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Merit-based Incentive reporting

3C leverages your Chronic Care Management (CCM) program to incorporate and report on care quality activities that help increase your Merit-based Incentive Payment System (MIPS) score. 

Analytics with a purpose.

As part of the Centers for Medicare and Medicaid Services’ (CMS) Quality Payment Program (QPP), MIPS is a quality payment incentive program that drives improved healthcare outcomes and reduces costs. MIPS is measured by four performance categories:

  • Promoting Interoperability (formerly Meaningful Use)
  • Quality (replaces PQRS)
  • Improvement Activities
  • Cost (replaces VBM)

3C sets this as a standard to identify the various gaps within your practice and the care you deliver. Thru artificial intelligence 3C consistently learns from these gaps so providers have better visibility on how to provide a more efficient and effective style of care than ever before. 

Check your MIPS eligibility HERE by just entering your NPI on the Quality Payment Program (QPP) website to determine if you are an eligible clinician.

INSIDE MIPS

Achieve Your Goals Strategically

 

For patients with complex and chronic conditions, MIPS sets the standard and playbook for quality healthcare. The 3C Platform integrates with your EHR (electronic health record) to instantly identify those gaps then our clinical team closes them for you. For example:

Reduce readmissions.

Machine learning can reduce readmissions in a targeted, efficient, and patient-centered manner. Clinicians can receive daily guidance as to which patients are most likely to be readmitted and how they might be able to reduce that risk.

Predict propensity-to-pay.

Identify who needs reminders or financial assistance then predict their likelihood of payment changes over time and after particular events.

Reduce hospital Length-of-Stay (LOS).

Health systems can reduce LOS and improve other outcomes like patient satisfaction by identifying patients that are likely to have an increased LOS and then ensure that best practices are followed.

Reduce 1-year mortality.

Health systems can reduce 1-year mortality rates by predicting the likelihood of death within one year of discharge and then match patients with appropriate interventions, care providers, and support.

Predict no-shows.

Health systems can create accurate predictive models to assess, with each scheduled appointment, the risk of a no-show, ultimately improving patient care and the efficient use of resources.

Prevent hospital acquired infections (HAIs).

40% of patients with central-line associated bloodstream infections (CLABSIs) die. By predicting which patients with a central line will develop a CLABSI, clinicians can monitor high-risk patients and intervene early.

Predict & prevent chronic disease.

Machine learning can help hospital systems identify patients with undiagnosed or misdiagnosed chronic disease, predict the likelihood that patients will develop chronic disease, and present patient-specific prevention interventions. 

2020 MIPS Categories

Quality (Formerly PQRS)
Quality is the largest required category, including 218 available measures. Providers are required to report on 6 measures, including one high-priority or outcome measure.

Promoting Interoperability (Formerly Meaningful Use)
Promoting Interoperability includes 11 measures across 4 categories. Providers must report on all 4 categories with a minimum of 7 measures. Five are required measures, and the remaining 2 must report on public health registries or clinical data registries.

Improvement Activities
This performance category has 105 measures in 2020. Providers must a combination of medium and high weight activities to total 40 points. All providers who provide a CCM program through ChartSpan automatically receive the full 40 points for this category.

Cost
Cost is calculated by CMS and will be based on Medicare claims.

Substantial Financial Consequences

Providers have up to 9% of their total fee-for-service reimbursements at risk during the next 36 months, resulting in annual decreased or increased reimbursements.

In 2020, the performance threshold is 45, up from 30 last year. Physicians under that level will receive a negative payment adjustment of their Medicare Part B payments.

Physicians whose performance meets or exceeds a final score of 85 points (known as the exceptional performance threshold) will be eligible for an additional positive payment adjustment of their Medicare Part B payments for exceptional performance.