Navigating the 2023 MIPS Program Categories for Hospitalist Physicians
The 2023 Merit-based Incentive Payment System (MIPS) is an essential part of the Quality Payment Program (QPP), which aims to reward eligible clinicians for providing high-quality, efficient care. As a hospitalist, it is important to understand the nuances of each MIPS category and how they impact your overall score. In this blog post, we will break down the four MIPS program categories for hospitalist physicians: Quality, Promoting Interoperability, Improvement Activities, and Cost.
Quality (30% of overall score)
The Quality category measures the outcomes of the care provided by hospitalists, focusing on the effectiveness, safety, and patient-centeredness of the care. In 2023, hospitalists are required to report on six quality measures, with at least one outcome measure or another high-priority measure.
Unique to the hospitalist specialty, there are several measures specifically designed to evaluate the care provided during hospitalization, such as:
Hospital-based readmission rates
Inpatient mortality rates
Timely communication with primary care providers upon patient discharge
These measures can help hospitalists identify areas for improvement and enhance the quality of patient care. However, we recognize that getting the data you need for these measures can sometimes be challenging. This is why we offer other Quality collection mechanisms to help hospitalists find and gather data for population specific measures to simplify the Quality collection process.
Promoting Interoperability (25% of overall score, but can be re-weighted for individuals or small groups)
Promoting Interoperability aims to assess how hospitalists are using electronic health records (EHRs) to improve patient care, share information securely, and engage patients in their care. This category focuses on four objectives:
E-Prescribing
Health Information Exchange
Provider to Patient Exchange
Public Health and Clinical Data Exchange
Hospitalists may be eligible for re-weighting of this category due to the nature of their work. If a hospitalist works in a facility that primarily uses paper records or faces other unique challenges related to EHR use, they can apply for a hardship exception. If granted, the 25% weight for Promoting Interoperability will be redistributed to the Quality category.
Improvement Activities (15% of overall score)
The Improvement Activities category evaluates the efforts of hospitalists in enhancing their practice and patient care. Hospitalists need to participate in a combination of high-weighted and medium-weighted activities to meet the requirements.
Unique to hospitalists, there are several activities tailored to the inpatient setting, including:
Multidisciplinary rounds with care team members
Implementation of antibiotic stewardship programs
Participation in sepsis management programs
These activities can help hospitalists better coordinate care and improve patient outcomes.
Cost (30% of overall score)
The Cost category measures the resources used to provide care to patients. Hospitalists are evaluated based on their performance in cost measures, such as Medicare Spending per Beneficiary (MSPB) and the Total Per Capita Cost (TPCC).
Unique to the hospitalist specialty, the MSPB measure includes costs associated with inpatient hospital services, post-acute care, and other related services during a 30-day episode of care. This measure highlights the importance of cost-effective care and care coordination in the hospital setting.
Understanding the 2023 MIPS program categories is crucial for hospitalists as they strive to improve patient care and optimize their MIPS score. By focusing on the nuances of each category unique to the hospitalist specialty, physicians can identify opportunities for improvement and enhance the overall quality of care.
For help in maximizing your MIPS score in all 4 categories, including Cost, Chirpy Bird Inc.com offers affordable monthly subscription services to help develop simple strategies to protect your performance and revenue. Schedule a free call today to learn more.
