This year the Merit-based Incentive Payment System (MIPS) went through some really important changes that solo practitioners, as well as physicians working in bigger practices, must know of. One of the changes, for example, was that Mental Health practices and Physical Therapists became eligible to participate in this MIPS in 2019. MIPS is essentially a way for the CMS i.e., the Center for Medicare and Medicaid Services rewards physicians on the basis of certain outcomes and values. Healthcare providers are evaluated for their performance in four areas i.e., Cost, Quality, Improvement, and Interoperability.

Some recent changes particularly helped smaller clinics help perform well under the Quality Payment program. According to the CMS, they remain committed to identifying the options which encourage the practice staff in smaller clinics meaningfully take part in the MIPS.

Overall Accommodations & Flexibilities

  • Group Formation

Practices with 10 or lesser clinicians can team up with bigger practices. This allows grouped practices to participate in MIPS.

  • Bonus Points

If practices submit data for one measure, they qualify for six bonus points which will be added to the score in the Quality performance category. Previously, there were only 5 points which were added to the total score.

Quality Performance Category Accommodations

  • Submission Mode

Practices can choose to submit data in multiple forms. They can choose to submit through Medicare Part B claims, by logging on to Qpp.cms.gov or you can let an intermediary CEHRT submit it for you.

  • Points Measurement

You will be awarded three points if you submit for a measure in the Quality category that does not meet completeness requirements. These 3 points are for smaller practices while larger practices get 1 point only.

Interoperability Category Accommodations

  • Exception of Hardships

Small practices can apply for a hardship exception, which would make the performing interoperability category reweighted to 0 percent. If the application gets approved, the category will not affect the final score and the 25% it normally accounts for will be reallocated. The hardship exception application, in this case, will need to be approved before December 31st, 2019 for it to apply to the final score of the current year.

Improvement Category Accommodations

  • Weight of Activities

High-weighted activities receive twenty score points while medium-weighted activities receive ten score points in the improvement category. Smaller practices get two times these points in both cases.

  • Required Activities

Smaller practices can report only two activities in total for medium-weighted ones or only one for heavy-weighted ones. Larger practices can report two times the numbers for smaller practices.