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Your Ultimate Guide to MIPS, 2018 Edition

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CMS has a way of giving you 1000 puzzle pieces, without giving the clear big picture. This book helps put all the pieces together.

Finally! A decoded, organized, easy-to-read, concise, and detailed reference and teaching tool for MIPS with everything you need to be successful for all physician practices! A must read for practice managers, administrators, executives, or clinicians navigating MIPS, Health IT Consultants and anyone interested in the details of the CMS, Merit Based Incentive Payment System (MIPS).

By Joy Rios

This practical, action-oriented book by Joy Rios, MBA, CHTS-PW (in print or eBook) is a comprehensive guide to all MIPS program categories. This book will help stakeholders navigate the MIPS program and its nuances in easy to understand terms to help achieve MIPS program success.

In the current landscape, it is up to the practice employee to do the research and understand the program. Rather than aggregating all of the information that is available online, let Joy Rios and this book do it for you – using this guide will take the pressure off you and your staff members! You will enjoy a sense of empowerment in being able to take the information in the book and apply it directly to your practice – to have more meaningful conversations with EHR vendors, billers/coders, etc.

Healthcare is moving from a pay-for-service model to a pay-for-performance model. Many – in fact, arguably most – healthcare professionals do not understand how this will happen. Your Ultimate Guide to MIPS, 2018 Edition gives you a full spectrum of content.

Table of Contents

Chapter 1: Welcoming a New Healthcare Paradigm
  • Getting to Know MACRA
  • Making the Transition
Chapter 2: MIPS Overview
  • Eligibility
  • Reporting Options
  • Changes to Scoring by Year
  • Lessons Learned from the Field
Chapter 3: Getting to 100
  • Quality
  • Where Measures Come From
  • Measure Selection Strategy
  • Submission Methods Available
  • CMS-Calculated Population-Based Measures
  • Benchmarking Providers
  • Topped Out Measures
  • Quality Performance Category Scoring
  • Bonus Score
  • Improvement Scoring
  • Calculation of Final Quality Performance Score
  • Scoring Example
  • When Clinicians Don’t Have Enough Measures to Report
  • Publicly Reported Quality Measures
  • Keys to Success
  • Resources
  • Lessons Learned from the Field
  • Advancing Care Information (ACI)
  • EHR Certification Edition
  • Option 1 – 2014 Edition EHR
  • Option 2 – 2015 Edition
  • Option 3 – 2014/2015 Combo Edition
  • Understanding ACI Scoring
  • Base Score
  • Performance Score
  • Bonus Points
  • Composite Score
  • 2014 Edition Scoring Example Table 3-20 2014 Edition certified EHR technology Scoring Example
  • Keys to Success
  • Resources
  • Lessons Learned from the Field
  • Cost
  • Attribution for MSPB Measure
  • Total Per Capita Cost for All Attributed Beneficiaries
  • A Little More About Primary Care Services
  • A Little More About Attribution
  • Scoring
  • Get to Know Your QRUR
  • Episode-Based Cost Measures Coming in Future Years
  • Hierarchical Condition Categories (HCC) and Risk Adjustment Factor’s (RAF) Role
  • Keys to Success
  • Resources
  • Lessons Learned from the Field
  • Improvement Activities
  • List of Improvement Activities
  • Score
  • Keys to Success
  • Resources
  • Lessons Learned from the Field
  • Calculating the Composite Performance Score
Chapter 4: Reporting Your Data
  • Enterprise Identity Data Management Account
  • Quality – A Little More About QRDA-3 Submissions
  • Resources
Chapter 5: Public Reporting

Glossary of Terms
Joy Rios

Joy Rios MBA,CHTS-PW, is a California native who has lived on both coasts of the U.S. as well as in between. She is a health IT enthusiast with a passion for the intersection of technology and sustainability.

In her ongoing pursuit to make sense of the initiatives that are designed to transform our healthcare system to one that rewards quality of care over the quantity of care provided, Joy is sharing her findings and engaging audiences. She has created curricula, trained hundreds of healthcare professionals through online workshops, written for various health IT publications; and Tweets regularly at @askjoyrios. She is currently responsible for training Inform Diagnostics consulting team in the various aspects of MIPS.

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