An eyecare practice sought expert guidance from VMG Health, formerly BSM Consulting, to navigate the Centers for Medicare & Medicaid Services’ (CMS) Quality Payment Program (QPP). The practice desired to maximize its performance in the mandated Merit-Based Incentive Payment System (MIPS) arm of the QPP. As a proactive, multi-location practice with a new administrator unfamiliar with MIPS, they aimed to avoid penalties while setting themselves up for long-term success.
Situation
The practice recognized that MIPS had the potential to significantly impact their reimbursement. The physician and administrator requested support from VMG Health, to increase their understanding of MIPS and to ensure the practice was positioned for reporting success. Though astute and motivated, the new administrator needed training in the complexities of MIPS, including timelines, workflows, and performance of measures. Their immediate goal was to avoid penalties, while their long-term goal was to achieve the highest possible incentives under the program.
Solution
VMG Health began with an introductory call to assess the practice’s MIPS knowledge and readiness. Then, it facilitated webinar training and provided resources to help the team understand MIPS measure requirements and establish a successful reporting framework. Ongoing, monthly follow-up calls addressed QPP processes, compliance deadlines, and practice and EHR workflows, with regular updates and reminders provided to ensure timely reporting. As CMS released MIPS scores, VMG Health reviewed the results, offering clarity and improvement strategies, which strengthened data-tracking processes and set the practice up for sustained success.
Success
With VMG Health’s guidance, the practice significantly improved its overall MIPS composite score, which includes practice performance of measures in each of the Quality, Promoting Interoperability, and Improvement Activities categories, as well as an understanding of how to affect the Cost category outcomes, avoiding penalties and earning program incentives. The practice continues to perform well in the MIPS program and sees ongoing improvement through regular consulting for support and expertise throughout the year. Over time, they achieved their initial goal of avoiding reimbursement penalties and became high performers in the program. Their commitment to understanding and mastering MIPS allowed them to reach exceptional performer status during the years it was available.
Even as the team members responsible for MIPS reporting changed, VMG Health ensured continuity by providing training and support to new staff. Today, the practice continues to perform well in the MIPS program and maintains regular communication with VMG Health to stay updated on program changes and ensure compliance with future reporting cycles.
