Specialty Registries can Help Medicare Providers Increase their Revenue
Psychologists who serve Medicare beneficiaries are eligible (and sometimes required) to participate in the Merit-based Incentive Payment System (MIPS), one of two payment models within Medicare's Quality Payment Program established to incentivize value and quality over volume.
Psychologists are required to participate in MIPS unless they fall under the low-volume threshold (LVT). A psychologist will fall under the LVT if they bill less than $90, 000 or provide care for less than 200 Medicare Part B patients or have less than 200 covered professional services. However, psychologists who want to participate in MIPS to potentially receive reimbursement incentives may opt-in if they meet one of the LVT criteria, such as if they provide over 200 covered professional services.
MIPS reporting can be challenging, especially finding quality measures that are relevant to specific specialties, such as mental and behavioral health. The American Psychological Association (APA) has partnered with Healthmonix via the Mental and Behavioral Health Registry (MBHR), gathering leading experts in the field to develop measures that are evidence-based, address gaps in care, and track patient outcomes. With these measures, psychologists can make MIPS reporting more relevant and less burdensome and improve patient outcomes.
In addition to access to relevant quality measures, the MBHR team at Healthmonix can guide you through the MIPS reporting process including offering tips on workflow, while the comprehensive, user-friendly platform gives you real-time feedback on your MIPS performance to ensure your success and maximize your reimbursement!
Start preparing now to see MIPS ROI despite a harder program in 2022
Psychologists who see Medicare beneficiaries will want to start preparing now for Merit-based Incentive Payment System (MIPS) reporting in 2022. Numerous changes make it more difficult to avoid penalties but increase the potential incentives.
The minimum performance threshold has increased to 75 points from 60 points in 2021. Because of this, it is likely that more providers will be penalized; however, because MIPS is a budget neutral program, incentives will also be at the highest levels for top performers.
So, what steps can you take to maximize your return on investment (ROI)?
- Get the most out of your quality measures by choosing the right measures (consider QCDR and new measures that will yield at least 5 to 7 points).
- Have an internal meeting with your staff to discuss the importance of MIPS in 2022.
- Get the right tools in place: assessment tools or measure documentation checklists, EHR, billing process, and submission platform/registry.
- Start tracking in January using a program like the MBHR that can provide quality measure benchmarks early in the year.
- Track more than 6 quality measures (8-10) and watch their performance. You can eliminate measures throughout the year to optimize your time.
Want help? With the Mental and Behavioral Health Registry, Healthmonix’s quality reporting team guides you through the reporting process, while the comprehensive, user-friendly platform gives you real-time feedback on your MIPS performance.
Measuring quality and increasing MIPS reimbursement in 2022
There is growing evidence for the effectiveness of measurement-based care in reducing symptoms, improving retention, and increasing patient satisfaction with care. Increasingly, demonstrating quality of care is also a requirement for reimbursement for many providers. The Mental and Behavioral Health Registry (MBHR) includes approximately 21 MIPS identified measures and 15 specialty measures, exclusive to the MBHR, for psychologists and other behavioral health practitioners to track patient outcomes, meet quality reporting requirements including those in MIPS, and keep your practice competitive.
The MBHR includes measures to screen for anxiety disorders and report anxiety disorder treatment response. It also includes measures related to impaired functioning, such as sleep quality, pain interference, and social role functioning.
New for 2022 is a suite of quality process measures specifically for neuropsychology and assessment-oriented psychologists. These measures are tailored to an assessment-oriented practice model, and it is essential that reporting on these measures occurs so that they remain available in the registry for future use. These measures include:
- MBHR11: Cognitive Assessment with Counseling on Safety and Risk:
Successful completion of this measure includes cognitive assessment with reporting of results documenting how assessment results informed potential patient safety risks
- MBHR12: Provision of Feedback Following a Cognitive or Mental Status Assessment with Documentation of Understanding of Test Results and Subsequent Healthcare Plan:
Successful completion of this measure includes administration of cognitive assessment with feedback of results to patient/caregiver and corresponding documentation that the receiver of information understood the results of assessment and corresponding recommendations.
- MBHR15: Cultural-Linguistic and Demographic Factors in Cognitive Assessment:
Successful completion of this measure includes administration of cognitive assessment with reporting of results including integration of relevant patient-related cultural and linguistic factors.
- MBHR 16: Comprehensive Cognitive Assessment Assists with Differential Diagnosis:
Successful completion of this measure includes administration of cognitive assessment with reporting of results including clarification of relevant diagnostic factors.
- MBHR17: Improved Efficiency: Time Interval for reporting results of cognitive assessment:
Successful completion of this measure includes administration of cognitive assessment with feedback/reporting of results to patient or other receiver (i.e., caregiver/referral source) within 14 days of completion of the evaluation.
These specialty measures give psychologists and other professionals who use the MBHR more flexibility in reporting patient-reported outcome measures in order to successfully participate in MIPS to receive increased reimbursement. Here are steps to take now to get reporting year 2022 off to a strong start:
- Select measures that fit into your specialty and workflow by exploring the MBHR measures that match up with your patients and provided services
- Determine measures that have smaller denominators
- Identify measures that are not topped out
- Find new measures that you can report as they will yield at least 5 to 7 points:
- MBHR13 Social Role Functioning (7)
- MBHR14 Sleep Quality Response (7)
- MBHR15 Cultural-Linguistic and Demographic Factors in Cognitive Assessment (7)
- MBHR 16 - Comprehensive Cognitive Assessment Assists with Differential Diagnosis (7)
- MBHR17 Improved Efficiency: Time Interval for reporting results of cognitive assessment (7)
- MBHR12 Provision of Feedback Following a Cognitive or Mental Status Assessment with Documentation of Understanding of Test Results and Subsequent Healthcare Plan (5)
- MBHR11 Cognitive Assessment with Counseling on Safety and Risk (5)
Want help? With the MBHR, Healthmonix’s quality reporting team guides you through the reporting process, while the live dashboards and comprehensive platform help identify gaps in care, performance improvement, score optimization, and outlier detection.