Does Your MIPS Team Have the Tools It Needs to Keep Your Practice on Track?

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Are you on track with this year’s Merit-Based Incentive Payment System (MIPS)? If you haven’t yet started, you need to get busy.

Empower Your MIPS Team

Who are your MIPS champions? Your practice should have a MIPS point person and at least one backup. A MIPS physician champion should be respon­sible for ensuring that MIPS staff have the resources and, importantly, the time that they need.

Can your MIPS team access these key MIPS resources? You need to be a member of the Academy and/or the American Academy of Ophthalmic Executives (AAOE) to access these oph­thalmology-specific MIPS materials:

• aao.org/medicare—the Academy’s MIPS hub page provides access to “road maps,” detailed measure specifications, and much more.
• aao.org/eyenet/mips-manual-2021 —the six sections of the annual MIPS manual were posted online in January and February, and a print version will arrive with the May EyeNet.
• aao.org/iris-registry—the IRIS Reg­istry user guide walks you through the key MIPS steps.
• aao.org/practice-management/listserv/e-talk—AAOE members use the e-Talk listserv to share MIPS tips.

For the latest MIPS news, watch for Washington Report Express (emailed every Thursday); Medicare Physician Payment Update (first Saturday of the month); and Practice Management Express (every Sunday; AAOE members only).

Not an Academy or AAOE member? Visit aao.org/join and aao.org/membership/join-aaoe.

Make sure your clinician information is up to date. Do the following:

• Visit https://qpp.cms.gov/participation-lookup to check on the MIPS status of each clinician in your practice.
• If clinicians have left or joined your practice, make sure the information at https://pecos.cms.hhs.gov reflects that. Also, if your practice is reporting via the IRIS Registry, use a help desk ticket to report any clinician turnover by Sept. 1 (aao.org/iris-registry/user-guide/submit-help-desk-ticket).

Are Your MIPS Plans on Track?

Harder to avoid the penalty. To avoid a payment penalty, you need a MIPS final score of at least 60 points in 2021 (up from 45 points last year). To avoid the maxi­mum –9% MIPS payment penalty, you will need a score of at least 15.01 points (up from 11.26 points last year), and the closer you get to 60 points, the low­er your penalty will be. Because CMS has raised the bar, you can’t assume that you will avoid the penalty with the same measures and the same level of performance as last year. This is espe­cially true for small practices that don’t use EHR to report quality (see “Are You a Small Practice With No EHR?” in the EyeNet MIPS manual).

Make sure you understand the specs. For detailed specifications on quality measures, promoting interoper­ability measures, and improvement activities, visit aao.org/medicare. Also visit aao.org/medicare/quality-reporting-measures and download the 2021 Clinical Quality Measure Specification and Benchmark Table to review the scoring information for quality measures; you’ll note that many have significant scoring limitations when reported by claims.

Reporting quality via IRIS Registry–EHR integration? Check your measures at least quarterly to look for potential problems in data mapping or workflow. You need to finalize measure selection by June 1 and complete measure refine­ment by Oct. 31. If you make changes to your EHR system, notify the IRIS Registry vendor by June 15.

Reporting quality manually via the IRIS Registry? Have you entered your quality measure data from January, February, and March into the IRIS Registry? If not, it’s advisable to start catching up. Although your data entry into the IRIS Registry doesn’t have to be done in real time, you should not leave it until the end of the year.

Reporting quality via Medicare Part B claims? If you plan to meet the 70% data completeness criteria for a mea­sure, remember that you need to report throughout the year in real time.

Can you boost your PI score? Promoting interoperability (PI) is MIPS' EHR-based performance category. For tips on improving your performance rate for the Provide Patients Electronic Access to Their Health Information measure, visit aao.org/practice-management/article/mips-tips-provide-patients-electronic-access.

Know the deadlines. Mark the key dates for performance year 2021 down in your calendar.