ChartSpan helps you maximize your positive payment adjustment for future Medicare Fee-For-Service reimbursements. We do so by leveraging your Chronic Care Management (CCM) program to incorporate and report on care quality activities that help increase your Merit-based Incentive Payment System (MIPS) score. ChartSpan assigns a dedicated MIPS consultant and provides comprehensive reporting and analytics to track quality performance by working directly with your Quality team and/or ACO – all at no additional cost.
As part of the Centers for Medicare and Medicaid Services’ (CMS) Quality Payment Program (QPP), MIPS is a quality payment incentive program that drives improved healthcare outcomes and reduces costs. MIPS is measured by four performance categories:
- Promoting Interoperability (formerly Meaningful Use)
- Quality (replaces PQRS)
- Improvement Activities
- Cost (replaces VBM)
These four categories are scored and combined into a single compliance program. While a consolidated program eliminates confusion and multiple measures, it also can dramatically improve your fee-for-service revenues and annual earnings through positive payment adjustments.
If you are unsure about your MIPS eligibility, enter your NPI on the Quality Payment Program (QPP) website to determine if you are an eligible clinician.
Customer Success Metrics
How ChartSpan Helps You Meet MIPS Goals
Quality is at the heart of MIPS, particularly for patients with complex and chronic conditions – and those are exactly the patients targeted with ChartSpan’s Chronic Care Management and annual wellness visits. Our care coordination software and team work together to identify gaps in care in your EHR (electronic health record). Not only do we identify the care gaps below, but we also close them for you. A few examples are:
Colorectal cancer screening
Breast cancer screening
Advance care plan
BMI screening and follow up
Depression screening and follow up
By participating in ChartSpan’s Chronic Care Management, practices will automatically receive a 100% in the Improvement Activities category because CCM alone satisfies 2 medium and 1 high weight, bringing scoring to a total of 40 points (the required amount)!
ChartSpan knows it can be difficult to stay on track with your quality initiatives, especially with a program as detailed and complex as MIPS. That is why our MIPS consultants provide monthly MIPS reporting that details your performance scores. You can reach out to your dedicated MIPS consultant at any time to ask questions.
Substantial Financial Consequences
Providers have up to 9% of their total fee-for-service reimbursements at risk during the next 36 months, resulting in annual decreased or increased reimbursements.
In 2020, the performance threshold is 45, up from 30 last year. Physicians under that level will receive a negative payment adjustment of their Medicare Part B payments.
Physicians whose performance meets or exceeds a final score of 85 points (known as the exceptional performance threshold) will be eligible for an additional positive payment adjustment of their Medicare Part B payments for exceptional performance.
For more information on the Final Rule on the 2020 Physician Fee Schedule, read our blog post.
2020 MIPS Categories
|Quality||Promoting Interoperability||Improvement Activities||Cost|
Quality (Formerly PQRS)
Quality is the largest required category, including 218 available measures. Providers are required to report on 6 measures, including one high-priority or outcome measure.
Promoting Interoperability (Formerly Meaningful Use)
Promoting Interoperability includes 11 measures across 4 categories. Providers must report on all 4 categories with a minimum of 7 measures. Five are required measures, and the remaining 2 must report on public health registries or clinical data registries.
This performance category has 105 measures in 2020. Providers must a combination of medium and high weight activities to total 40 points. All providers who provide a CCM program through ChartSpan automatically receive the full 40 points for this category.
Cost is calculated by CMS and will be based on Medicare claims.