The worst time for an MIPS-eligible clinician is when it comes to deciding the most appropriate quality measures and choosing what method of submission to use for collecting and submitting their data.

To submit data for the quality, you need to understand that quality is more important than the other categories of the MIPS assessment. If you choose to apply for ACI exclusion, then its weight is moved onto the quality category, pushing its significance higher up than the other remaining categories.

Secondly, it is imperative to understand that despite there being liberty to choose a different submission method for each category, each category MUST have its submission method. Selecting and implementing a reporting method can be tasking since it requires a lot of foresight, preparation, and actual resource implementation to make sure the present situations are knit seamlessly with the future aspirations.

 There are several submission methods for submitting these data, namely:

  • Claims,
  • Electronic health record (EHRs)
  • Qualified clinical data registries (QCDRs)
  • CMS web interface
  • CAHPS for MIPS

MIPS reporting is the remission of performance data by eligible clinicians for assessment. The reportable performance categories for the MIPS reporting are quality, improvement activities and the advancing care information.  The cost data need not be submitted separately because the Centers for Medicare and Medicaid Services (CMS) can deduce it from the data from administrative claims data.

To choose a method of submission, it is important to understand that only one submission is acceptable per category. This means that a lot of consideration has to be put into all the MIPS reporting scenarios. An introspective analysis of the merits and demerits of each situation and how it applies to the context of your practice is needed. The choice of reporting method will determine your justification for the need for pay adjustment from Medicare.

Individual versus group submissions

When reporting as an individual, the following data is required:

  • Qualified clinical data registry (QCDR)
  • Qualified registry
  • EHR
  • Claims

When reporting as a group, you need the CMS web interface and CAHPS for MIPS survey in addition to the above named. When choosing a data submission method, the following factors should be put into consideration.

  • The costs associated with that method
  • The ease of use and the ease of submitting data to the submission vendor
  • The impact of the submission method on your practice
  • Measure availability
  • Benchmarks

The bottom line is to select a method that will help you gain an excellent score. These marginal gains can be furthered by checking all your strong points and choosing a method that augments them and gains the most incentives for your practice. If you intend to get the highest score attainable, you will have to go through all the benchmarks to ascertain which gets the most points for your practice.

While it may look enticing to submit to the MIPS registry through the EHR vendor reporting tools because of the simplicity, it may not be the best method available out there. Despite offering higher benchmarks, reducing the data extraction workload and other added advantages, you may be limited since it relies on the HER vendor for vendor selection and the method may not be at all flexible for your practice and may require a lot of modification to suit the vendor requirement.

It is crucial that you go through all available methods and choose one that works for your practice and helps you attain your goals. It takes a lot of reviews, discussion and compromise to get what you want.

Published by Lucy Jones