Optimizing MIPS in 2023: A Guide for Physical, Occupational, and Speech Therapists
The Merit-based Incentive Payment System (MIPS) is an integral part of today's healthcare system. For therapists, understanding MIPS is crucial to maximize performance and incentives. This guide offers insights into each category of MIPS, complete with tips and examples specific to physical, occupational, and speech therapists.
Quality
Quality measures form the largest chunk of the MIPS score. In 2023, therapists need to report on six measures for at least 70% of all eligible patients across all payers. This includes one outcome measure, or another high-priority measure if an outcome measure isn't applicable. For example, a physical therapist may choose "Functional Outcome Assessment" (PT/OT), an occupational therapist could opt for "Documentation of Current Medications in the Medical Record," while a speech therapist could consider "Preventive Care and Screening: Influenza Immunization." Accuracy in tracking and reporting these measures is essential. Some Quality measures that are population specific for therapists might include:
Physical Therapy:
1. Functional Independence Measure (FIM): Assesses a patient's level of independence in activities of daily living.
2. Pain reduction or management: Measures the effectiveness of pain management interventions.
3. Range of motion (ROM) improvement: Evaluates improvements in joint mobility and flexibility.
4. Gait speed: Measures changes in walking speed and mobility.
5. Patient satisfaction: Assesses patient's perception of the therapy services received.
6. Patient-Reported Outcomes Measurement Information System (PROMIS).
7. Adherence to Clinical Practice Guidelines: There are numerous guidelines for various conditions such as stroke, low back pain, osteoarthritis, etc. Providers should adhere to these guidelines for high-quality care.
Occupational Therapy:
1. Activities of Daily Living (ADL) performance: Evaluates a patient's ability to independently perform self-care tasks.
2. Upper extremity function: Measures improvements in fine motor skills, grip strength, and dexterity.
3. Adaptive equipment use: Assesses the effectiveness of assistive devices or equipment in enhancing independence.
4. Work-related outcomes: Measures the patient's ability to return to work or engage in meaningful occupations.
5. Functional Independence Measure (FIM): Similar to physical therapy, it assesses the patient's level of independence in daily activities.'
Speech Therapy:
1. Speech intelligibility: Measures improvements in the clarity and comprehensibility of speech.
2. Articulation accuracy: Evaluates the accuracy of producing speech sounds.
3. Language skills: Assesses improvements in receptive and expressive language abilities.
4. Fluency: Measures improvements in speech fluency for individuals with stuttering or other fluency disorders.
5. Swallowing function: Evaluates improvements in swallowing abilities and safety.
6. Improvement in Communication: Tools like the Functional Communication Measures (FCM) can be used to track a patient's progress over time.
7. Patient and Family Satisfaction: Measures might include feedback from the patient and their family on the effectiveness of the therapy and the therapist's communication.
Promoting Interoperability
Physical, occupational, and speech therapists are not required to participate in the Promoting Interoperability category. Instead, these clinicians are considered "non-patient facing". However, it can significantly boost your overall MIPS score. This category focuses on patient engagement and electronic health information exchange via certified electronic health record technology (CEHRT). For instance, therapists can provide patients with electronic access to their health information, contributing to enhanced patient engagement and improved overall care.
There are several potential components of Promoting Interoperability that could be applicable to PTs, OTs, and SLPs, such as:
1. Electronic Prescribing: Although therapists don't typically prescribe medication, e-prescribing systems can be used to communicate other types of recommendations or interventions.
2. Health Information Exchange (HIE): This involves the ability to send, receive, find, and use health information in a manner that is appropriate, secure, timely, and reliable.
3. Provider to Patient Access: This includes giving patients access to their own health information electronically, potentially through a patient portal.
4. Public Health and Clinical Data Exchange: This might involve contributing data to registries or other public health data systems.
5. Electronic Health Records (EHR) Integration: Ensuring that speech therapy, physical therapy, and occupational therapy documentation and progress notes are integrated into the patient's electronic health record. This allows for easy access and sharing of information among different healthcare providers involved in the patient's care.
6. Standardized Terminology: Using standardized vocabularies and coding systems, such as SNOMED CT or ICD-10, to document and communicate diagnoses, interventions, and outcomes. This promotes consistency and improves communication across different therapy disciplines and healthcare settings.
If PTs, OTs, and SLPs are included in the Promoting Interoperability category in the future, they would likely need to demonstrate their use of CEHRT to meet these and other objectives. In any case, interoperability is an important goal for all healthcare providers, as it can improve care coordination, patient engagement, and overall quality of care.
Improvement Activities
Improvement Activities (IA) rewards clinicians for activities that enhance clinical practice. Therapists must attest to completing up to four improvement activities over a minimum of 90 days during the performance year. A physical therapist, for instance, could implement interventions that manage chronic disease, while an occupational therapist might focus on activities that improve behavioral health, and a speech therapist could engage in telehealth services for patients with communication impairments.
Attest that you completed up to 2 high-weighted activities or 4 medium-weighted activities for a minimum of 90 days. Groups with 15 or fewer participants or if you are in a rural or health professional shortage area, attest that you completed 1 high-weighted or 2 medium-weighted activities for a minimum of 90 days. A group can attest to an activity when at least 50% of the clinicians in the group perform the same activity during any continuous 90-day period (or as specified in the activity description) in the same performance year. There are over 100 possible activities to choose from. The following are IA suggestions for your specialty:
Physical Therapy:
1. Implementing evidence-based practice guidelines: Incorporating the latest research and evidence-based guidelines into clinical practice to improve patient outcomes.
2. Quality improvement projects: Conducting projects focused on specific areas such as reducing wait times, improving patient satisfaction, or enhancing therapy protocols.
3. Patient education programs: Developing educational materials or programs to empower patients with knowledge about their condition, treatment plans, and self-management strategies.
4. Performance measurement and tracking: Regularly monitoring and assessing key performance indicators (KPIs), such as functional outcomes or patient satisfaction scores, to identify areas for improvement.
5. Collaboration and interdisciplinary teamwork: Establishing collaborative relationships with other healthcare professionals and disciplines to enhance patient care and promote coordinated treatment approaches.
Occupational Therapy:
1. Developing and implementing standardized protocols: Creating standardized protocols and guidelines for specific interventions or conditions to improve consistency and quality of care.
2. Client-centered goal setting: Emphasizing the importance of involving patients in setting therapy goals and incorporating their preferences and priorities into treatment plans.
3. Continuous professional development: Engaging in ongoing education and professional development activities to stay updated with the latest research, techniques, and interventions in occupational therapy.
4. Using technology and assistive devices: Exploring innovative technologies and assistive devices that can enhance occupational therapy interventions and improve patient outcomes.
5. Quality assurance and outcome measurement: Implementing systems to monitor and measure patient outcomes, functional gains, and satisfaction to identify areas for improvement and track progress over time.
Cost
The Cost category is scored automatically using administrative claims data - meaning therapists aren't required to submit data. Measures include total per capita cost and Medicare spending per beneficiary. This category incentivizes reduced costs while maintaining or improving quality.
How We at Chirpy Bird Can Assist
At Chirpy Bird Health IT Consulting, we specialize in the MIPS landscape, providing clinicians with the necessary tools to optimize performance and incentives. Here's how we can help:
MIPS Consulting: We offer guidance on measure selection, data submission methods, and performance feedback tailored specifically for physical, occupational, and speech therapists.
Reporting Assistance: We assist in accurately capturing and reporting on Quality and Improvement Activities measures, ensuring data completeness and correctness.
Performance Optimization: We identify opportunities for score improvement to help you maximize incentives.
Educational Resources: We provide resources to keep you up-to-date on the MIPS program and changes.
With a partner like Chirpy Bird, you can confidently navigate the MIPS landscape, ensuring you meet all requirements and achieve the highest possible incentives. For more detailed updates on MIPS for therapists in 2023 or expert guidance contact us today at 888-647-7247 or via email at hello@chirpybirdinc.com for a FREE quote to get a MIPS expert as part of your team today.