Introduction
The merit-based incentive payment system (MIPS)
The Merit-Based Incentive Payment System was established with the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Prior to this legislation, physicians who treated Medicare patients were subject to the sustainable growth rate (SGR), which mandated a 20% payment reduction.
MIPS is budget-neutral, which means that any positive payment adjustments are determined by the amount provided for negative payment adjustments. These payment adjustments are based on performance in MIPS two years prior. For example, participation in MIPS in 2019 will determine the Eligible Clinician’s (EC) or group’s payment adjustment in 2021.
MIPS first year began on January 1, 2017. MIPS has since changed some of its reporting requirements, objectives, and measures. These changes are intended to align with key initiatives determined by the Centers of Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC).
Tackling MIPS with an electronic health record platform
In addition to creating and enforcing MIPS, the Centers for Medicare & Medicaid Services (CMS) have increased pressure on practices to adopt certified electronic health record technology (CEHRT). Electronic Health Record platforms provide the most secure methods of recording, tracking, and managing patient data.
Some EHRs have longer implementation times and more cumbersome workflows than others, reducing their overall efficiency. With that said, many practitioners recognize that this technology has the potential to improve their jobs by providing better access to patient information, as well as streamlining communication between patients and practitioners.
EHR platforms are also the most effective means by which practitioners can participate in MIPS. In fact, it’s now nearly impossible to pass MIPS and avoid penalties under its Advancing Care Information (ACI) component without the use of a truly intuitive EHR platform. That’s why Netsmart has focused on developing a MIPS solution for GEHRIMED that’s specifically designed to help practitioners in the long-term/post-acute care space avoid penalties and earn better bonuses.
Stories of success and beyond with GEHRIMED
Making the Transition
Before GEHRIMED, Health Care Providers, LLC had never used an EHR platform before. “We were the typical practice that utilized handwritten charts and submitted billing requests as such,” said Dr. James Demidovich. But as regulations from CMS intensified and the practice grew, HCP realized that it needed a system to help relieve the manual workload of submitting information. The company turned to GEHRIMED for assistance.
“It helped to completely streamline our process,” said Dr. Demidovich. “It has made our workflows easy and efficient, and it really simplified everything on our end. GEHRIMED is extremely easy to use, and the way MIPS is integrated into the platform makes it almost impossible to be penalized.”
GEHRIMED built-in functionalities
CMS did not design MIPS with long-term/post-acute medicine in mind. However, GEHRIMED continues to implement new methodologies in its platform that make it as painless as possible for these practitioners to participate.
The GEHRIMED EHR integrates MIPS reporting elements into the practitioner’s daily workflows so once-recorded data can serve multiple purposes. Before closing out patient encounters, practitioners are
automatically prompted to answer a few simple questions that directly funnel MIPS information to necessary reporting fields.
GEHRIMED also provides practitioners with a MIPS-specific dashboard so they can evaluate their progress at any point in the year. There’s even a MIPS calculator that allows practitioners to estimate what scores they would receive based on their current practices, creating time and opportunity for MIPS focused adjustments. The remainder of this case study shares testimonials from four different practitioners who manage patient data with the GEHRIMED EHR platform and use its MIPS functionalities specifically to participate and achieve success in the CMS initiative.
Reporting Made Easy
Dr. Demidovich also noted that GEHRIMED has helped Health Care Providers,
LLC improve its reporting processes, which were previously entirely manual. “The MIPS dashboard and reporting system coupled with the streamlined encounter documentation makes everything easier on our end,” he said. “It’s a much better system, more efficient, and honestly makes everybody’s lives easier. There’s a lot of potential for things to get lost in the shuffle when dealing with patient care, and GEHRIMED prevents that.”
Meanwhile, Carespring NP, LLC used another EHR system before switching to GEHRIMED. Dr. Art Gendelman said they found their former platform to be so cumbersome and time-intensive that his team couldn’t effectively record months’ worth of data at a time. Luckily, GEHRIMED now gives them all of that wasted time back.
“GEHRIMED is so much simpler, and I barely spend any time recording for MIPS,” he said. “It’s extremely intuitive and tells you which ones to complete. Last year we got 100% of what we should have gotten without going back and having to update anything.”