Emergency Room Clinicians & MIPS                  2017-2018

December 12, 2017

Emergency medicine clinician groups often ask these questions as they scramble to put together a plan for the 2017 Merit-based Incentive Payment System (MIPS) reporting year and prepare for 2018.

Our practice sees patients in a hospital setting, not an office setting. What does that mean for our reporting requirements? What quality measures should we choose to report for 2017? How do we report for Advancing Care Information (Meaningful Use) when the hospital system owns the system we document on?

No worries! We are going to cover the following questions here to ensure your emergency medicine practice has the right formula for success.

Let’s start with some MIPS background basics, know that in 2017 you may be subject to report on three categories of MIPS: Quality, Advancing Care Information (ACI), and Improvement Activities. In 2018, a fourth category will be added: cost. Each category makes up a percentage of your overall total composite score, the final score that will affect your Medicare Part B reimbursements in future years.

The Advancing Care Information category is primarily used to demonstrate your meaningful use of a Certified EHR Technology (CEHRT), making up 25% of your total composite score.  Per CMS in 2017, “Hospital-based clinicians will have their Advancing Care Information performance category score reweighted to 0% of their final score.

A hospital-based eligible clinician is defined as furnishing 75% or more of their covered professional services in either the inpatient hospital (Place of Service 21), outpatient hospital (Place of Service 22), or emergency department (Place of Service 23) setting.

In the case of reweighting to 0%, CMS will assign the 25% from the Advancing Care Information performance category to the Quality performance category so that 85% of the total MIPS final score will be based on Quality.” These factors will be adjusted for the 2018 MIPS reporting period.

Which quality measures should my emergency medicine practice choose? 

There are 243 quality measures available to providers to select and report to CMS for MIPS. How will you decide the best measure set for your organization? 

Below are the most commonly selected quality measures amongst the emergency medicine providers using Whittle Advisors’ MACRA Advisory Solution: 

Good news, unlike for PQRS, under MIPS you do not need to let CMS know ahead of submission whether you are reporting as an individual or a group (unless you are reporting via the CMS Web Interface or participating in CAHPS for MIPS). In the Whittle Advisors platform, you can track both individual and group performance all year long, and decide at submission time which route you want to go.

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