Cooperating for better care.

Robert Tennant

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MIPS looms, but maybe you can opt out


Providers are girding their loins to comply not only  with the next stage of the Meaningful Use program, but also a  new mandated electronic reporting requirement: Medicare’s Merit-based Incentive Payment System (MIPS).

The MIPS combines parts of the Physician Quality Reporting System (PQRS), the Value-based Payment Modifier, and Meaningful Use into one single program based on quality, resource use and clinical-practice improvement.

Robert Tennant, senior policy adviser with the Medical Group Management Association (MGMA),  told MedPage Today that the two programs are very inter-twined:
“Even though Meaningful Use was sunsetted, it’s now effectively 25% of your MIPS score, so it never really goes away.” And because it is so much of the MIPS score, “it’s potentially more impactful on your reimbursement.”

But Linda Delo, D.O., a family physician in Port Saint Lucie, Fla., told the online news service that, as MedPage paraphrased her, “{P]hysicians can get out from under MIPS in some cases if they become part of an alternative payment model such as an Accountable Care Organization (ACO), a bundled payment model, or a patient-centered medical home (PCMH), rather than continue in the traditional fee-for-service Medicare program.”


Big trouble seems to loom with ICD-10


Medscape reports that almost 25 percent  of  physicians’ offices said in a survey they won’t be ready when the new, more complex International Classification of Diseases, 10th edition (ICD-10),  arrives Oct. 1.  Another 25 percent said  that they weren’t  sure if  they’d  be ready.

“The latest Workgroup for Electronic Data Interchange (WEDI) survey also found that only about 20 percent of physician practices have started or completed external testing. That percentage is up from the 10 percent of physicians who said they had done external testing in results released in March.”

Robert Tennant, vice chairman of the WEDI group and government affairs senior policy adviser for the Medical Group Management Association,  told Medscape that the survey indicates  big trouble.

“The physician side of the provider community — they’re really struggling,” Tennant said. “I think the government has not done a very good job about explaining the return on investment for physicians; it’s not clear at all why we’re doing this.”

“Also, many are at the mercy of their software vendors,” he said, noting  that if the software isn’t up to date, physicians can’t submit the codes or test the systems.

“What that tells us in the industry is that we’re looking at potentially a situation, where the light switch is flipped and things don’t work,” he said.




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