3 Ways to Resolve Recent Payment Collection Issues in Medical Billing

Ace 2023 MIPS Reporting by Scoring High in Improvement Activities

In the rapidly evolving healthcare landscape, providers haven’t settled for average care at any point. Rather, they are looking for opportunities to implement meaningful quality improvement activities. Here, the MIPS has not only served its purpose but also offered payment adjustments. Perform well, score higher (hit the performance threshold), and unlock a positive payment adjustment. Here, let us mention the payment adjustment rate for the 2023 MIPS program specifically. Well, it is more than what a provider can desire as a reward for their exceptional performance. It is up to 9%—the maximum payment adjustment rate—for MIPS reporting.

So, are you looking for the right ground to drive a positive change in your practice? Why not think about going outside the box and engaging in meaningful improvement activities? And as a MIPS consulting services provider, we can assure you that there is no better way to do this than through MIPS participation.

What now? Are you ready to showcase your devotion to taking quality care to the next level? MIPS 2023 gives you the right direction to get engaged in quality improvement activities. You can focus on areas that need more effort and work hard.

Let’s see what the PFS final rule for the 2023 MIPS program entails for improvement activities. And what is the rule for submitting the IAs for 2023 MIPS reporting?

MIPS asks for Submitting Improvement Activities

Improvement activities are one of the four pillars of the MIPS program. It contributes 15% of the MIPS final score weightage. So, clinicians have to choose IAs following the guidelines already provided in the PFS final rule. For now, we have three approved combinations of improvement activities:

  • 2 high-weighted activities,
  • 4 medium-weighted activities, or
  • 1 high-weighted activity and 2 medium-weighted activities.

As per the rule for 2023 PY, the MIPS participants have a minimum of a 90-day performance period. Each activity fully describes all the details necessary for participants to become familiar with. The same 90-day period or other defined time frame is not required for multiple activities to be carried out.

There is another point that you need to focus on here. We have a rule specified for groups, virtual groups, and APM entities. For the attestation to an IA at least 50% of clinicians must perform the same activity. Furthermore, they have to do so during any continuous 90-day performance period in the same PY.

MIPS 2023 Improvement Activities: What’s Coming Your Way?

Like previous MIPS reporting years, QPP has again provided MIPS participants with a diverse set of IA. All these activities align with the participants’ expertise. They may vary from clinical enhancement to patient involvement to population health management. By taking part in these activities, providers may advance their expertise and improve patient outcomes.

New Improvement Activities: 4

  • Deploy certified health information technology for electronic health record data security tags.
  • Make a plan to enhance the care provided to LGBTQ patients and put it into action.
  • COVID-19 Vaccine Achievement for Practice Employees.
  • Maintain and put into action a language access plan.

Removed Improvement Activities = 6

  • Engagement in a QCDR that encourages the application of patient engagement technologies.
  • Participation in a QCDR, which promotes interactive chances for collaborative learning networks.
  • Application of QCDR for feedback reports that include population health.
  • Participation of the leadership in continual guidance and an obligation to improve practices.
  • Prescription Drug Monitoring Programme consultation
  • The PCI Bleeding Campaign

* Because it is now a MIPS requirement, participation in a QCDR is no longer eligible as an improvement activity. *

Modified Current Activities = 5

  • Practice enhancements for the bilateral exchange of patient information.
  • Completion of training and receipt of an authorized waiver for opioid medication-assisted therapy.
  • Practice improvements that involve community resources to meet patient health objectives.
  • Implementation of practice adjustments, formal quality improvement methodologies, or other practice improvement procedures.
  • Use of QCDR data for continuing practice evaluation and development.

Cost Changes for 2023 MIPS

The 12-month reporting cycle and requirements mostly remained the same. However, CMS has decided to set a maximum cost improvement score of 1/100 percentage points for the cost performance category. It started with the 2022 performance period. So, MIPS 2023 did not include any sort of change to the cost.

How to Score Higher in MIPS Reporting This Year

Obtaining the maximum of 15 points for the Improvement Activities score entails the following:

  • If there are 15 or fewer physicians in the group billing under the same TIN, the clinician may choose any of the following combinations: 2 medium-weighted activities OR 1 high-weighted activity
  • MIPS participants may get special status. So, the clinicians with the special statuses of Non-patient Facing, Health Professional Shortage Area (HPSA), or Rural have the following combination for selection: 2 medium-weighted activities OR 1 high-weighted activity
  • To get full credit for this category, clinicians working with larger groups (16 or more) will need to attest to more activities: 1 high-weighted activity and 2 medium-weighted activities, OR 4 medium-weighted activities AND 2 high-weighted activities

Conclusion

Providers in healthcare are the most devoted people. They participate in MIPS reporting and report their Medicare Part B claim data to CMS. Not only do they get payment adjustments based on performance, but they also get feedback. These feedbacks help them speed up their efforts for better patient outcomes. Every category of MIPS reporting has its motives and goals. But MIPS quality improvement activities help you address your unique areas of focus and expertise. Overall, those who become a part of MIPS can demonstrate high levels of quality care and patient outcomes through MIPS.

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