Not Too Late to Succeed Under MIPS Adopt next-generation technology to stay on top of your game BY JULIE C. SERVOSS, MD

Almost a full year has passed since the Cen- ters for Medicare & Med- icaid Services (CMS) deemed 2017 as the tran-

sitional year for independent physi- cians to comply with the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA has two available tracks: Alternative Payment Models (APMs) and a Merit-Based Incentive Payment System (MIPS). At this point, most physicians should at the very least, be aware of MIPS, but for those still unfamiliar: MIPS replaces the previous years’ Medi- care reimbursement system and exist- ing value-based care programs (phy- sician quality reporting system or PQRS, meaningful use and the value- based modifier) with a new pay-for- performance program. While we can expect to see ongoing shifts in the leg- islation, the new program is focused on quality, value and accountability and emphasizes quality of care over number of patients seen. Regardless of MIPS’s original intent to improve health care for both patients and phy- sicians, the new legislation can result in negative Medicare payment adjust- ments if not followed correctly.

Avoid Negative Payment Adjustments If physicians want to succeed under MIPS, crafting a MIPS strategy can- not be avoided. A strong compo- nent of a successful MIPS strategy is adopting next-generation tech- nology. This can make a major dif- ference and ease the reporting bur- den by automating tedious tasks. If you examine in depth the financial and scoring rules that MIPS uses,

you will find that every measure you meet can potentially translate into more dollars starting two years after the reporting year. To start, physicians should evaluate

their electronic health record (EHR) system. To perform well under MIPS, certified EHR technology is required to exchange information across pro- viders and with patients to support improved care delivery. The final rule incentivizes providers to use a certi- fied EHR system. It states that if a cli- nician utilizes end-to-end electronic reporting, he or she will get bonus points in the Quality category. Editor’s note: Certain exemptions

related to ASCs apply. For more informa- tion, visit macra-qpp.

Modern, innovative EHR systems

can organize clinical data in a struc- tured

format, empowering doctors

to extract meaningful insights at the patient and population levels. In addi- tion, instead of relying on any one physician’s descriptive assessment of a diagnosis or treatment, physicians that have access to an interoperable plat- form can reference relative findings from their peers, thereby eliminating redundancies, automating communi- cations and improving outcomes. Editor’s note: Currently, no ASC- specific EHR certification exists. In addition to investing in a mod-

ern, innovative EHR system, here are a few tips to better prepare physicians for MIPS success: ■■

you an idea of the changes your practice needs to make to avoid the penalty phase of the MACRA composite score.


Data accuracy is key—With MACRA, your performance is com- pared with similar groups across the country. Therefore, the data you enter needs to be accurate to ensure an adequate description of your practice is reported.


Meet your performance marker— It is important for physicians to review quality measure benchmarks and understand what is required for above-average performance. To do this, put practice strategies and clini- cal workflows in place to help meet the criteria.

Review your Quality and Re source Use Reports (QRUR)—This report indicates your practice’s perfor- mance on quality and cost. You can obtain your previous reports via CMS’ web site. This will give

Keep up with your ICD-10—The 10th revision of the International Statistical Classification of Dis- eases and Related Health Problems (ICD-10) is and will continue to be a crucial part in the transition as we move toward quality reporting. Accuracy on the highest level such as ICD-10 needs to be maintained and up-to-date. Overall, physicians must under- stand the impact of MIPS, stay ahead of the changes and adjust their practice accordingly. Just like with any new legislation, there is bound to be natu- ral friction with the transition to MIPS, but the right technology can ease the process and help you succeed. To learn more about the current timeline of MIPS and requirements, visit


Julie C. Servoss, MD, is the medical director of gastroenterology at Mod ernizing Medicine in Boynton Beach, Florida. Write her at

The advice and opinions expressed in this article are those of the author and do not represent official Ambulatory Surgery Center Association policy or opinion. 16 ASC FOCUS NOVEMBER/DECEMBER 2017|

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