CMS estimates that approximately 90 percent of eligible clinicians, including providers and provider groups, will choose the MIPS reporting path in 2017 to comply on MACRA*, versus an Advanced Alternative Payment Model (APM) such as a Medicare Shared Savings Program through an Accountable Care Organization (ACO). With the start of the Q1 2018 data submission period fast approaching, eligible clinicians (ECs) should be preparing to report now.
While many providers found success under the former PQRS and Meaningful Use program, significant differences with MIPS mean that past performance does not equal future success. For example, ECs are now required to compete against industry benchmarks to achieve a positive adjustment or even just avoid a negative adjustment; participation alone is no longer “good enough.”
“MIPS is a very dynamic program with increased risk over time and shifting expectations,” explained nThrive Senior Consultant Moshe Starkman. “What was good enough for a positive incentive in payment year 2019 could be a negative adjustment by 2021. In other words, maintaining a status quo approach to reporting could result in a plus one percent adjustment in 2019 but a negative three to four percent in 2021. Successfully navigating MIPS requires a level of performance and scoring comprehension that most practices and even health systems are not adequately prepared for.”
The nThrive MIPS Registry solution takes a holistic approach to quality reporting. Built on top of nThrive’s world-class performance analyzer engine, nThrive provides health care providers with the knowledge and tools necessary to identify areas of opportunity essential to thriving under the Quality Payment Program’s multi-faceted requirements.
From Patient-to-Payment(SM), nThrive provides all the technology, advisory expertise, services, analytics and education programs health care organizations need to thrive in the communities they serve. Formerly known as MedAssets, Precyse and Equation, nThrive is built on a legacy of excellence. Most recently, nThrive acquired two leaders in their fields, Adreima – a provider of patient-centered, clinically integrated revenue cycle services that help patients find coverage and meet their financial obligations – and e4e Healthcare Services – a business process outsourcing company. The five organizations together combine top talent and capabilities in the health care industry into a single enterprise. For more information, please visit www.nThrive.com.
*The Medicare Access & Chip Reauthorization Act (MACRA) was passed in 2015. The CMS Quality Payment Plan (QPP) is the initiative to implement the MACRA law, with MIPS as the predominant scoring path.
Francesca Richards, nThrive
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