What is a Merit-Based Incentive Payment System (MIPS) and what are the measures?
The Merit-Based Incentive Payment System (MIPS) is a program through the Center for Medicare & Medicaid Services (CMS) that collects quality measures for medical practices enrolled in the Quality Payment Program (QPP). Key data and metrics are reported to CMS who then calculate a composite score based on the performance of each measure. Points are accrued based on performance and scores are compared between practices. This program is sometimes referred to as Traditional MIPS.
This final score determines future payment adjustments for Medicare reimbursement – positive, negative, or neutral. A good score can lead to higher reimbursement rates in the future, while a bad score can result in cuts to future reimbursements. The general trend is that high performance on MIPS measures is getting harder to achieve.
Starting in 2023, the newest reporting option is MIPS Value Pathways (MVPs), which are a set of measures related to a specialty or medical condition. These are likely the future of MIPS reporting software and are more complicated than traditional MIPS measures.
How are measures extracted now?
MIPS measures have previously been fairly easy to extract. Currently, most practices extract these measures manually from their practice data and submit them by themselves. This is time-consuming, error-prone, and expensive. Once the data is submitted, it cannot be taken back or edited, so the performance score can come back as a surprise, particularly as the threshold for a good score has become increasingly difficult.
As MIPS measures become more complicated and MVPs continue to grow, practices will need a way to extract and report their performance data to the government affordably and automatically. Reimbursement adjustments are a zero-sum game between practices, so those who fail to submit adequate measures could see up to a 9% cut in their future Medicare revenue. It’s time for a new solution that can save radiology practices time and money with a trusted solution to report their data to the government and Qualified Clinical Data Registries (QCDRs) for the highest possible score.
What is changing about the MIPS landscape?
Starting with performance year 2022, the score threshold to avoid cuts to Medicare reimbursements is much higher. Previously, it was easy to achieve a high MIPS score without much work. Now, the number of national radiology measures continues to be depleted and bonus points removed. It is becoming much more difficult to avoid a negative reimbursement adjustment.
The Radloop Solution:
Radloop Measure Extractor (ME)
Radloop’s Measures Extractor (ME) is the market-leading, cost-effective solution that utilizes AI to automatically extract and report important MIPS data to the government and QCDRs. Radloop is the only company that offers a complete, customizable solution for your practice. We work with you to significantly increase the chances of a positive reimbursement adjustment by streamlining the process and allowing users access to new measures for a higher total points floor. We work to protect your Medicare revenue and grow reimbursements for your practice.
The financial return from a negative to positive Medicare reimbursement adjustment using ME often well-exceeds the cost of the ME product.
Who does this benefit?
The MIPs extraction tool benefits radiologists and radiology groups as they navigate the changing government rules of reporting quality data. Going forward, it will be increasingly difficult to avoid a negative Medicare payment adjustment. The extraction tool automates the reporting of national and QCDR measures to greatly improve the chances of a positive payment adjustment. This helps radiologists increase the reliability of their revenue stream and works to improve the quality of care. At Radloop, our platform aims to improve the whole radiology care ecosystem for physicians, patients, and other stakeholders.
Why Work with Radloop?
Close the loop on Actionable Findings
Radloop is an industry-leading platform that represents the future of modern healthcare. We are on a mission to solve a major gap in healthcare today. We leverage the power of AI and natural language processing to improve patient care and lower the burden on our healthcare professionals. We have years of experience working with radiology practices, billing companies, insurance companies, and hospitals to implement robust interoperable communication . We integrate seamlessly with EMRs and have a dedicated, responsive team to help make Radloop the best solution for your situation. At Radloop, we are at the forefront of using healthcare data to improve patient outcomes.
A smarter way to coordinate care.
A smarter way to coordinate care.