Reimbursements

The ongoing reporting demand for the federal Merit-based Incentive Payment System (MIPS) program may be challenging for your practice. But if you see more than 200 Medicare Part B patients, you are eligible for bonuses that you want to take advantage of.

MIPS is facilitating changes in practice patterns across podiatry, wound care and office-based labs. Physicians can potentially earn higher reimbursements and benefit from more focused processes.

To be eligible for MIPS means providing the proper documentation to qualify. CarePICS is the solution you need to gather and report all MIPS requirements.

What Exactly is MIPS?

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established MIPS in 2017. This points-based program was voluntary at first but became mandatory for Medicare-participating physicians in 2019.

Eligible clinicians can choose every year to continue to be paid on a fee-for-service basis and report cost and quality data. You can submit clinical quality measures (CQMs) to MIPS through claims, registries, Qualified Clinical Data Registries (QCDRs), health information technology developers and certified survey vendors.

Clinicians are evaluated by MIPS after each performance year based on a 100-point performance scale divided into four categories:

• Quality (40% of score)
• Promoting interoperability (25% of score)
• Improvement activities (15% of score)
• Cost (20% of score)

Providers may be reimbursed more (for meeting quality outcomes) or less (if they fall below an averaged national metric).

“If you don’t meet MIPS standards, then reimbursement payments can be dinged by as much as 5%,” says Dr. Chris Bromley, President of CarePICS. “There’s no specialty society or quality measures to create the kind of system that documents and transmits the necessary materials to Qualified Clinical Data Registries to get reimbursed.”

How Can CarePICS Help with MIPS?

Fortunately, CarePICS created an authoritative HIPAA-compliant virtual care platform that guarantees better patient outcomes while increasing reimbursement. Clinical staff can use CarePICS for wound measurement and documentation to create structured, consistent electronic health records. These EHRs are all collected into a centralized hub and passed along to QCDRs.

There are several CQMs that podiatrists and wound care clinicians should be aware of in relation to patients, especially those with diabetes:

• MIPS Measure #126: Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy
• MIPS Measure #127: Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention – Evaluation of Footwear
• MIPS Measure #128: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
• MIPS Measure #226: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
• MIPS Measure #318: Falls: Screening for Future Fall Risk

Physicians can reconfigure processes to focus more on reporting these CQMs to MIPS. Nurses can make it a priority to ask a patient their MIPS info as soon as they are in the exam room.

“An office can speed up documentation for a new patient by 55% when using CarePICS,” says Dr. Bromley. “And the documentation process can speed up by as much as 85% with subsequent visits.”

CarePICS is an efficient tool for submitting quality data to MIPS. Maximize MIPS reimbursements with the easy-to-use mobile and web app.

For more information

How can you know you’re sending the best possible data to meet the four MIPS categories? Visit the CarePICS website to learn more about the virtual hub technology’s powerful consolidating and coordination functionalities.

About CarePICS

CarePICS^® is a HIPAA-compliant telehealth platform designed to manage vascular disease and wound care patients. CarePICS enables virtual consults, telehealth visits, clinical image reporting, and automated medical supply ordering.