MIPS Consulting & Quality Improvement Services
Maximize Scoring Opportunities and Avoid Penalties with Expert MIPS Consulting Services
Our quality consulting empowers you with access to knowledgeable experts and industry leading best practices – to maximize merit-based incentive payments (MIPS) and other incentives, so your team can focus on their day-to-day responsibilities.
Facing quality issues like these? We can help.
Administrative Burden
We help your practice develop an effective strategy leveraging medical devices and technology, enabling better patient care coordination, data collection, and outcomes measurement. This prevents administration from being overworked.
Lack of Organization
We offer a concise assessment summary, presenting actionable MIPS performance recommendations to guide and refine your performance objectives, ensuring organizational coherence.
Underperformance
Through our quality consulting services, we assist in meticulously selecting and enhancing clinically relevant quality measures. Our goal is to consistently elevate your performance standards.
Complex Requirements
We stand ready to address your needs, offering tailored guidance and insights. Our expertise ensures you navigate the demands of your field with clarity, confidence, and a deep understanding of your needs.
MIPS Made Easier with Medical Advantage
We keep track of deadlines and requirements, so you do not have to worry about missing important deadlines or losing out on incentives. Quality-based incentive payment system regulations and requirements are constantly evolving – at least once per year – and organizations just like yours find it difficult to keep up with the changes. Medical Advantage has a goal to see more organizations be successful with MIPS, and our consulting team is committed to monitoring all the changes and updates that come along to ensure that our clients stay informed and compliant.
Reporting
Reporting to a qualified registry is a significant component of MIPS compliance, and it can be a daunting task for healthcare providers. Our MIPS solution includes support with implementing quality systems for reporting, filling out forms, and submitting data efficiently to avoid any errors.
Documentation
MIPS documentation can be extremely complex, and it might be challenging to understand all the changes and complexity of regulations. Our team of MIPS consulting experts can help you make sense of new documentation in simple terms, and ensure you are doing everything by the book.
Compliance
MIPS compliance is crucial for healthcare providers, as it can lead to penalties or missed incentives. Our team of experts can help you develop a comprehensive MIPS plan so that you can be confident that you are compliant with every regulation. Achieving compliance helps our clients earn more in incentives.
Benefits of Quality Consulting
Our MIPS consultants work with you to develop a strategy that maximizes your performance and Medicare payments:
Proven Performance
Our clients outperform the national average in MIPS scores and are among the program’s top performers, often receiving CMS’ Exceptional Performer status.
One-on-One Attention
We work closely with your team to meet practice- and program-specific measurers.
Knowledgeable Consultants
Our consultants have a wide breadth of knowledge in federal programs and healthcare best practices that empower us to lead organizations to success in MIPS.
Increased Revenue
Our MIPS solutions include guidance to maximize your incentive opportunities and avoid penalties.
Burnout Relief
Clear direction and feedback to providers and staff allows them to focus less on “checking boxes” and more on patient care quality.
Higher ROI
With a clear and aligned strategy across programs, our MIPS solutions prioritize efforts on high-yield activities.
Proven Success Through Hands-On Support
Our consultants are experienced healthcare professionals with a track record of delivering clients results. Read for yourself.
Subject Matter Experts Bringing Hands-on Experience from Hundreds of Practices
We have spent two decades working with physicians and practices to help improve patient care, quality, efficiency, profitability, and compliance. Our consultants readily apply a seasoned clinical and administrative point-of-view to quickly identify improvement opportunities for quality score performance.
Are you taking full advantage of your participation in…
- MACRA / QPP / MIPS
- CPC+ and Primary Care First
- Alternative Payment Model (APM) Participation
- Patient Centered Medical Home (PCMH)
- Healthcare Effectiveness Data and Information Set (HEDIS)
- Commercial Programs
- Medicare Stars
Medical Advantage’s consultants can help you achieve top performance for your organization in these areas and more.
Talk to one of our experts today
Frequently Asked Questions About MIPS Consulting
What are the Four Categories for MIPS Reporting?
1.) Quality: The Quality category assesses the quality of care provided by measuring various aspects of patient care, clinical outcomes, patient safety, and care coordination.
2.) Promoting Interoperability (formerly Advancing Care Information): This category focuses on the use of certified electronic health record technology (CEHRT) to promote the exchange of health information and improve patient engagement.
3.) Improvement Activities: The Improvement Activities category assesses providers’ efforts to engage in activities that improve clinical practice and patient care. These activities can include initiatives related to care coordination, beneficiary engagement, population health management, and other ways of enhancing the overall quality of care.
4.) Cost (formerly Resource Use): The Cost category evaluates the cost of care provided by healthcare providers. It assesses the resources used for specific episodes of care and compares them to national benchmarks.
What Are the MIPS Measures?
Quality Performance — This performance category requires quality reporting for healthcare professionals in least six quality measures, including one outcome measure, covering different domains of care.
Distribution of Promoting Interoperability Performance —To fulfill this category successfully, healthcare providers must achieve a certain score by fulfilling a set of required measures focused on the use of certified electronic health record technology (CEHRT).
Distribution of Improvement Activities Performance — This category aims to improve patient outcomes and patient experience of care with a weight of 15% of the total MIPS score.
Category Distribution of Cost Performance — This quality payment program is not required for participation as CMS will automatically calculate the score based on the Medicare claims data. However, it is up to healthcare providers to ensure that the care they provide is both cost-effective and of high quality.
Who are eligible clinicians for MIPS?
Eligible clinicians for MIPS are those who provide a certain level of service to Medicare patients. Physicians, physician assistants, clinical nurse specialists, nurse practitioners, and other health care professionals may be eligible.
What is the penalty for MIPS in 2023?
The penalty accessed for not meeting the performance threshold for MIPS PY2023 is -9% which will be applied to Medicare Part B claims/allowed charges beginning Jan 1, 2025. Penalties are always two years post the performance reporting year.
