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Quality Payment Program

Driving Medicare Quality Payment Program Success: Solutions for Reporting MIPS and MACRA Data to CMS

Maximizing Medicare Quality Payment Program Success: Simplifying MIPS & MACRA Data Reporting

Discover how value-based care is driving success in the Medicare Quality Payment Program and learn practical solutions for reporting MIPS and MACRA data to CMS for maximum reimbursement. Stay ahead of the curve in healthcare payment reform.

The goal of ModuleMD's value-based care services is to ensure compliance with MACRA/MIPS, CPC+, PCMH, and other quality program reporting criteria, and maximize MIPS, MVPs, and MACRA incentives. The convenience of automated MIPS data collection coupled with thorough analytics can help your practice succeed under value-based care systems.

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Medicare Access and CHIP Reauthorization Act

MACRA, or the Medicare Access and CHIP Reauthorization Act, significantly changed how Medicare reimbursed clinicians. Stressing "value over volume," MACRA established the Quality Payment Program (QPP), unifying existing quality reporting programs and creating two paths for eligible clinicians; Alternative Payment Models (APMs) or Merit-Based Incentive Payments System ( MIPS).

MIPS compares four factors of a clinician's practice.

  • Quality of care
  • Cost of care provided
  • Promotion of Interoperability
  • Improvement Activities
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The Transition from MIPS to MVPs

The Centers for Medicare and Medicaid Services (CMS) finalized the MIPS Value Pathways (MVP) framework in 2020 to further streamline MIPS.

MVPs encompass quality measures like patient population, outcome, or other high-priority achievement, cost measures relevant to the specific condition they address, and the specialty field of medicine. To qualify for MVP participation, practices are also required to sustain a foundational layer of health measures targeted to their patient population and promote the interoperability of performance metrics.

While, its full implementation was delayed due to the COVID-19 pandemic., 2023 reporting period is an opportunity for voluntary participation in MVPs as an alternative to MIPS.

The Transition from MIPS to MVPs

The Goals of MVPs
Why They Are the Future of MIPS

Among other things, MVPs are intended to reduce the administrative burden placed on physicians and their staff. MVPs streamline the multiple MIPS programs further and can result in payment bonuses to eligible Alternative Payment Models (APM) participants.

Participation is currently limited to certain specialties, but the program will be expanded to replace conventional MIPS reporting.

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The Goals of MVPs

Essential Changes in MIPS and MVPs
Beginning in 2023

Beginning in 2023, seven MVPs will be eligible for voluntary participation in a MIPS pathway. Many eligible clinicians see the MIPS program as a cumbersome. With MVPs, CMS has taken a giant leap towards simplifying MIPS reporting for providers by creating seven unique pathways that cater to medical specialties, medical condition, or episode of care, making it easier for eligible clinicians to participate in MIPS and achieve high scores.

Another significant change to be aware of is the transition away from positive payment adjustments through MIPS. Also implemented this year, payment adjustments will only decrease the amount of reimbursement paid by as much as 9%. A practice that bills $1.5 million in Medicare annually can potentially lose $135,000 in restitution.

Patient Engagement

MIPS Performance
Why MIPS Performance is a Critical Aspect of Your Practice

A thorough understanding of the data underlying your practice is the key to spotting opportunities for growth or room for improvement. Automated MIPS data collection and fast, robust analysis can significantly impact your ability to optimize performance in any of the four core value-based care areas evaluated by MIPS.

It is in the best interest of any practice to ensure accurate and thorough MIPS and MACRA data reporting. ModuleMD can help track metrics that must be measured for adequate MIPS reporting, including industry-leading and specialty-specific EMR usability and content, automatic MIPS Composite Score reporting, built-in MIPS data submission, and benchmarking and analytic tools that provide real-time insight into how well your practice is performing.

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Why Choose ModuleMD?

ModuleMD helps streamline workflows, frees clinical staff to attend to other matters, and provides invaluable insight into your practice's performance. Our robust EHR solutions accomplish this by drilling down on population trends, care utilization metrics, and quality measure assessments, all from structured, patient and health system generated data.

ModuleMD provides the convenience of automated MIPS data collection coupled with thorough analytics that can emphasize strengths and identify potential weaknesses. This understanding can be the key to your continued prosperity under value-based care systems.

ModuleMD's MIPS reporting features

Keeping track of the metrics that must be measured for adequate MIPS reporting is time-consuming. ModuleMD can help you with features like:

  • Industry-leading and specialty-specific ONC-Certified EMR
  • Benchmarking and analytic tools that provide real-time insight into how well your practice is performing at the practice and patient level
  • Ensures compliance with MACRA/MIPS, CPC+, PCMH, and other quality program reporting criteria
  • Maximizes your MIPS, MVPs, and MACRA incentives with advice and guidance from our expert-level team

The Challenge of MIPS/MACRA Reporting Under Value-Based Care Protocols

ModuleMD's Value-Based Care services help ensure compliance with MACRA/MIPS, CPC+, PCMH, and other quality program reporting criteria. In addition, ModuleMD clients have access to QPP support services from an expert panel who can help optimize your practice's performance and technology that allows providers to maximize incentives.

Patient Engagement

ModuleMD Helps Providers Stay Up-To-Date on MIPS Quality Payment Programs (QPP)

It's easy to track, achieve, and monitor compliance with Quality Payment Programs (QPP) with ModuleMD. We stay ahead of government mandates and technology trends to help simplify the process. ModuleMD empowers providers with the information they need to meet MACRA/MIPS and other quality program reporting criteria to maximize reimbursement.

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Why do practices nationwide choose ModuleMD?

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