Radiology & MIPS Reporting:                Formula for Success

November 21, 2017

Radiology groups often ask these questions as they scramble to put together a plan for the 2017 Merit-based Incentive Payment System (MIPS) reporting year and prepare for 2018.

Our practice includes both, diagnostic and interventional, radiology procedures. What does that mean for my reporting requirements? Am I a non-patient-facing or patient-facing clinician? What quality measures should we choose to report for 2017?

No worries! We are going to cover the following questions here to ensure your radiology practice has the right formula for success.

Let’s start with some MIPS background basics, know that in 2017 you may be subject to report on three categories of MIPS: Quality, Advancing Care Information (ACI), and Improvement Activities. In 2018, a fourth category will be added: cost. Each category makes up a percentages of your overall total composite score, the final score that will affect your Medicare Part B reimbursements in future years.

What if I am a non-patient facing clinician? 

If you provide a minimal amount of patient-facing services, you may be designated as a non-patient facing clinicians and may not have to report on Advancing Care Information. The Advancing Care Information category is primarily used to demonstrate your meaningful use of a Certified EHR Technology (CEHRT), making up 25% of your total composite score. If you are offering a patient-facing service, you will be subject to the requirements of this category. A non-patient facing MIPS-eligible clinician is clinician who bills 100 or fewer patient facing encounters annually. A non-patient facing MIPS-eligible group is a group in which at least 75% of eligible providers are designated as non-patient facing clinicians. If you are non-patient facing, you are not subject to report on the ACI category requirements and instead the 25% from your ACI category will be reweighted to the Quality category

Which measures should my radiology practice choose? 

There are 243 quality measures available to providers to select and report to CMS for MIPS. How will you decide the best measure set for your organization? Below are the most commonly selected quality measures amongst the radiology providers using Whittle Advisors’ MACRA Advisory Solution for MIPS reporting:

Good news, unlike for PQRS, under MIPS you do not need to let CMS know ahead of submission whether you are reporting as an individual or a group (unless you are reporting via the CMS Web Interface or participating in CAHPS for MIPS). In the Whittle Advisors platform, you can track both individual and group performance all year long, and decide at submission time which route you want to go.

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