MIPS 2022 - Navigating the Path to Achieve More Than 75 Points
Providers and clinicians, let the seventh round of the CMS Merit-based Incentive Payment System (MIPS) games begin, and may the odds be ever in your favor.
No, we’re not in a dystopian drama, but not unlike the Hunger Games, clinician reimbursement rates are directly tied to their performance in a government program where every year the rules change and the stakes grow higher. This year, CMS leaves little wiggle room for error, where to simply avoid a penalty requires earning a minimum of 75 out of 100 total points.
When you look at the rules more closely, you’ll quickly see that earning 75 points will not be a walk in the park. In years past, many medical practices have waited until March or April to start their quality payment program initiatives. However, in 2022, there is literally no time to waste. If your organization didn’t start collecting data on January 1, it’s safe to assume that you’re already behind.
This year’s MIPS categories are divided among Quality (30%), Cost (30%), Promoting Interoperability (PI) (25%), and Improvement Activities (15%).
The Quality category continues to require six measures, of which each necessitates 70% data completeness and a minimum of 20 eligible instances. However, this category is a bit of a conundrum, even for practices and professionals well-versed in the program, because more than 80 measures underwent substantive changes. This means that each of these measure’s benchmarks was reset and their point potential has been reduced from a maximum of 10 points to 0 points, except for small practices, who can earn 3 points.
Another challenge is that the Cost category is at its all-time high, having reached the 30% weight that it is required to be worth by law in 2022. This means if you have no idea if or how your Costs have been scored historically, you may soon be in for a rude awakening. Many MIPS clinicians have avoided this category in the past or have benefited from the category’s low weight, by comparison. This year, and going forward, it’s tied with Quality for the highest weighted category.
Tracking the meaningful usage of your EHR through the Promoting Interoperability category will require a full-time effort for at least 90 days to maximize the points available here. Plus, attention must be paid to both the Security Risk Assessment and the new SAFER guideline requirements, each of which is scoreless category prerequisites before any points can be earned. Although small practices qualify to automatically reweight the points from this category over to Quality, that just puts more pressure to perform extremely well over there.
Perhaps the only silver lining to the change in MIPS requirements this year is that the Improvement Activities category continues to be a steadfast way to earn 15 percentage points. However, with the new activity options available and some substantive changes made this year, practices will want to check and double-check each activity’s data validation needs.
Regardless of which categories you focus on, the path to 75 points is not clear-cut. There are several “what-if” scenarios to the program and expert navigation from the start is the best way to land in a place of success.
Over the next four weeks, we will give you a closer look at each category and the nuances you will need to navigate.
Week 1 - January 18th, Quality - The Secret to Success
Week 2 - January 25th, Promoting Interoperability
Week 3 - February 1st, Breaking Down Cost
Week 4 - February 8tht, The Do’s and Don’ts of Improvement Activities
If you need expert MIPS support at an affordable monthly cost, Chirpy Bird offers one-on-one help to ensure you reach your optimal MIPS score.
Contacts us at:
888-647-7247