By Jim Tate, EMR Advocate
MACRA/MIPS Subject Matter Expert
Twitter: @JimTate, eMail: jimtate@emradvocate.com
I sure hear a lot about fake news these days. In the world of politics, we hear a constant chant: “This is fake, that is fake, everything is fake”. I guess it is in the eye of the beholder as to what is true. There is the whole truth, the partial truth, misstatements of fact and downright Pinocchio lies. One person’s lie is another’s truth. I guess it has always been that way in politics. So, what does this have to do with MIPS?
Accurate information is critical for anyone affected by the CMS MACRA/MIPS program. My Dad used to say, “you can’t know the players without a scorecard”. With just a slight twist of that phrase we have, “You can’t succeed in MACRA/MIPS without accurate information”. There is just too much at stake to allow fake news related to MIPS to take one down the wrong road. I have run across three categories of what I call MIPs Fake News.
- Old information: What once was true is now false. Using search engines to find MIPS information can be extremely hazardous to your MIPS health. This morning I googled “MIPS information” and received over 16,000,000 results. On the first page there were links to information, even from CMS, that was 18 months old. With all the proposed rules, final rules, and updates it is obvious there is a lot of stale news out there. It was true at one time, but no longer. Beware.
- Misinformation: This category of fake news comes from those folks who just don’t know what they are talking about. It could be about group vs. individual reporting, submission options, or even selection of appropriate quality measures selection. Decisions based on their pronouncements can be like a time bomb with a long fuse. Based on the two-year delay between performance periods and reimbursement periods the effects of their advice may not arise until well down the road. When those chickens come home to roost it can be hell to pay.
- Partial information: This is perhaps the most insidious type of MIPS fake news. It has a modicum of truth but not the whole truth. A perfect example is the widespread advice from associations, vendors, and even consultants to choose the Test Option in 2017 and thereby “avoid a downward payment adjustment.” Sounds like great advice but only rarely is the downside of this option revealed. You will end up with a public MIPS score of 3 out of 100. Not too good on your professional reputation.
What to Do: Treat MIPS information like you were filing taxes. You want to make the best decisions based on the most current, complete, and accurate information. If you see the value in a MIPS consultant make sure you perform your due diligence. Are they a Johnny-come-lately? Look for help with someone who has a long track record in Meaningful Use and PQRS. Pretty simple, but pretty important.
This article was originally published on MIPS Consulting Blog and is republished here with permission.