MIPS: It Takes a Village

How To Maximize MIPS Participation In Your Practice

Does Your Clinic Take A Team Approach To MIPS?

Azalea recently held a webinar educating clinics on navigating regulatory programs such as MIPS and the importance of value-based reimbursements. A common misconception is that the MIPS burden rests solely on clinical staff and providers. While they play a big role, creating a team environment in your clinic, focusing on communication and team member buy in is critical.

What does a team approach look like? Let’s explore common roles within the practice and how each is tied into effectively participating in MIPS.

Watch the full MIPS webinar

Front Office Staff

Being patient facing, the front office staff including administration, scheduling, referral, and medical records staff, absolutely play a role in a clinic’s MIPS program. 

Key Contributions:

  • Setting up and maintaining medical records
  • Completing referral orders
  • Inviting patients to sign up for the patient portal
  • Training new staff

Scribes

Not applicable to every practice, but it is important to note in the absence of a scribe, who at the clinic fulfills these responsibilities. 

Key Contributions:

  • Coding and documenting visits
  • Releasing patient education to patients
  • Promoting completed chart notes signed by physicians in a timely manner

RHC Readiness Quiz

Are you considering becoming an RHC? There are federal bebefits for being a certified RHC but first you’ll need to pass inspection. See if you’re ready to take pass your RHC inspection by taking our short mock quiz.

Providers

Clinicians are the lifeblood of the practice. They provide the clinic’s primary service to patients and set the tone and expectations for the practice with their own actions and adherence to operating procedures.

Providers must ensure all relevant info is documented, charts are reviewed and signed off on in a timely manner (typically within 4 days). Providers are critical role models for other clinical staff.

Key Contributions:

  • Following clinical workflows
  • Reviewing and signing off on all needed charts
  • Determining plan of care

Mid-Level Providers

Mid-Level Providers

With their patient work directly tied to MIPS standards, it is critical that clinical staff and mid-level providers also follow documented clinical workflows and ensure their charts are complete and signed off on by themselves and their review physician in a timely manner.

Key contributions:

  • Preparing patient for encounter, vitals
  • Utilizing basic EHR clinical quality tools
  • Helping use templates for eCQM info
  • Helping coordinate care plan as needed

Teamwork Pays Off When It Comes To MIPs

Working as a team on your MIPS goals should be an ongoing effort that is monitored and adjusted often. As MIPS’ thresholds continue to increase, solid workflows and a team environment established now will setup your clinic for ongoing MIPS success.

While we did not see a shift in category weights for 2020, the minimum performance threshold did rise from 30 to 45 points and the exceptional performance threshold rose from 75 to 85 MIPS points. Additionally, maximum penalties for not reporting MIPS have increased from 7% to 9% in 2020.

The performance thresholds and penalties will continue to rise until 2022.

What Do I Need To Know About The MIPS Cost Performance Category?

The Cost Category is one of four performance categories and makes up 15% of your total QPP (Quality Payment Incentive Program) score. Get the details on MIPs and maximize your reimbursements.