Docs risk reputation damage by reporting minimal MIPS data
This year, physicians can avoid a payment penalty in the Medicare Quality Payment Program by simply submitting a minimal amount of data. But that small amount of data could cause a bigger problem in 2019.
In the first year of the program, under the Medicare Access and CHIP Reauthorization Act (MACRA), physicians can ease their way into the program requirements. Under MACRA’s Merit-based Incentive Payment System (MIPS), physicians can submit as little as one quality measure improvement activity for any time period in 2017 and avoid a financial penalty. The more data they submit, the more potential to earn a payment incentive.
Further reading: How to succeed under MIPS
Data entered for 2017 for quality (60% of a physician’s overall score), advancing care information (25%) and clinical improvement activities (15%) will affect 2019 reimbursement under the program. Not submitting any data will result in a 4% payment penalty two years from now.
So while easing into this new realm of value-based care and quality metrics may seem attractive to physicians still figuring things out, Tom Lee, PhD, MBA, chief executive officer and founder of software solution provider SA Ignite warns physicians to maximize their efforts.
Speaking at the American College of Physicians (ACP) conference in San Diego, Lee said this is because part of the Medicare Quality Payment Program lets the Centers for Medicare & Medicaid Services (CMS) publish each physician’s annual score (as well as scores for all participating physicians) on its Physician Compare website. Furthermore, it will also share that data with other third-party ratings sites including HealthGrades, Yelp and Google.
“Don’t lose track of this,” Lee warned. “That score will be in the public domain even if you are just simply trying to avoid a payment penalty [in 2019 by testing out the program’s data requirements].”
That means patients and others will see physicians’ scores online, likely without the context included. So a low score, either due to poor performance or just simply doing the bare minimum to meet quality metric requirements will essentially look the same.
And, Lee noted, the score follows physicians who switch organizations--becoming, in essence, a part of that physician’s permanent file. That reputational damage alone could affect mergers and acquisitions, contracting and other evaluations of the physician.
“[MACRA] is a competitive program,” said Lee. “All the scores, out of 100, for you and other physicians will be published on Physician Compare for everyone to see.”