New MIPS Physical Therapy Rules and Why Does it Matter to Your Practice?
How will MIPS Impact Physical Therapy
- First of all MIPS or Merit-Based Incentive Payment System is a program that will rank outpatient rehab practices, high to low, nationwide
- Labels practices as “winners” and “losers.” The “losers” will pay the “winners” a percentage of revenue
- As a result, it will be multiple times more complex than G-codes, PQRS, and eval complexity codes, combined
- Due to the complexity, it requires ground-up rewrites for current outpatient rehab EMRs to comply
- Will “wash out” numerous EMR providers who can’t afford to make these substantial changes
- Is designed to put practices who document on paper out of business. And it will succeed
- Consequently, this will be the most significant change in outpatient rehab reimbursements of our careers
MIPS is a subject that deserves your full attention.
Furthermore, the goal of this library is to provide outpatient rehab practice owners with expertise and scope on these seismic changes. This topic is fluid. CMS won’t provide final guidance until November 1, 2018. But savvy practice owners are preparing today because they understand that “winning” involves lead times much longer than 60 days.
This MIPS library is dynamic.
Therefore, content will be added each month. We encourage you to sign up for these updates. Our intention is to provide you with a solid macro understanding of new terminology and tactics. We will then discuss the necessary action steps, far in advance, enabling you to align your practice with requirements in a proactive and calm environment.
While the rest of outpatient rehab recoils against this daunting program on January 2nd, we want your practice to be comfortable, compliant and positioned to enjoy bonus payments.
The “Links” section below is updated whenever fresh news or content is available from third-party sources.
MIPS CMS 2019 final rule:
APTA Video “Everything You Need to Know About MIPS:
Pop Quiz, are you ready for MIPS?
More Helpful Links:
Finally, “Installments” will grow to 10 discussions. We analyze breaking news with a clear, just-the-facts approach. Sign up to receive updates.
Get Updated on The Newest MIPS Info
Learn more about what each category means;
Learn more about each section and how they affect your clinic.
Systems 4PT is one of the few EMRs that provides integrated patient outcome reporting, at no charge. We also quantify therapist efficiency, (because “Cost” is another component of the MIPS score). While several independent outcome analysis tools are available, they charge by therapist, by month (every month) and are not integrated with EMR.
MIPS’s nickname is “Pay for Progression”. Question: How will you succeed, when competing against other practice’s progression, when your practice has no way to measure its own progression? The answer is, you probably won’t.
Since mid-2018, thousands of rehab practices have been measuring and improving their outcomes. MIPS “is a competition between practices”. If other practices improve more rapidly than yours does (because you can’t measure patient progression), you’ll likely find yourself paying the 7% to 9% takebacks (which are given to the winning practices).
If you want to know which EMR will succeed best with MIPS, simply identify the EMR that provides the data needed to succeed with MIPS.
Systems 4PT is the only EMR that recommends PQRS coding and defensive documentation to the therapist. PQRS was last submitted in 2016. At that time, using a 3 to 7-minute workflow, 60% of the market satisfied PQRS requirements, (40% failed). Whereas, in 2016, 99.3% of Systems4PT therapists complied with PQRS, and our workflow took only 10 seconds.
If you want to know which EMR will perform best with MIPS, simply identify the EMR that has delivered the highest compliance with the components of MIPS. (The answer is Systems 4PT)
Interoperability is the ability to electronically send and receive patient healthcare information with other medical providers. The electronic communication is not sent via fax. Interoperability is push-button submission or retrieval, operating at the speed of light. Therapists can send plans of care, directly to the referring doctor. Or therapists can access surgical reports, imaging, PCP notes, which is displayed on their computer. There’s no lag time associated with “print a document, send a fax, receive a fax, deliver the fax to the therapist”.
Interoperability is an expensive technology which costs many hundreds of thousands of dollars to develop. While most EMRs can’t afford to offer it, Systems4PT interoperability is provided at no charge.
Interoperability is required by MIPS in 2020, however, Systems4PT provides interoperability in 2019. Systems4PT practices will be aggressively communicating to referral sources, “We’re interoperable. We’re fast and easy to work with. It’s time to deemphasize low-tech paper, fax-based practices”. With interoperable communication, referral sources will quickly abandon paper-based practices.
“Improvement Activities” are required by MIPS in 2019. This includes direct, electronic communication from the practice to the patient. Looking at interoperability and patient engagement, it’s obvious that CMS wants all communication to be electronic, and they mean now! Systems4PT Patient Relationship Module satisfies CMS high and moderate-weighted activities. In addition, we leverage this electronic, patient-direct communication with a robust, high-tech marketing capabilities aimed at vastly increasing your direct access patient referrals.
A word of caution: Beware of EMR software that charges extra for their patient relationship module. These nickel-dime-pirates know that the CMS requires patient engagement. Realizing that you have no choice, they force you to pay extra for the technology, swindling you out of thousands of dollars each year! Systems4PT’s Patient relationship module is provided at no charge.
Has your EMR been communicating about MIPS throughout 2018? Systems4PT has been developing MIPS technologies since 2017. As discussed, many of these solutions are expensive, long lead time projects. If your EMR is not clearly communicating how they will measure outcomes and cost, or provide interoperability and patient engagement, then they’re setting your practice up to fail.
At its core, MIPS forces us all to embrace technology. If your low-tech EMR is not on the forefront of these topics, your practice will suffer.
Systems4PT provides the fastest, most-compliant MIPS workflow in outpatient rehab. Our goal is have the highest percentage of MIPS-bonus practices in the industry. We hope you’re part of the celebration!