Tips for Increasing Your MIPS Score

increasing MIPS score

Beginning in 2017, MIPS (Merit-based Incentive Payment System) will make up an important part of a provider’s payment from CMS.

A higher MIPS score can lead to more revenue for a practice – and a lower MIPS score can lead to penalties that will decrease revenue from CMS. Each year, CMS will set a threshold for performance. If your practice beats that threshold, your Medicare Part B payments won’t be impacted. However, should your practice drop below that threshold, penalties could be applied.

2017 is a lot closer than we all would like to think, so it’s imperative to start learning how to increase a MIPS score now.

There are four essential components to the MIPS score that we’ll go through.

The Meaningful Use (MU) Component

MU can refer to a lot of different things, but for the purposes of MIPS in 2017, it primarily means making use of electronic health records (EHR). This is key, since MU will comprise 25 percent of your overall MIPS score.

Ideally, your practice started the Medicare or Medicaid programs in 2014, which was the last year to join the Medicare program and take advantage of its incentives. If not, it’s likely that your practice has been vulnerable to penalties each year. Starting to fully embrace certified EHRs now can greatly improve your MU portion of your MIPS score.

There are four benefits practices receive from EHR implementation anyway, so it’s a good best practice to follow regardless of MIPS.

The PQRS and VBM Component

The Physician Quality Reporting System (PQRS), along with the Value-Based Modifier (VBM), are both integral to your practice’s score and will account for half – 50 percent – of your score. Thus, increasing compliance with these two areas will have the single largest impact on increasing a MIPS score.

If you haven’t already, start monitoring PQRS measures and report them on a regular basis. Additionally, either register through the Group Practice Reporting Option (GPRO) – which is available if you have two or more professionals who are eligible and are billing under Medicare and have the same TIN – or report at least half of your groups eligible professionals on an ongoing basis.

It’s crucial to choose and follow at least one of the measures for VBM. Additionally, make sure you’re fully participating with PQRS. Many practices aren’t, and that will punish them in 2017.

The VBM Cost Measures Component

The third component also involves VBM – specifically, the cost measures. This will account for 10 percent of your MIPS score. CMS calculates these cost measures on your behalf based on your Part B claims that you submit. On one hand, there is less work for you to do; on the other hand, improving this component is more difficult than with others.

The Clinical Practice Improvement Component

Finally, Clinical Practice Improvement (CPI) will comprise the remaining 15 percent of your MIPS score starting in 2017. CPI involves using a rigorous analytical framework to assess every process in the delivery of health care, and measuring the inputs and outputs in the form of patient outcomes. This is probably the most unfamiliar concept for practices because, unlike the other three components, this is a new concept from CMS that doesn’t incorporate or replace any pre-existing program.

CPI activities are broken up into six subcategories, and each activity is weighted according to its importance, from medium to high. An example of a high-weighted activity is beneficiary engagement, which includes collecting data on patient experience and satisfaction.

Reaching a perfect score of 100 percent requires a provider to reach 60 points broken out by high and medium (worth 20 points and 10 points, respectively). Becoming approved as a Patient Centered Medical Home (PCMH) results in an automatic 100 percent rating, as is being certified as a “comparable specialty practice.”

Increasing Your MIPS Score

Improving your MIPS score needs to be a major priority between now and 2017. One recommendation is to focus on the largest areas, which would be MU and PQRS/VBM components. Adopting EHR is very important and is one single step that can result in an immediate improvement (although it does take time).

Consult with a third-party consultant to learn more about how you can improve MIPS.