With the “end” of PQRS, following Performance Year 2016, comes the transition to MIPS –
the Merit-Based Incentive Payment System. MIPS takes effect for Performance Year 2017. MIPS evaluates the quality-of-care provided to patients.
There are some notable differences between PQRS and MIPS, two of these being the range of patients eligible for reporting and the set reporting periods.
Eligible Patients
As this is a Medicare program, one would expect to report solely on Medicare patients. This was the case with PQRS; however, it is not so under the new system. MIPS requires reporting on all patients across all payers. Every patient you see in Performance Year 2017, and for the foreseeable future, is a part of your data set and must be reported.
It is advisable to work with your team as soon as possible to identify the measures you want to report. One way to choose your measures is to start by reviewing the available measures. Then, try to find measures that designate what you are already reporting and providing for your patients. Finally, always be attentive to your documentation. Your documentation must clearly indicate that the services and procedures you are reporting on were completed.
We can take a look at Measure 130: Documenting Current Medications in the Medical Record.
Description: Percentage of visits (typically E&M services) for patients aged 18 years and older for which the eligible professional attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications’ name, dosage, frequency and route of administration.
Performance:
Step 1: Obtain, update, or review a patient’s current medication list.
Step 2: Document the medical record to reflect this action with the required documentation components from the description.
After reviewing the details of the documentation requirements, you can add this measure to your MIPS reporting. This not only allows you to avoid an adjustment but opens the possibility to earn an incentive!
Reporting Period
Depending on the measure, PQRS required reporting on roughly 60% of eligible Medicare patients for the full performance year. In the Transition Year (2017), clinicians can choose to report on a 90 day period or up to the full year. If you start with a 90-day period that does not yield full participation for your chosen measures, you would then expand up to 365 days. Starting in Performance Year 2018, reporting on the full year will then be required.
Avoid possible negative adjustments, participate in MIPS!
For more information, you can visit https://qpp.cms.gov.