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Physicians’ Clinic of Iowa Turns to Azara Healthcare to Optimize MIPS Performance

PCI uses IgniteMIPS to drive efficiencies, improve scores, avoid penalties, and increase revenue.

The Customer

PCI_logoBased in Cedar Rapids, Physicians’ Clinic of Iowa (PCI) is one of Iowa’s largest, private specialty medical groups. Made up of more than 90 physicians, surgeons, and mid-level providers, PCI meets nationally recognized standards for education, knowledge and experience to provide patients in Eastern Iowa a superior healthcare experience in a wide range of specialties and subspecialties. 

Independent and locally owned, PCI has provided families a choice in where they receive their specialty care since its establishment in 1997. PCI specialists see patients at the PCI Medical Pavilion, as well as offering inpatient and surgical care at Cedar Rapids hospitals, Surgery Center Cedar Rapids and surrounding community medical centers. Accredited on-site imaging and laboratory, state-of-the-art technology, infusion center, and more, help deliver tailored solutions and successful outcomes. 

The Challenge

Healthcare organizations face unique challenges when navigating the CMS Quality Payment Program (QPP), a value-based Medicare payment model designed to reward physicians for demonstrating high quality, cost-efficient care. Under the QPP, the Merit-Based Incentive Payment System (MIPS) ties payments to meeting quality metrics and achieving a high level of performance. MIPS is the only national benchmark for medical specialties. All currently available options to comply with MIPS require the submission of clinical quality measures. 

With multiple specialties and often multiple sources for tracking billing and clinical data, PCI found aggregating all available performance data in a coherent, efficient, and centralized manner manually and technically daunting. Further, while a critical piece of compensation for many physicians, MIPS is a complicated, perplexing, and continually changing program. 

“With MIPS, CMS was continually raising its game to encourage meaningful participation and improve outcomes,” said Kim Rieff, EMR Development Manager for PCI. “That became overwhelming since I was the only one managing the program, and it required a substantial amount of time to monitor the changes and the data, and implement quality improvements.” 

Due to the financial risk of program participation, understanding how PCI could best optimize its MIPS performance scores felt out of reach, said Rieff. “To try and wrap my arms around the number of options and selecting and reporting on the right MIPS measures was daunting. Some measures felt downright unattainable.” 

Another challenge for PCI, said Rieff, was trying to align MIPS with existing workflows. “I was bogged down manually entering data, printing and saving Excel files, and sharing spreadsheets individually with each doctor. There was no easy way to integrate and view the data collectively as an organization,” she said. 

To successfully navigate MIPS attestation and meet performance threshold scores, PCI needed a solution to streamline their quality reporting process and better harness their data to measure and improve care quality, as well as reduce administrative burnout. 

“It became apparent that we needed a partner to remove the clerical and regulatory burdens of MIPS, and provide full transparency into our performance data,” said Rieff. 

The Solution

PCI sought a vendor that could provide advisory services and optimize their MIPS performance data to drive efficiencies, improve scores, avoid penalties, and increase revenue. 

To meet its clinical, administrative, regulatory and financial goals, PCI selected Azara Healthcare’s IgniteMIPS platform. IgniteMIPS is an automated, cloud-based solution that helps organization’s manage every stage of the MIPS process, including eligibility, predictive analytics, monitoring, and submission. The solution helps track performance from an organizational perspective down to the individual clinician and measure. 

Specifically, Azara’s IgniteMIPS solution: 

  • Takes the guesswork out of MIPS performance scores and provides full transparency into an organization’s performance data 
  • Monitors performance trends relative to organizational goals 
  • Reveals workflow and training issues 
  • Detects gaps in data completeness that may otherwise go unnoticed in the EHR 
  • Engages, aligns, and motivates clinicians based on specific goals and objectives for MIPS and value-based care 
  • Sets goals for quality measures 
  • Creates measure sets to manage performance for groups of specialists or departments 
  • Delivers intuitive and relevant MIPS scorecards

“PCI was really looking for a vendor that could not only help provide regulatory guidance in terms of MIPS, but a solution that could help them identify exactly where they needed to focus their efforts in order to avoid penalties and earn positive payment adjustments,”

ERICA ARIAS, Director of Client Success | Azara Healthcare

The Results

PCI implemented the IgniteMIPS solution in June 2019. One-on-one training, consulting and mentorship were provided to help PCI develop a personalized MIPS strategy to maximize performance and earning capabilities for both practice- and program-specific measurers. 

“When we first engaged with Azara*, their consultant worked with me over the phone for hours to walk me through the program requirements and evaluate which set of measures could be managed more efficiently with IgniteMIPS’ specialized scorecards and reporting tools,” said Rieff. “With the solution seamlessly integrated with our EHR, we easily began to see where PCI could make some quick wins with our submissions.” 

Azara’s IgniteMIPS solution immediately helped PCI to: 

  • Assess which reporting methods would be best suited for PCI 
  • Determine what their quality scores would look like under different scenarios 
  • Predict and monitor PCI’s performance as compared to other national benchmarks 
  • Decide which set of measures would enhance PCI’s quality scores and meet their clinical and business objectives 
  • Estimate the program’s overall financial impact on PCI 
  • Remain up-to-date with the complex and ever-changing MIPS and Quality Payment Program (QPP) rules as they are released 
  • Incorporate the rules’ changes into the solution and assist PCI in understanding the impact to their organization 

“Prior to adopting Azara’s IgniteMIPS solution, there was considerable frustration with the lack of clarity around the program requirements and the amount of effort needed to participate successfully,” said Rieff. “Now we have the ability to easily identify opportunities for score and reimbursement improvements, and even have the capability to test various scenarios before we finalize and submit our measures.” 

With the IgniteMIPS solution in place, PCI was able to raise its score from 67 to 87 points in the first year of reporting and outperform the MIPS national average, often meeting CMS’ Exceptional Performer status. 

Now PCI is able to comply “without a second thought” and is relieved of the regulatory and administrative burdens imposed by the program, said Rieff. 

“I can collaborate with Azara’s regulatory experts year-round to interpret the MIPS rules and examine how those annual changes impact our performance,” Rieff continued. “And because the solution is continually updated to reflect the most current reporting rule policies, it ensures that we are not submitting data on outdated measure specifications.” 

Clear performance data also gives PCI credibility and confidence to collaborate with their physicians on how to improve quality measures for reporting. “All of our providers have on-demand access to their quality metrics to analyze their performance efficiently and accurately,” said Rieff. “That transparency on the provider level has been motivational for our clinicians to boost our quality performance scores and prioritize the program.” 

Rieff adds that PCI now has an effective, proven solution to navigate their MIPS roadmap and visualize their reporting data in a way that is meaningful, easy to interpret, and actionable. 

“Thanks to the IgniteMIPS solution, we are able to bring multiple sources of data into one place, drill down on specific providers and individual physicians, and remove the administrative overhead to drive real organizational change,” she said. “The advantage of using a technology-based compliance solution, versus a manual one, to earn points has really proved beneficial to our MIPS score and performance benchmarks.” 

To learn how Azara Healthcare can help empower your organization to improve the quality and efficiency of care for your patients, contact us at:

*SPH Analytics Population Health Division merged with Azara Healthcare in December 2020.