For providers in the US, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) has authorized a program. The merit-based incentive payment system underlies this scheme. Every year, the Centers for Medicare and Medicaid Services, REVENUE CYCLE MANAGEMENT publishes a final rule that needs a few changes to be put into place. The MIPS 2023 reporting obligations are no different. MIPS is a program that looks at how well a provider takes care of patients and rewards or punishes them based on the results.
The four types of MIPS remain the same across all reporting years, though. Various adjustments may be made to each category metric. But the main reason why eligible professionals are asked to take part in the MIPS program is to improve patient care. So, MIPS reporting makes it so that eligible clinicians can only offer professional medical services covered by Medicare Part B. If they can maintain this throughout the performance year, MIPS offers them a reward based on the MIPS score points they receive.
Let’s focus on MIPS 2023 and examine the reporting alternatives available to MIPS-eligible doctors.
MIPS Eligibility and Conditions for 2023
As CMS has already stated in its prior statements, the selection of MVPs will begin in the performance year of 2023. Because of this, different changes have been made to MIPS programs as a result of the switch from MIPS to MVPs. Here are some specific details about participants’ MIPS eligibility.
The Traditional MIPS Program still has four reporting areas for doctors to choose from quality (30%), cost (30%), improvement efforts (15%), and promoting interoperability (25%). Each participant will send in data for three of the four categories, but not the cost category. If necessary, CMS will take care of this on its own.
The performance of doctors who are MIPS-eligible will be used by CMS to determine the MIPS final score. Each sort of involvement will receive a final score, which will range from 0 to 100 points.
Based on their MIPS point, the participant will then be able to get a reward or a punishment. Depending on how well you did during the MIPS payment adjustment year, you could get a negative, neutral, or positive payment.
The reimbursements for the eligible clinicians’ Part B-covered services for MIPS 2023 will be made in CY 2025.
The MIPS Participation’s Available Reporting Option This year, MIPS revealed its list of eligible clinicians before PY 2023 even began. Participants must now select the MIPS reporting option and measure. For this, MedICD provides MIPS consultation services. To increase their MIPS score, we can help them choose the optimal measures. In any case, there are three ways that participants can satisfy their reporting duties.
It serves as the standard foundation for all MIPS participants. Since MIPS was introduced and launched for the first time, they have been taking part in it. In any case, it’s important to remember that the MIPS program has changed a lot in the past few years. Every MIPS-eligible participant must first select their mode of participation, whether it be an individual, a group, or a virtual group. The data for each category is then made available via a chosen collection type. Every participant’s MIPS final score is determined by CMS based on their performance outcomes.
Different Payment Model (MIPS APM)
It is an additional MIPS reporting option. In MIPS 2023, a participant may also show up as a MIPS APM entity. The extensive reporting requirements were having a negative impact on the MIPS program. The MIPS program was enrolling a large number of participants. In order to complement the increased patient-care standards in healthcare, MIPS has also undergone a number of improvements. As a result, QPP has added a new route for all MIPS participants. Every participant is required to provide a predetermined set of quality measurements as a MIPS APM entity. They will also submit information in support of measure sets that promote interoperability, similar to the Traditional MIPS framework. However, yearly analysis of improvement activities category data is done.
Value Pathways for MIPS (MVPs)
This option for MIPS participants’ reporting is rather complex. Participants starting with the MIPS 2023 performance year can choose this option. In the following years, CMS has chosen to alternate using MVPs and Traditional MIPS. As a result, MVPs provide a measure collection based on a specialty or medical condition. It gives all activities and metrics for a connected approach to high-quality care a more streamlined grouping. Participants for MVPs will select, collect, and provide fewer quality measurements and improvement activities (as compared to traditional MIPS). They will also detail all of the actions taken to advance interoperability (the same as reported in traditional MIPS). The data for the cost performance category and population health indicators will be gathered and calculated for your benefit by CMS.
That’s all there is to say about MIPS 2023 reporting pathways. Each participant is free to select their preferred reporting method whenever it suits them. MedICD is a MIPS-qualified registry that offers consulting services for MIPS. These services will help you get the highest possible participation score for any reporting method you choose.