MIPS Reporting – What’s at Stake for You?

MIPS reporting is complicated and can negatively affect your reimbursement if ignored. So how can providers mitigate the stress and financial risk that comes with this new program? Alpha II, a TPS platinum marketplace partner and national leader in automated MIPS reporting, provides tips and tricks to help practices optimize their scores and Medicare reimbursements.

MIPS reporting is complicated and can negatively affect your Medicare Part B reimbursement if ignored. So how can providers mitigate the stress and financial risk that comes with this program? Alpha II, a TPS platinum marketplace partner and national leader in automated MIPS reporting, provides tips and tricks to help practices optimize their scores and Medicare reimbursements.

MIPS is the CMS program that requires clinicians to transition from fee-for-service to value-based care model or face significant financial penalties and even reputational harm. The stakes have been raised every year and the final rule for the 2024 reporting period is even more complex than it has been in the past, further increasing the stress, burden, and financial risk for a healthcare practice.

To put it into perspective how significant the MIPS program is, it is estimated that over 900,000 clinicians who bill Medicare Part B are subject to MIPS. It’s no longer sufficient to simply submit data but now you must compete to earn points, and points are directly tied to your reimbursements. For the 2023 reporting period, a clinician must earn 75 out of the possible 100 MIPS points to avoid penalty. Failure to comply or earn enough points will result in a negative adjustment applied to every Medicare Part B claim. The maximum penalty is 9%, which equates to a $9,000 per clinician hit to the bottom line for every $100,000 billed to Medicare.

Within this framework, all healthcare practices regardless of size or specialty, must evolve their approach to MIPS to assure their financial viability. However most do not understand, or have awareness of, the different reporting methods available to them. Many clinicians erroneously still think that a registry is the only reporting option available to them or that they are required to use a registry. Or, they think that their EHR automatically covers their reporting obligation. This misperception and general lack of awareness is detrimental to the financial interests of any practice. And going forward, traditional legacy reporting systems (registry or EHR) may be unable to fulfill enough of the reporting criteria to avoid the minimum score penalty.

But there is another reporting methodology available to clinicians. This other reporting methodology, known as Certified EHR Technology or CEHRT, has emerged as the superior reporting methodology. Reporting through a CEHRT dramatically improves the efficiency and effectiveness of the MIPS reporting process, especially when done using ONC-certified software. CEHRT reporting uses eCQMs (electronic Clinical Quality Measures), which are a better way to optimize the points that can be earned.

TriZetto Provider Solutions’ platinum Marketplace partner, Alpha II, is the national leader in automated MIPS reporting and is classified as a CEHRT reporting method. Alpha II has cloud-based, ONC-certified software that fully automates the MIPS reporting process. And along with all the inherent benefits of working with a CEHRT reporting partner, Alpha II’ service requires minimal IT or administrative support. No cumbersome spreadsheets are required for reporting. It will save significant time while maximizing your financial upside.

Learn more about how Alpha II can help your practice earn every MIPS point you can because the stakes are high. Now is the time to optimize your MIPS score and to protect your Medicare reimbursements and bottom line.