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MACRA Insists: Simplify Your Business Processes for High Quality Patient Care (and Better MIPS Scores)



Exceptional MIPS Performance Increases Pressure for Clinicians for MIPS 2019

Healthcare’s shift towards value-based care has made quite an impact on both clinicians and patients—clinicians get Medicare reimbursements for improvement in care processes and health outcomes, and patients get better sooner. Everybody wins right? Healthcare organizations performed exceptionally well in 2017, the first year of the MACRA initiative. A staggering 93% of MIPS eligible clinicians received a positive payment adjustment for their performance in 2017 and only 5% of organizations received a negative payment adjustment in 2019 according to Centers for Medicare & Medicaid Services (CMS).

This only adds pressure for healthcare organizations to meet the more demanding MIPS 2019 performance year changes. The new MIPS 2019 performance category weights include the quality (45%), promoting interoperability (25%), cost (15%), and improvement activities (15%)—their final score will depend solely on the quality and quantity of data reported to CMS on each of these categories. Despite the demanding reporting requirements, there is an incentive to report well on the quality measures in 2019. Clinicians have the opportunity to earn up to a 7% maximum MIPS-based incentive and a potential performance bonus on their service fees.

To satisfy the 30-point threshold and avoid negative payment adjustments in the payout year 2021, clinicians need to report quality measures on each of these categories under the Quality Performance Program (QPP) and fulfill the data completeness criteria. Many fully scheduled clinicians, especially in smaller practices, find the QPP’s reporting requirements very burdensome. Many clinicians report only the bare minimum just to avoid penalties.

HealthcareITNews reports, “Among the biggest complaints: the time required to file reports, the challenge of understanding detailed requirements, uncertainty around how MIPS performance is scored and the financial cost of capturing and reporting quality measures.” To meet the quality reporting demands, many organizations will have to adjust their workflows and business processes moving forward. With ‘quality of performance’ driving 45% of the MIPS scoring criteria in 2019, overlooking any aspect of the healthcare workflows, like outdated technology or slow processes, can be the cause for penalties in 2019.

The Value of Simplifying Business Processes with Secure & Easy-to-use File Transfer Tools

So, what will give back more time to clinicians to meet the demands of the QPP in 2019? Streamlined workflows and more efficient care processes. More time for clinicians equates to better patient outcomes and higher MIPS payment adjustments. By implementing intuitive, highly adaptable and easy-to-use secure messaging and file transfer solutions, clinicians will be able to speed manual care processes involving transferring PHI, and in return have more time to focus on quality patient care. Clinicians will also be able to realize greater rewards with QPP for having more time to spend on reporting data for quality and improvement activities with efficient healthcare workflows.

Many healthcare customers have seen major improvements in their hospital workflows by streamlining document delivery processes involving patient medical records and other HIPAA regulated documents. Massachusetts General Hospital (MGH) significantly streamlined their workflows, giving time back to their clinicians to focus on patient care with Biscom SFT, Biscom’s secure file transfer solution. With MGH having nearly 1.5 million patient visits per year and more than 50,000 accompanying requests for patient records, Mark Haas, Associate Director of Health Information Services realized the significant impact a secure file transfer solution would have on simplifying their business processes and patient record security. After implementing SFT, the hospital experienced a 104% increase in productivity when using SFT to exchange a record as compared to its previous paper-based methods. This translated into significant cost and time savings in all aspects of the hospital’s process, from materials and postage to supplies and personnel.

With the ability to track all confidential document activity using SFT and the capacity to adjust security levels, MGH reduced the potential for error in the file transmission process and improved patient satisfaction by ensuring a critical level of protection for all their patient PII. Simple and secure tools like Biscom’s on-premise and cloud secure file transfer and secure messaging solutions have a major impact on the time clinicians spend on cumbersome patient care processes.

Biscom SFT and Transit for Healthcare

Biscom offers both on-premises and cloud secure file transfer and secure messaging solutions to meet the needs of all enterprise healthcare organizations and small practices. With powerful security measures to meet HIPAA compliance and adhere to Meaningful Use, clinicians can confidently transfer patient records, lab and test results, HIPAA regulated documents, or order prescriptions. Simple and intuitive enough to use without IT intervention, these simple, yet powerful tools streamline hospital workflows, allowing clinicians to focus on quality patient care and coordination, and realize greater rewards for submitting more data to CMS on QPP’s quality measures.

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