Up until last year, avoiding a MIPS penalty was relatively easy.  Combined with the fact that the bonus payments were small (less than 2%), many practices have taken a “no big deal” approach to MIPS reporting.  Things are changing for 2020; the threshold to avoid this year’s penalty (a whopping 9%) is now 45 points, many of the measures you’ve used in the past are now “topped out” and the threshold to get an extra bonus is 85 points.  This webinar will tell you the five things you need to know for 2020 and suggest strategies for succeeding in 2020.

  1. The MIPS Performance Threshold has increased: To avoid a negative payment adjustment as a result of the 2020 performance year, MIPS eligible clinicians will be required to earn a minimum of 45 points. Those who earn less than 45 points may be subject to a 9% payment adjustment when payment adjustments are released in 2022. MIPS eligible clinicians aiming for the exceptional performance adjustment will need to earn a minimum of 85 points during the 2020 MIPS performance year.
  2. Some of the measures you used in 2019 may not work for 2020.  Many practices have reported on the same measures for the past few years.  For 2020, some of these measures have been identified as “topped out” by CMS and even a 100% performance rate will earn you only a few points.  Did you report on Fall Risk for 2019?  It is now topped out at 3 points for 99.9% performance.  Documentation of Current Medications is now topped out at 7 points for a perfect performance. With the combination of reduced point score and increased thresholds to avoid penalty, practices are well-advised to re-examine their measure selection.
  3. The MIPS Performance Categories are weighted the same as 2019: Rather than shift the weighting of the performance categories, as was suggested in the Physician Fee Schedule proposed rule, CMS has chosen to retain the performance category weightings established during the 2019 performance year. The weighting of the MIPS performance categories will be as follows:
    a. Quality: 45%
    b. Cost: 15%
    c. Promoting Interoperability: 25%
    d. Improvement Activities: 15%
  4. You now have more flexibility (and tools) for reporting.  There are new tools in the market that use AI and ML to “read” the patient chart and extract data needed for measure reporting. Join our webinar on Feb 20th to see one of these tools in action.
  5. MIPS Value Pathways will start in 2021: Get involved. CMS has decided to move forward with MIPS Value Pathways, a conceptual framework that will allow MIPS eligible clinicians to participate through an aligned set of measure options that are more relevant to their specific scope of practice. Make sure that you and or your specialty society is engaged in the selection of these measures.  CMS tends to assume that all practices are hospital-owned. MIPS Value Pathways will be officially introduced as a participation option in the 2021 performance year.

Want to learn more?  Sign up for Somerset’s Avoid the 9% Penalty: Five Things You Need to Know about MIPS for 2020 webinar on Thursday, February 20th at 1pm ET.


We Can Help
Mapping your strategy and priorities across technology applications is as much art as it is science. Contact us at 317-472-2200 or to help determine the best technology portfolio for your practice. We can help you brainstorm ways to align your IT capabilities with your strategic and operations business priorities.

Karen L. Clark, CPHIMS, FHIMSS
317.472.2241 (o)
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