year for all the MIPS categories. It is expected that MIPS will be fully effective from 2018.
So, gazing this scenario, it will be up to the physicians and the medical billers are coders to be up on their toes and embrace these changes with pin-point precision.
Outline of the Improvement Activities (IA) Category
As per the Centers for Medicare and Medicaid Services (CMS) Final Rule representing the MIPS, Improvement Activities are ‘those that support broad aims within healthcare delivery, including care coordination, beneficiary engagement, population management, and health equity.’ These activities have been recognized as improving clinical practice or care conveyance, and are going to bring about enhanced healthcare results. There are 92 such activities accessible from which EC’s may decide for 2017, each with a weight of either “High” or “Medium”.
High-weighted activities are worth 20 points each, and medium-weighted activities are 10 points each. To procure full credit for the IA classification, an aggregate of no less than 40 points from any mix of activities is required – for instance, 4 medium-weighted, 2 high-weighted, or 2 medium-and 1 high-weighted.
For specific practices and EC’s, the estimation of every activity is multiplied so that high-weighted activities are worth 40 points and medium-weighted activities are worth 20 points. Therefore, just 1 high-weighted or 2 medium-weighted activity would be essential.
These practices and EC’s include:
- Smaller practices of less than 15 EC’s
- EC’s situated in a rural or health professional area
- EC’s who are non-patient facing
Reporting and Documenting the Improvement Activities
The choice to report as individual ECs or as a group will require some adjusting of advantages and disadvantages, and it will require a comprehensive look at all the MIPS categories since reporting must be done reliably utilizing one technique or alternate across all the classifications. For the IA category for reporting as a group just a single EC in the gathering needs to perform each selected activity and the whole gathering gets credit! This gives an overwhelming favorable position to group reporting over individual EC reporting in the IA category, particularly for large groups.
The reporting and documenting of Improvement Activities will be finished following the year end by authenticating that the activities were completed using a CMS-provided verification framework. This technique is fundamentally the same as the past CMS projects, for example, Meaningful Use, and it requires that documentation be kept to demonstrate that activities were performed in case of an audit by CMS.
Contrasting Quality Performance and Advancing Care Information, which supplant more seasoned CMS programs, the Improvement Activities classification is absolutely new and it will require some investment to be completely understood, both by Physicians and medical billing and coding personnel.
Below are some key ideas for Radiology practices to remember about the IA categories:
- Radiology facilities with less than 15 ECs and the individuals who are considered non-patients facing only need to report 1 high-weighted or 2 medium-weighted IAs to get the full credit of 40 points.
- Just around twelve or so improvement activities are presently applicable to radiology, and few are high-weighted.
- Most appropriate IAs will be found in the Beneficiary Engagement, Care Coordination and Patient Safety and Practice Assessment classifications.
Group reporting provides favorable position since a single individual participation offers credit to the whole group.