RCM tip of the day: Consider 2018 MIPS final performance categories

Final performance categories under the Medicare Access and CHIP Reauthorization Act's Merit-based Incentive Payment System should be a key focus for hospital revenue cycle leaders going into the New Year, according to Joncé Smith, vice president of revenue cycle management at Stoltenberg Consulting.

Ms. Smith shared the following tip with Becker's Hospital Review.

"Starting in 2018, the MIPS final performance categories will shift not only in weight, but also some of the categories will require additional reporting data than was previously expected. The weight for each performance category will be: Quality (50 percent), Improvement Activities (15 percent), Advancing CARE Information (25 percent) and Cost (10 percent).

"Eligible or not for 2018 reporting — revenue cycle leaders should pay close attention to the new requirements for both Cost and Quality. For example, Cost's weight in the final MIPS score is the most significant shift revealed by CMS for 2018. Previously, it was expected to still weigh in at 0 percent of the final score. By 2019 (the 2021 payment year), CMS plans to increase cost to 30 percent of the total performance score. For 2018, it's also important to note that both Cost and Quality require an entire year of reporting. The best way to respond to these changes is to collaborate with a cross-departmental team that can identify needed initiatives to ensure the organization can maximize its reimbursement."

If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series. 


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