As you’re gearing up for 2017, selecting the best Quality measures to report under MIPS is essential for you to be able to achieve the highest possible Final Score. This is the only way to improve your chances to receive a positive Medicare payment adjustment rather than a reduction to your future revenues.
Use these steps to help you choose the best possible Quality measures:
- Measure definition — A good first step is to review the measures and look for those that involve reporting CPT® codes, diagnoses, and/or demographic criteria that match the patients you see. The specialty and subspecialty measure sets may be particularly helpful here to narrow your choices. And you might also review how you performed on the same or similar measures under the Physician Quality Reporting System (PQRS) because many of the measures come directly from that program.
- Rely on your data — Use your billing data to identify your most frequently reported procedure and diagnosis codes. And then you should look for measures that include these codes. Keep in mind that although PQRS focused on whether you reported on the measure enough times, MIPS is more similar to the Value-Based Modifier (VBM) quality component, which is more concerned with your performance rate on your reported measures.
- Patient eligibility — You should look for measures that apply to your patient population. That means avoiding those measures where you have fewer than 20 eligible cases because these will receive an automatic minimum score, regardless of how good your performance is.
- Make sure clinicians are on board — Once you narrow down the measures that you feel are important, be sure to include your clinicians before you finalize that list. It’s important that your providers believe the measures are appropriate and applicable to demonstrating quality. They have to be on board for this to work, and if they aren’t behind the measure, then they won’t participate. And if you’re reporting as a group practice, this hurts everyone.
- Capture your data — Choose measures that you can do well with, meaning that you regularly complete the activity — such as reporting specific codes, documenting particular patient data, etc. — that the measure requires. And part of this is making sure you have or can develop a mechanism (such as your electronic health record or other documenting method) for capturing the data needed to report the measure. Of course, this will depend on the reporting options available for the measure, your EHR’s functionality, and your internal workflows and processes.
- Review the Quality measures to look for those that reflect your current services and patients.
- Make sure you have enough patients that are eligible for a measure because you need more than the minimum to make it worth your while.
- Get your providers on board with the measures you choose because they are the ones who will be documenting the data.
To ensure you stay compliant with MIPS reporting requirements, check out the Coding Leader online MACRA training page at http://codingleader.com/collections/macra. Each session listed gives you access to national experts that walk you through MACRA compliance in plain-English so it’s easier for you to understand and put into practice.