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A MIPS 2017 Success Story

MIPS 2017 Submissions Are Over! What’s Next?

Congratulations to everyone who worked diligently to understand the Merit-Based Incentive Payment System (MIPS) program and implement a quality improvement strategy for a successful MIPS Submission!

It would be nice to take a long summer break. However, MIPS is a year-long process, and now is the time to start planning and optimizing your measure results for success in 2018.

SPH Analytics (SPH) would like to share the challenges, successes, and lessons learned from the 2017 reporting year.

MIPS Submission Success Story

Gastroenterology Associates of Pensacola, one of the busiest endoscopy centers in Florida, partnered with SPH to report on MIPS for 2017, to set the practice up for success in years to come.

The Challenge

One of the challenges the practice faced was that their current EHR and Practice Management System were not automatically generating the Quality Data Codes (QDCs) required for the MIPS Registry Measures. Data mining would be needed to access documentation of these quality actions.

The Gastroenterology Associates of Pensacola team worked with SPH to identify to 6 measures to target for the 2017 MIPS submission. The practice’s providers were already performing the necessary quality actions for these measures. The challenge would be accessing the correct data elements in the EHR and Practice Management System to demonstrate achievement of these measures.

SPH’s Three Facet Data Mining

The Solution

SPH Analytics used its proprietary Three Facet Data Mining, to identify additional data points in their EHR or other Practice Management Systems that qualify for their selected measures. This approach was iterative over multiple data pulls, identifying data elements for numerator credit and denominator exclusions to increase performance scores and accurately capture the true performance.

Partnering with SPH Analytics allowed Gastroenterology Associates of Pensacola to achieve a 100% score for the Quality Performance Category while maintaining the optimal workflow in their EHR, reducing the burden on their providers. This would not have been accomplished using their EHR alone.

Gastroenterology Associates of Pensacola is now fully prepared for a successful MIPS submission in 2018!

Lessons Learned

Are you prepared for a successful 2018 MIPS submission? Healthcare organizations should begin now to prepare in order to avoid negative penalties and be eligible for bonus payments.

Gastroenterology Associates of Pensacola took some important actions to follow the path to success. Here are some recommendations based on lessons learned:

  • Review your MIPS Preliminary Feedback report by logging into the Centers for Medicare & Medicaid Services (CMS) portal via Enterprise Identity Management (EIDM). CMS will be releasing the MIPS Final Feedback report by July 1, 2018.
  • Check your 2018 eligibility. CMS updated the 2018 eligibility calculations. The low volume threshold was expanded so verify your eligibility now:
  • Partner with a QCDR vendor soon to review your 2018 MIPS action plan. As a Qualified Clinical Data Registry (QCDR), SPH offers an end-to-end solution to not only fulfill reporting requirements under Medicare’s Quality Payment Program (QPP), but to monitor, manage, and improve performance throughout the data collection year to optimize measure performance and reimbursement. We use our Three Facet Data Mining throughout the reporting year to identify data points in your EHR systems that qualify for the measure and iteratively improve your scores over time.
  • View your MIPS Registry Measure results on the SPH Analytics Quality Measures dashboard. Quickly use drill-down capabilities to the patient list level to view and close care gaps.
  • Find a vendor who can help you seamlessly submit to CMS. SPH has a proprietary MIPS submission workflow tool that takes only a few minutes to sign off and submit via the CMS API.

Best Wishes for a Successful MIPS 2018 Submission