Maximize Your 2024 MIPS Performance
Are you prepared for the Merit-Based Incentive Payment System (MIPS) in 2024? Navigating this Medicare performance-based incentive program can be daunting, whether your practice is a seasoned participant or a newcomer. With upcoming reductions in Medicare reimbursement, participation might be more beneficial than ever. If your practice serves Medicare patients and you're uncertain about how to optimize MIPS for your practice, or even where to begin, keep reading for some valuable tips.
This year, take steps to secure a positive payment adjustment under the MIPS Program.
Are you prepared for the Merit-Based Incentive Payment System (MIPS) in 2024?
Navigating this Medicare performance-based incentive program can be daunting, whether your practice is a seasoned participant or a newcomer. With upcoming reductions in Medicare reimbursement, participation might be more beneficial than ever. If your practice serves Medicare patients and you're uncertain about how to optimize MIPS for your practice, or even where to begin, keep reading for some valuable tips.
Guidance Analytics and ImagineSoftware team up to offer Automated Radiology MIPS Reporting Solution — Guidance Analytics
Guidance Analytics™, a leader in automated Merit-based Incentive Payment System (MIPS) reporting, for radiology practices partners with ImagineSoftware™, the leading provider of revenue cycle management technology. Through the partnership, ImagineSoftware will integrate Guidance Analytics’ MIPS reporting technology as a solution for customers to accurately report upon and comply with Medicare’s Quality Payment Program.
NEW YORK, NY | February 19, 2024 - Guidance Analytics™, a leader in automated Merit-based Incentive Payment System (MIPS) reporting, for radiology practices partners with ImagineSoftware™, the leading provider of revenue cycle management technology. Through the partnership, ImagineSoftware will integrate Guidance Analytics’ MIPS reporting technology as a solution for customers to accurately report upon and comply with Medicare’s Quality Payment Program.
At the cornerstone of this partnership, Guidance Analytics and ImagineSoftware offer a comprehensive approach to automating the radiology revenue cycle and MIPS reporting workflows. Leveraging both systems, radiology practices and billing organizations streamline workflows, increase accuracy, and maintain compliance, all producing significant financial impact.
Guidance Analytics’ Managing Member, Brian Gale, MD, MBA commented, “We are excited to enter this partnership with ImagineSoftware and look forward to helping their customers streamline their MIPS reporting process, maximize their MIPS payment adjustments, and help them provide quality outcomes to their patients.”
“Our partnership with Guidance Analytics is evidence of our commitment to driving efficiency and accuracy for our clients, through cutting-edge technology and a strong partner network that match our vision,” states Tim White, ImagineSoftware’s Vice President of Channel Partner Sales. “Between ever-changing volumes, legislative changes, and labor shortages, it is critical for providers and practice administrators to automate workflows for efficient revenue cycle operations, and compliance-maintaining workflows. Together, ImagineSoftware and Guidance Analytics are enhancing radiology practice operations, allowing our clients to focus their time on the quality of the patient experience.”
About Guidance Analytics
Guidance Analytics, the leading provider of automated Artificial Intelligence (AI) solutions for radiology quality management. Our platform includes a state-of-the art AI solution that rapidly evaluates and scores MIPS measures and a dynamic dashboard, DataLUX™, that gives our practices real-time MIPS performance feedback and provides workflow to manage and improve their individual measure scores. Coupled with our consulting sessions we help our radiology practices maximize their MIPS payment adjustments and Break Through the MIPS Reporting Barrier.
About ImagineSoftware
ImagineSoftware™ is the leading provider of revenue cycle management technology, including medical billing automation software and Artificial Intelligence-driven platform. Offering powerful technology solutions for medical billing offices, physician practices, and hospitals for over 20 years, ImagineSoftware™ currently serves more than 75,000 physicians across 43 specialties. ImagineSoftware™ solutions improve financial efficiency, build provider reputation, and ultimately improve the patient experience.
For more information, visit imagineteam.com and follow us on Twitter @ImagineTeam or connect with us on LinkedIn “ImagineSoftware (Technology Partners, LLC)”.
You want a QCDR for MIPS
Radiologists generally have only two MIPS categories available to them. Quality, which comprises 85% of their overall MIPS score and Improvement Activities (IA) for the remaining 15%. Unless they are classified as a small practice of fifteen or fewer radiologists where the reweighting becomes 50% for each the two categories. This puts radiologists in position of relying heavily on their Quality score to contribute to their overall MIPS score.
Radiologists generally have only two MIPS categories available to them. Quality, which comprises 85% of their overall MIPS score and Improvement Activities for the remaining 15%. Unless they are classified as a small practice of fifteen or fewer radiologists where the reweighting becomes 50% for each the two categories. This puts radiologists in position of relying heavily on their Quality score to contribute to their overall MIPS score.
Most practices are only submitting traditional QPP measures to CMS. Unfortunately, there are fewer and fewer QPP measures that are relevant to radiologists. Many of these measures have been eliminated and benchmarks are becoming more and more stringent, yielding fewer points per measure each year.
How can radiologists expand available measures?
The best way for radiologists to add measures is to take advantage of the ACR Qualified Clinical Data Registry (QCDR). The ACR offers twenty-two additional measures designed specifically for radiologists. The ACR's benchmarked measures can earn ten points. More measures are expected to be benchmarked this year.
Guidance Analytics is the best way for radiologists to take advantage of the ACR QCDR Measures
Our AI platform, Velocity MIPS Reporter, automatically analyzes your data and determines MIPS scores for both the ACR QCDR and traditional MIPS QPP measures. Our consultants host regular MACRA optimization sessions during the year to help your practice stay on track to optimize providers’ performance and maximize your Medicare payment adjustment.
Higher 2023 MIPS Penalties is Good News
Prior to 2022, CMS has never penalized more than 3% of all providers. The rules have recently changed. CMS is now required to penalize everyone with below-average scores. In 2022, CMS estimates that approximately 33% of all providers will pay into the penalty pool. In 2023, the number increases to 38%.
Prior to 2022, CMS has never penalized more than 3% of all providers. The rules have recently changed. CMS is now required to penalize everyone with below-average scores. In 2022, CMS estimates that approximately 33% of all providers will pay into the penalty pool. In 2023, the number increases to 38%.
Average scores will get tougher to achieve in 2023. The first five years of MACRA were structured to be easy. Many of those elements have gone away. Bonus points on Quality were eliminated in 2022 and the Exceptional Bonus Pool has been eliminated in 2023. Benchmarks continue to get tougher, and penalty thresholds are higher.
The good news is that the penalty pool is used to fund the payment pool. Radiologists who score above the penalty threshold can earn up to a 9% positive payment adjustment. In 2023, there is real money on the table for higher performing radiologists. However, most practices will need assistance to achieve higher MIPS scores.
Velocity MIPS Reporter uses AI to automatically analyze your data and determine MIPS scores. Our consultants host regular MACRA optimization sessions during the year to help your practice stay on track to optimize providers’ performance and maximize your Medicare payment adjustments.
The CMS 2023 Quality Payment Program Final Rule is Here - Learn What Changes are Ahead for MIPS Reporting
The Centers for Medicare and Medicaid Services (CMS) released the Final Rule changes to the Quality Payment Program for 2023 on November 1, 2022. The rule provides policy updates to the traditional Merit-based Incentive Payment System (MIPS) program and the new MIPS Values Pathway (MVPs) framework.
The Centers for Medicare and Medicaid Services (CMS) released the Final Rule changes to the Quality Payment Program for 2023 on November 1, 2022. The rule provides policy updates to the traditional Merit-based Incentive Payment System (MIPS) program and the new MIPS Values Pathway (MVPs) framework.
2023 Performance Threshold
The proposed rule will continue to use the 75 point performance penalty threshold for the 2023 performance year.
Exceptional Bonus Pool
There will no longer be an additional performance threshold for exceptional performance in 2023. The 2022 performance year is the last year clinicians can earn an exceptional performance bonus.
MIPS Performance Category Weights
There will be no changes to the MIPS performance category weights in 2023. For most radiologists, Quality will continue to be weighted at 85% and Improvement Activities will be weighted at 15%.
For small practices, CMS will continue to automatically reweight Improvement Activities performance categories. Quality and Improvement Activities will each be weighted at 50%.
*non-patient facing radiologists
Improvement Activities Updates
There are no major changes to the MIPS Improvement Activities (IA) category other than updates to the IA inventory. CMS is adding four new activities, modifying five current activities, and removing five existing improvement activities from the IA inventory
2023 Quality Measure Benchmarks:
The following changes in Quality measure benchmarks go into effect beginning with the 2023 performance period:
Measures with a benchmark - The 3-point floor is removed for measures that can be scored against a benchmark. These measures will receive 1-10 points.
Measures without a benchmark - The 3-point floor is removed for measures without a benchmark (except small practices). These measures will receive 0 points (small practices will continue to earn 3 points).
Measures that don’t meet case minimum requirements (20 cases) - The 3-point floor is removed (except small practices). These measures will earn 0 points (small practices will continue to earn 3 points).
MIPS Value Pathways (MVPs)
CMS will make MVPs available for reporting gradually, beginning with the 2023 performance year. However, there will not be any radiology MVPs in 2023.
Presentation: MIPS Overview and Strategies for 2023
Guidance Analytics recently participated in an education session about MIPS, the CMS Final Rule for 2023 and strategies for radiology practices.
Guidance Analytics recently participated in an education session about MIPS, the CMS Final Rule for 2023 and strategies for radiology practices.
The 2023 Quality Payment Program Proposed Rule is Here - Learn What Changes are Ahead for MIPS Reporting
The Centers for Medicare and Medicaid Services (CMS) released proposed changes to the Quality Payment Program for 2023 on July 7, 2022. A 60-day comment period will be open until September 6, 2022. The proposal could undergo additional changes before the final regulation is issued in November.
The Centers for Medicare and Medicaid Services (CMS) released proposed changes to the Quality Payment Program for 2023 on July 7, 2022. A 60-day comment period will be open until September 6, 2022. The proposal could undergo additional changes before the final regulation is issued in November.
2023 Performance Threshold
The proposed rule would continue to use the 75 point performance penalty threshold for the 2023 performance year.
Exceptional Bonus Pool
There will no longer be an additional performance threshold for exceptional performance in 2023. The 2022 performance year is the last year clinicians can earn an exceptional performance bonus.
MIPS Performance Category Weights
CMS is not proposing any changes to the MIPS performance category weights in 2023. For most radiologists, Quality will continue to be weighted at 85% and Improvement Activities will be weighted at 15%.
For small practices, CMS will continue to automatically reweight Improvement Activities performance categories. Quality and Improvement Activities will each be weighted at 50%.
2023 Quality Measure Benchmarks:
The following changes in Quality measure benchmarks go into effect beginning with the 2023 performance period:
Measures with a benchmark - The 3-point floor is removed for measures that can be scored against a benchmark. These measures will receive 1-10 points.
Measures without a benchmark - The 3-point floor is removed for measures without a benchmark (except small practices). These measures will receive 0 points (small practices will continue to earn 3 points).
Measures that don’t meet case minimum requirements (20 cases) - The 3-point floor is removed (except small practices). These measures will earn 0 points (small practices will continue to earn 3 points).
New measures- New measures are subject to a floor of 7 points in the first year and 5 points in the second year.
MIPS Value Pathways (MVPs)
CMS will make MVPs available for reporting gradually, beginning with the 2023 performance year. However, there will not be any radiology MVPs in 2023.
Click below to read the ACR Preliminary Summary of Radiology Provisions in the 2022 MPFS Proposed Rule
Can I take an automatic MIPS exemption in 2022?
CMS continues to offer an Extreme and Uncontrollable Circumstances Exception in 2022. In prior years, they provided an automatic exemption to all providers who didn't report. In 2022 the exemption is no longer automatic. Providers must demonstrate that they've been affected by extreme and uncontrollable circumstances that impact their MIPS performance categories.
CMS continues to offer an Extreme and Uncontrollable Circumstances Exception in 2022. In prior years, they provided an automatic exemption to all providers who didn't report. In 2022 the exemption is no longer automatic. Providers must demonstrate that they've been affected by extreme and uncontrollable circumstances that impact their MIPS performance categories.
We have been advising practices to consider that 2022 will be the best year in the history of MIPS to earn real money. With the exceptional bonus pool set to expire for 2023, and the expectation that 40-50% of all providers will be penalized, the pool of money available for positive payment adjustments is more significant. You should consider claiming your fair share.
Velocity MIPS Reporter uses AI to automatically analyze your data and score MIPS and ACR Quality measures. Our consultants will provide your practice with MACRA optimization sessions throughout the year. We will help your practice stay on track to optimize providers’ performance and maximize your Medicare payment adjustments.
Let Guidance Analytics:
Analyze your radiology practice's MIPS performance
Provide a financial projection of your 2022 payment adjustment
Are Higher 2022 MIPS Penalties Good News?
Prior to 2022, CMS has never penalized more than 3% of all providers. The rules have changed this year. CMS is required to penalize everyone with below-average scores. This means that nearly 50% of all providers will pay into the penalty pool.
Prior to 2022, CMS has never penalized more than 3% of all providers. The rules have changed this year. CMS is required to penalize everyone with below-average scores. This means that nearly 50% of all providers will pay into the penalty pool.
Average scores will get tougher to achieve in 2022. The first five years of MACRA were structured to be easy. Many of those elements go away this year. Bonus points on Quality have been eliminated, benchmarks get tougher, and penalty threshold are higher.
The good news is that the penalty pool is used to fund the payment pool. Radiologists who score above the penalty threshold can earn up to a 9% positive payment adjustment and benefit from the bonus pool. In 2022, there is real money on the table for higher performing radiologists. However, most practices will need assistance to achieve higher MIPS scores.
Velocity MIPS Reporter uses AI to automatically analyze your data and determine MIPS scores. Our consultants host regular MACRA optimization sessions during the year to help your practice stay on track to optimize providers’ performance and maximize your Medicare payment adjustments.
VIDEO: Where we are with MIPS and MACRA in radiology
A review and update for the Centers for Medicare and Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS). Published by Radiology Business.
A review and update for the Centers for Medicare and Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS). Published by Radiology Business.
West County Radiological Group Signs Agreement with Guidance Analytics for Velocity MIPS Reporter™ and Velocity Follow-up Manager™
NEW YORK, NY, February 23, 2022 – Guidance Analytics, provider of automated Artificial Intelligence (AI) solutions for radiology quality management announced today that it has signed an Agreement with West County Radiological Group, a leading radiology practice in Saint Louis County, MO for the full suite of Guidance Analytics’ solutions
NEW YORK, NY, February 23, 2022 – Guidance Analytics, provider of automated Artificial Intelligence (AI) solutions for radiology quality management announced today that it has signed an Agreement with West County Radiological Group, a leading radiology practice in Saint Louis County, MO for the full suite of Guidance Analytics’ solutions:
Velocity MIPS Reporter™
Radiology practices must review hundreds of thousands of radiology reports in order to comply with Medicare's Quality Payment Program (QPP), which has significant financial impact. Manual review can be inaccurate, slow, and expensive. Guidance Analytics offers an automated AI solution, Velocity MIPS Reporter™ to evaluate radiology reports rapidly and accurately to determine the Merit-Based Incentive Payment System (MIPS) scores. The solution provides interim feedback, enabling providers to improve their performance during the year.
Velocity Follow-up Manager™
The process to schedule recommended follow-up imaging exams is fraught with challenges. As many as 35% of these exams are never scheduled. Velocity Follow-up Manager™, is a solution that closes the loop on these missed procedures, reclaims lost revenue and mitigates the potential patient liability from missed appointments.
“Guidance Analytics is our first partner chosen for its AI capabilities. With the changes in MIPS quality measures, it was imperative to find a partner who could take the burden off our coders, maximize our MIPS scores, and ensure we are providing quality care for our patients,” stated Carol Hamilton, Practice Administrator at West County Radiological Group.
Guidance Analytics’ Managing Member, Brian Gale, MD, MBA commented, “We are excited to partner with West County Radiological Group and look forward to helping them maximize their MIPS payment adjustments as well as help them provide quality outcomes to their patients.”
About West County Radiological Group
West County Radiological Group (WCRG) is the largest private radiology practice in the St. Louis area. Since 1969 they have been serving the Saint Louis area and other regions in Missouri through their partnership with the Mercy Health System. Their practice areas include radiology, nuclear medicine, interventional radiology, stroke, and radiation oncology. WCRG also has a fully staffed medical physics group providing diagnostic and radiation therapy services for a variety of facilities throughout Missouri. For more information, please visit https://westcountyradiology.com/.
Guidance Analytics to showcase solutions at RSNA 2021
Guidance Analytics, LLC today announced it will be showcasing their two solutions at the Radiological Society of North America (RSNA) 2021 Annual Meeting, Velocity MIPS Reporter and Velocity Follow-up Manager. Using advanced Artificial Intelligence (AI) algorithms and deep industry experience, these solutions streamline workflows for radiology organizations.
Guidance Analytics, LLC today announced it will be showcasing their two solutions at the Radiological Society of North America (RSNA) 2021 Annual Meeting, Velocity MIPS Reporter and Velocity Follow-up Manager. Using advanced Artificial Intelligence (AI) algorithms and deep industry experience, these solutions streamline workflows for radiology organizations.
Velocity MIPS Reporter automatically processes radiology reports to score and submit Merit-Based Incentive Payment System (MIPS) Quality measures. This AI-powered solution has overall accuracy of over 99% and runs multiple times throughout the year. This feedback enables providers to improve performance during the reporting year to improve their MIPS scores. They have been certified by the American College of Radiology (ACR) to electronically submit quality measures data to the National Radiology Data Registry (NRDR).
Velocity Follow Up Manager scans radiology reports for pending follow up imaging recommendations. This enables practices to close the loop on incomplete imaging workups. This helps prevent scheduling leakage, reclaim lost revenue, and mitigate liability that could arise from lost follow-up procedures. The solution is HIPAA compliant and uses best in class security configurations.