MIPS Raising the Stakes for Independent Practices

In an interview with Medical Economics, health policy expert, Robert A. Berenson, MD, said the administrative burdens of the new merit-based incentive payment program (MIPS) could drive many small, independent practices out of business.

MIPS, which was introduced when Congress signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), combines previous quality reporting programs PQRS, Meaningful Use and the value-based modifier programs into one super-sized performance-based program. Although CMS has yet to release the program criteria, MIPS is set to begin with the 2017 performance year and physicians will see payment adjustments starting in 2019.

The new program raises the stakes for practices – with much higher penalties in play. Previous programs dinged practices up to 2% of revenue for non-compliance. MIPS will raise that penalty to a potential revenue loss of 9%.

Berenson told the publication, “Only about 50% of physicians in private practice today are submitting data for PQRS because of the administrative burden.” But because the penalty was only 2% practices felt ok about opting out. 2% wasn’t worth the hassle of the paperwork and tracking. “No one can afford to lose 9%, which means MIPS has the potential to hasten the demise of small practices.

What does this mean for your small practice?

Should you pull up stakes and sell to the nearest healthcare system? Not so fast. While it is true the penalties are going to be steeper and the administration for the program can be a hassle, independent practices can still thrive in this new environment.

How do you survive? It starts by working with a trusted partner. Your best option is to engage with a partner that has already made investments in the tools, systems, and training required to get practices through the existing quality programs.

Ask yourself, how well has my EHR vendor supported and assisted me with meeting PQRS and meaningful use requirements? Do they provide ongoing training and assistance as program requirements change? Do they have a high rate of attestation across their client base? If the answer is yes, chances are your vendor is already looking into ways they can improve their technology, workflows and training to help you through this next stage of performance measures.

If the answer is no, it may be time to find a new EHR partner. One that has made investments to ensure that their systems are ready, tested, confirmed, and that their clients have the right tools and training to successfully attest today and well into the future.

eMDs is a trusted partner for our clients when it comes to quality program attestation. We have helped thousands of physicians collect over $100,000,000 of incentive dollars. More importantly, we have been actively involved in helping customers transform their practices so that they are positioned to take advantage of the rapidly changing movement from fee-for-service to value-based reimbursement.

To learn more about MIPS, MACRA and other regulations impacting your practice, join us March 9 at 12 PM CST for a complimentary webinar.