MIPS submission has become an important part of every physician’s administrative duties. We cannot stress how much the accurate and timely QPP MIPS reporting matters when it comes to finances.
The time for MIPS 2020 submission period is about to end, and many physicians are looking up to MIPS Qualified Registries to submit data to CMS (The Centers for Medicare and Medicaid Services).
As you know that we have to submit data for four categories:
- Improvement Activities (IA)
- Promoting Interoperability (PI)
Physicians have to submit data for three categories. For the Cost category, CMS assigns points based on the submitted data.
Today, we will be discussing the performance category of Improvement Activities (IA) to efficiently strategize and maximize points.
What Improvement Activities Account For?
This category emphasizes the importance of:
- Care coordination
- Patient safety
- Beneficiary engagement
Each year, CMS implements some of the changes in MIPS quality measures. For the year 2020, there are two new activities, seven modified activities, and 15 removed activities. (Source: AAPC)
This category weighs 15% of the total MIPS score.
How to Obtain Full Marks in IA Category?
In order to achieve maximum points in the IA category, eligible clinicians must submit measures worth at least fifty points.
It is also compulsory for physicians to be in a Patient-Centered Medical Home, Medical Home Model, or similar specialty practice and a MIPS APM to get any recognition in this category.
How to Estimate Score for Improvement Activities (IA)?
You can use the MIPS calculator devised by the CMS or use the following formula to determine the total score.
IA Score = Total points for completed activities / 50 x 15
- High-weighted activities are worth 20 points each
- Medium-weighted activities are worth 10 points each
Physicians or MIPS Qualified Registries on their behalf have to report data accordingly to score.
There are some cases when physicians earn double points for each measure, such as forty points for high-weighted activities and twenty points for medium-weighted activities.
Such cases are only applicable to physicians:
- Working in small medical practices
- Working in rural areas (With a zip code in the most recent HRSA Area Health Resource File data set)
- Working in practices located in a geographic Health Professional Shortage Area
- Working as Non-Patient Facing Providers or Groups
Patient-facing encounter code determines non-patient facing status.
Who is a Non-Patient Facing Physician?
He/she is a MIPS eligible clinician who bills 100 or fewer patient-facing encounters (telehealth included) or a group with 75% of the clinicians billing with the group’s TIN (Taxpayer Identification Number) and are eligible non-patient-facing individuals.
CMS has established a list of the patient-facing encounter codes that include:
- Evaluation and management (E/M) codes
- Surgical and procedural codes
To report data for this category, physicians must submit data for continuous ninety days.
An eligible group or virtual group when performing an improvement activity can only report it when at least 50% of the clinicians participating in the respective activity. Moreover, at least 50% of the eligible MIPS clinicians have to perform the activity at the same time.
The data for Improvement Activities (IA) is reported via attestation, which requires yes/no statements, and you have to justify your statements.
P3Care is serving as MIPS Qualified Registry for four years now, and we know how the healthcare industry works. We have helped several clients reach their potential, and by potential, we mean the financial advantage to target incentives and bonuses.