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As rural physicians move into MIPS

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Cover by Sarah Wyman Whitman

Here’s some guidance in Hospitals & Health Networks for rural hospitals on how they can prepare for Medicare’s new Merit-based Incentive Payment System. Among the recommendations:

“Determine which clinicians are in and out’’

“A sizable percentage of small rural providers have been given a reprieve in 2017 from MIPS, which focuses on Medicare Part B. Exempt providers include Rural Health Clinics, Federally Qualified Health Centers and clinicians with low Medicare volumes. Specifically, clinicians who see fewer than 100 Medicare patients, or who bill less than $30,000 worth of Medicare services, will be exempt from MIPS participation in 2017.’’

“Identify who has to report what’’

“In 2017, eligible clinicians will be assessed in three MIPS categories: quality, improvement activities and advancing health information. Clinicians will be assessed on cost measures starting in 2018. CMS has also loosened reporting requirements for certain providers. For instance, rural providers can report two rather than four improvement activities.’’

“Avoid transition-year complacency’’

“CMS is allowing providers to choose how much data they report in 2017. While providers will receive a 4 percent penalty in 2019 if they don’t submit any data, they can avoid this penalty by reporting a minimum amount (for example, one quality measure). While small rural hospitals may welcome this respite, they need to be careful not to procrastinate and fail to get ready for 2018, when providers might have to submit a year’s worth of data or risk a 5 percent penalty in 2020.’’

“Determine the cost of participation’’

‘’Small rural hospitals should consider the costs and benefits associated with seeking MIPS bonuses, which will be at 4 percent or lower in 2017. ‘’ The cost could exceed the reward dollars organizations might potentially achieve.

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