In the first year of CMS’ Merit-based Incentive Payment System (MIPS), CareCloud, an EHR and practice management software company that offers a MIPS Success Guarantee Program to its users, is reporting that 100 percent of its physicians are avoiding penalties under the program — and nearly half are receiving additional bonus payments.
“MIPS is a score from one to 100,” Daniel Sabido, director of product marketing at CareCloud, told MobiHealthNews. “So you do a bunch of work and you submit it and you get graded on 1 to 100 in terms of the points that you get and they have thresholds. And the highest one is, anyone who scores a 70 out of 100 or more is going to get what CMS calls exceptional performance bonus. They expect 10 to 15 percent of physicians to be in that bucket. When you look at our clients, 45 percent scored 70 or more. That really wowed us internally, because we were focusing on avoiding penalties. So when those scores came back we threw a party actually.”
CareCloud uses both software and services to support its customers’ MIPS scores. The software includes a MIPS dashboard and clinical quality templates to help users track the appropriate metrics. But CareCloud also provides dedicated consultants to walk customers through the process and create customized plans for each provider.
“The problem with MIPS and MACRA and PQRS is it’s always a moving target,” Dr. Carlos Sessin, founding partner of Vanguard Rheumatology of Miami Beach, a CareCloud client, told MobiHealthNews. “Every year the target changes, the name changes, the acronym changes, and you have to stay up to date with what the requirements are. And once you understand what the requirements are, how do you capture that? How do you implement that? How do you record all that information and once you have all that information recorded how do you report that, and how much effort is it going to take?”
Sessin said it would have been very difficult to qualify for bonus payments without the help of his CareCloud account manager.
“She really deserves a lot of credit for being there and holding our virtual hand through the whole process,” he said. “Everything from before we actually had to start reporting, she sat down with us and explained, these are the requirements, these are the quality measures, the practice improvement activities, this is what advancing care information is, this is what they’re looking for, this is what you need to do, this is how you document what you’re doing. And then she helped me implement that into practice and then ultimately she also walked me through how to report that at the end of the reporting period.”
Polly Friend, a registered nurse and CareCloud’s senior director of clinical strategy, said that while the company is happy with the first year results, there’s a lot of work to be done as requirements and penalties ramp up for future years.
“The first year was 2017. We’re in the second year knowing there will be a lot of changes to come annually with these programs, and knowing that we’re not only responsible, but looking forward to making those changes and partnering with our clients to ensure that they have really long-term success,” she told MobiHealthNews. “I mean it’s great that this first year came out and we’re seeing such dramatic results, but we want to maintain that and make sure that in the long run and for the long term we’re going to see those kinds of numbers.”