No matter whether your practice is small or large, creating a Quality Improvement Team can provide the ability to remain viable in today’s rapidly changing healthcare landscape. Practices now face penalties up to 9 percent for 2020 and 2021 (an increase of 5 percent from when MIPS started) for poorly demonstrated performance. These penalties will only increase as the years go on, reaching 11 percent by the end of 2023. However, for practices that are able to properly demonstrate high quality and value, bonus potential continues to rise as well. In addition to MIPS, many insurance companies offer incentive programs with significant bonuses based on demonstration of high quality and value in a practice.
With the introduction of episode-based measures in the Cost category, many specialty providers are going to be seeing their Cost score affecting their overall MIPS score for 2019. With this new information coming out with the Final MIPS 2019 scores, many providers are asking how they can manage their score and maximize their MIPS points for the Cost category in the future.
Starting today, August 3, 2020, CMS is resuming suspended medical reviews as well as initiating new audits. While this should merely be a return to business as usual for MIPS providers, it is important to note that this resumption of CMS audits will now continue regardless of the status of the current public health emergency. To help our readers get ready, we thought this would be a good time to offer a quick refresher on preparing for and surviving a MIPS audit. For reference, check out our new eBook Winning the Game: Surviving a MIPS Audit.