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MIPS: Closing Out 2018 & Reviewing the Changes for Performance Year 2019 for Pathology

APS recently signed-off on the 2018 MIPS data that will be submitted on behalf of our clients to CMS in time for the April 2, 2019 deadline as required by the Quality Payment Program (QPP).  In order to closely monitor progress and work with our clients to ensure that optimal performance is being achieved, APS directly contracts with a qualified data registry to maintain the required data for each category of MIPS, as well as performing a continuous cycle of analysis of the data being submitted under the quality category throughout the performance year.

This means that APS is actively working on our clients’ MIPS data year-round in preparation for the annual deadline to CMS.  We create an ongoing cycle of uploading our client’s quality data to the registry for analysis.  The return results are individually reviewed by APS staff to monitor progress, confirm coding accuracy, and identify any needed follow-up with clinicians for additional documentation.  This allows us to make appropriate updates in near-real time; the cumulative data is then re-uploaded for processing and the cycle begins again.  To provide a sense of the volume created by this process, over 100 million cumulative patient accounts were analysed on behalf of our clients in the 2018 performance year.

2019, year 3 of the MIPS program, brings some changes.  Some of those changes reflect CMS’ efforts to reduce physician burden associated with the data collection and reporting required of MIPS.  On the other hand, some of the requirements have been made more challenging.  In fact with the increased rules this year, CMS is predicting a median score of 78.72 in 2019 which is 11.5% lower than the median score of 88.97 in performance year 2017.  Please review the below PDF for details on the changes.

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APS stepped in and took control of the transition and generated normal collections in our second month, improving billing, which is a huge accomplishment for our business.

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