The merit-based incentive payment system (MIPS)
The Merit-Based Incentive Payment System was established with the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Prior to this legislation, physicians who treated Medicare patients were subject to the sustainable growth rate (SGR), which mandated a 20% payment reduction.
MIPS is budget-neutral, which means that any positive payment adjustments are determined by the amount provided for negative payment adjustments. These payment adjustments are based on performance in MIPS two years prior. For example, participation in MIPS in 2019 will determine the Eligible Clinician’s (EC) or group’s payment adjustment in 2021.
MIPS first year began on January 1, 2017. MIPS has since changed some of its reporting requirements, objectives, and measures. These changes are intended to align with key initiatives determined by the Centers of Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC).
In addition to creating and enforcing MIPS, the Centers for Medicare & Medicaid Services (CMS) have increased pressure on practices to adopt certified electronic health record technology (CEHRT). Electronic Health Record platforms provide the most secure methods of recording, tracking, and managing patient data.
Some EHRs have longer implementation times and more cumbersome workflows than others, reducing their overall efficiency. With that said, many practitioners recognize that this technology has the potential to improve their jobs by providing better access to patient information, as well as streamlining communication between patients and practitioners.
EHR platforms are also the most effective means by which practitioners can participate in MIPS. In fact, it’s now nearly impossible to pass MIPS and avoid penalties under its Advancing Care Information (ACI) component without the use of a truly intuitive EHR platform. That’s why Netsmart has focused on developing a MIPS solution for GEHRIMED that’s specifically designed to help practitioners in the long-term/post-acute care space avoid penalties and earn better bonuses.
Before GEHRIMED, Health Care Providers, LLC had never used an EHR platform before. “We were the typical practice that utilized handwritten charts and submitted billing requests as such,” said Dr. James Demidovich. But as regulations from CMS intensified and the practice grew, HCP realized that it needed a system to help relieve the manual workload of submitting information. The company turned to GEHRIMED for assistance.
“It helped to completely streamline our process,” said Dr. Demidovich. “It has made our workflows easy and efficient, and it really simplified everything on our end. GEHRIMED is extremely easy to use, and the way MIPS is integrated into the platform makes it almost impossible to be penalized.”GEHRIMED built-in functionalities
CMS did not design MIPS with long-term/post-acute medicine in mind. However, GEHRIMED continues to implement new methodologies in its platform that make it as painless as possible for these practitioners to participate.
The GEHRIMED EHR integrates MIPS reporting elements into the practitioner’s daily workflows so once-recorded data can serve multiple purposes. Before closing out patient encounters, practitioners are automatically prompted to answer a few simple questions that directly funnel MIPS information to necessary reporting fields.
GEHRIMED also provides practitioners with a MIPS-specific dashboard so they can evaluate their progress at any point in the year. There’s even a MIPS calculator that allows practitioners to estimate what scores they would receive based on their current practices, creating time and opportunity for MIPS focused adjustments. The remainder of this case study shares testimonials from four different practitioners who manage patient data with the GEHRIMED EHR platform and use its MIPS functionalities specifically to participate and achieve success in the CMS initiative.Reporting Made Easy
Dr. Demidovich also noted that GEHRIMED has helped Health Care Providers, LLC improve its reporting processes, which were previously entirely manual. “The MIPS dashboard and reporting system coupled with the streamlined encounter documentation makes everything easier on our end,” he said. “It’s a much better system, more efficient, and honestly makes everybody’s lives easier. There’s a lot of potential for things to get lost in the shuffle when dealing with patient care, and GEHRIMED prevents that.”
Meanwhile, Carespring NP, LLC used another EHR system before switching to GEHRIMED. Dr. Art Gendelman said they found their former platform to be so cumbersome and time-intensive that his team couldn’t effectively record months’ worth of data at a time. Luckily, GEHRIMED now gives them all of that wasted time back.
“GEHRIMED is so much simpler, and I barely spend any time recording for MIPS,” he said. “It’s extremely intuitive and tells you which ones to complete. Last year we got 100% of what we should have gotten without going back and having to update anything.”
When Health Care Providers, LLC administrator Kristin Demidovich and her team discuss taking on new skilled nursing and long-term care facilities, they intentionally mention that they use GEHRIMED. This distinction helps them standout in a positive way. “The facilities know that patient care is our first priority,” she said. “It has completely streamlined our operations and allows us to share all of the necessary information with the respective parties.
”Elsewhere, Pioneer Continuing Care Providers is now the main provider group inits area, and its use of GEHRIMED has helped it outpace other local physicians who still handwrite or dictate their notes. “Our documentation is so fabulous compared to what we used to do,” said Dr. Karen Hoyt. “The templates are great, and it really makes the quality measures easy to complete.
”Dr. Christine Weller and her team at Weller Health Transitions, LLC have used GEHRiMED for three years now. She notes a great GEHRIMED benefit comes through its MIPS functionality. “The well-placed prompts allowed our group to achieve a MIPS score of over 99% last year in a few seamless swipes.” Also GEHRIMED’s intuitive design lends itself to easy on-boarding of new providers, employees and rotating residents.
Effective GEHRIMED integration includes dialogue with a clear, friendly, and available support team. Dr. Weller said her account manager is always able to answer her questions when she needs help, and Dr. Gendelman said his account manager always knows about his concerns and issues whenever he calls.
Dr. Demidovich also said that the initial training and support sessions effectively got his team on track, covering everything from the platform basics to MIPS to other CMS topics so they could get started immediately.
“I think the support that Account Management gives is essential because we’re not techies,” Dr. Hoyt from Pioneer Continuing Care Providers added.“Sometimes we ask the same question three or four times or forget that we asked it last week, and they’re so gracious with all of that.”
Customers can also elect to take advantage of one-on-one MIPS coaching in order to receive training and an analysis of MIPS progress throughout the year.
If you’re still putting pen to paper or using an EHR platform that lacks helpfulMIPS functionalities, consider giving GEHRIMED a try. “GEHRIMED makes everything simpler in the long run,” said Dr. Gendelman. “If you aren’t on it, you’re behind the times.”
Now that she and her team use GEHRIMED, Dr. Hoyt can’t imagine doing quality measures without it. Her improved documentation and easy ability to share detailed information across all team members are also made possible by the platform. Not to mention, the cost of GEHRIMED is offset by the bonus that her practice achieves in using the platform. “You need a system like this in order to take advantage of what the government has set in place,” she said.
Dr. Demidovich echoes Dr. Hoyt in noting that GEHRIMED essentially pays for itself. “Overall, it’s just a much better, efficient system,” he said. “There’s a lot of potential for things to get lost in the shuffle when dealing with patient care, especially when you have multiple physicians or NPs in one group. GEHRIMED takes that worry away.”
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