Without remote patient monitoring (RPM) services, your Merit-Based Incentive System (MIPS) score might be suffering more than you know. These additional billable services have kept countless clinicians afloat during the public health emergency (PHE), but without an influx of other services, RPM has become crucial to clinicians MIPS scores. To meet the MIPS Quality and Improvement Activity category requirements, clinicians need telehealth to reach remote, vulnerable, and isolated patients.
What is MIPS?
MIPS is used to determine Medicare payment adjustments. Eligible clinicians are given a composite score after reporting the measurements and activities collected during a performance period.
The Center for Medicare and Medicaid Services (CMS) collects these records to calculate your MIPS score. Your MIPS score then determines the payment adjustment that can be applied to your Medicare claims. Clinicians are rated based on four main performance categories:
- Quality
- Improvement activities
- Promoting interoperability
- Cost
Proposed changes to performance category weights for the 2021 performance period
One of the major changes to be made in 2021 relative to the 2020 performance categories is the overall threshold. In 2020, the performance threshold was 60 points. Now, it is being proposed that the threshold be lowered to 50 points. Remote monitoring services may be the key for many providers when attempting to fulfill this performance threshold.
Listed below are the main changes that have been made to each performance category:
Quality
The Quality performance category would be weighted at 40%, which is a 5% decrease from the prior year, 2020.
Improvement activities
The Improvement Activities performance category would be weighted at 15%, resulting in no change from its 2020 status.
Promoting interoperability
The Promoting Interoperability performance category would be weighted at 25%, also resulting in no change from its 2020 status.
Cost
The Cost performance category would be weighted at 20%, which is a 5% increase from 2020.
How can RPM improve your MIPS score?
With the CMS expansion of telehealth services, clinicians can add remote services to their MIPS score and increase their Medicare payment adjustments. This advancement in payment adjustments makes it possible for practices and providers to add all remote services from the duration of the public health emergency to their MIPS scores.
With the rapid evolution of proven and efficient remote care from fast growing remote monitoring companies, clinicians should implement remote services into practices as soon as possible. Not only does RPM provide patients with the proper care without the need for in-person visits, but RPM provides enough additional revenue for clinicians so that they can continue to provide that essential care. Additionally, the integration of artificial intelligence (AI) into RPM will alleviate some of the workload from understaffed practices, therefore helping clinicians achieve their desired scores even when short staffed.
What you need to know about MIPS in 2021
Eligible clinicians may continue to increase their MIPS scores as individual practitioners or as part of a practice, whether that be in person or virtually. In the past, there have been restrictions on the use of the alternative payment model (APM), a payment technique that provides incentive payments in order to deliver high quality and more cost effective care. Now, the mechanisms for APM Entities and MIPS submissions have been expanded to include all types of submission mechanisms.
With all types of payment and submission mechanisms accepted, the future of MIPS scores is wide open and more accessible than ever before. Take advantage of the unique opportunity to provide better and more personalized remote care for your patients while simultaneously improving your MIPS score with RPM.
