As a smaller practice, Grandview Radiology Associates in Sellersville, Pennsylvania, often found it challenging to navigate all of the required paperwork and reporting measures mandated by the Centers for Medicare and Medicaid Services regarding the new value-based care goals and initiatives, though the practice understood and appreciated their importance in the healthcare industry.

THE PROBLEM

“In 2016, we received a penalty notice on our Physician Quality Reporting System submission,” said Karen Beer, office manager at Grandview Radiology Associates.

“Then, when Medicare launched the Merit-Based Incentive Payment System, we knew that we needed to look for experts that could help us ensure our reporting was accurate moving forward, that we were able to receive the incentive bonuses and rewards offered as part of the program, and most important, free up time for our practice to focus on other administrative tasks within the billing department while improving our MIPs score," she explained.

PROPOSAL

That’s when Grandview began looking for vendors to help it and found one called Mingle Health through a partnership with the Pennsylvania Medical Society, also known as PA Med.

“We reached out to our contact at PA Med asking for referrals for a vendor that could help assist us with MIPS reporting and learned about Mingle Analytics, now Mingle Health, and its platform,” Beer said. “They mentioned that the MIPS Solutions platform was the best fit for us and that they’d be able to provide us a dedicated representative that would guide us through getting started and throughout the entire reporting process.”

One compelling point for Grandview was that Mingle offered a concrete, personalized plan to help avoid penalty that also analyzed and improved performance, which was important data for Grandview to extract, especially as a smaller practice with limited bandwidth.

“We also liked that we were able to easily integrate the platform into our existing technology tools and get started with little ramp-up time,” Beer explained.

MARKETPLACE

There are a variety of MIPS reporting systems on the market today. Vendors of these systems include AdvancedMD, Healthmonix, Medisolv, Medusind, Premier and SPH Analytics.

MEETING THE CHALLENGE

Before Grandview began integrating the Mingle platform into its workflow, the practice was pleased to learn that as part of MIPS Solutions it would have a dedicated consultant to guide it through the complex MIPS reporting program and requirements.

“Our consultant, Lisa Morin, created a plan to get us organized and assemble all of our information, explaining the plan to make our submission well ahead of logging into the portal,” Beer said. “Then, once our plan was in place, Lisa got us set up in the Mingle portal. The portal itself was very straightforward and easy to navigate.”

Grandview staff had never attended webinars or hands-on training for MIPS reporting, so it was a completely new experience for all staff, and as a small practice, it had very little time to resource for getting up to speed.

“When it came time to start the reporting process, we would follow the instructions in the portal and enter our data – it was that simple and straightforward,” Beer explained. “We were also able to manage the dashboard on our own to find measures that applied to our practice, complete with descriptions. Lisa then helped us with our quarterly report to see where we could make improvements, correct a few errors via the platform, and select the right measures.”

Grandview staff liked the personal touch because they were able to learn about the reporting process every step of the way. After just a few phone calls and one quarter of data entry, staff reported they felt like, “We’ve got this.” They said they were totally confident of MIPS success.

“Specific dashboard functionality that stood out to me included the ability to review our results directly in the submission dashboard and make edits there,” Beer said. “For example, we were able to see a reporting code that was entered incorrectly and upload correct files to remedy the issue. The ability to do this all from one place saved me so much time and helped immensely with getting organized.”

Mingle also provided quarterly reports throughout the year via the dashboard, so Beer was able to get a status update on how the reporting process was going as things went along, which saved time and helped Grandview better anticipate any additional changes it needed to make.

“I also enjoyed being able to jump on GoToMeeting with Lisa for conference calls where we could share screens and she could watch me go through the dashboard, pointing out any missteps or inaccuracies,” Beer said. “This assisted with the overall learning process and time with her was valuable in ensuring that our report was on track.”

RESULTS

After using the system for its 2017 reporting, Grandview achieved a near-perfect MIPS score of 96.27 – earning 81.27 points in the Quality Performance category and 15 points in the Improvement Activities category.

“We attribute this to both our consultant Lisa and the platform – it was very clear what was needed, the proper format for the data and how data was to be sent,” Beer explained. “The platform helped us catch errors in reporting that we may have never seen on our own. Our coders were using an incorrect diagnostic code that was caught through the MIPS Solutions reporting process and we were alerted so we could fix it, then resubmit.”

It’s thanks to little catches like these in the platform that came together to help Grandview build its score, she added. These incentives ultimately help the practice receive greater returns on each claim, as well as help knowing that the practice is on the right track and avoiding penalties, she said.

“In addition to our MIPS score improving, we also received a positive incentive and bonus as part of our Medicare Part B charges in 2019,” she said. “The knowledge and experience we’ve accomplished with the platform has given us historical data that is now being used to make improvements for 2018 reporting and in the future.”

ADVICE FOR OTHERS

“If you’re receiving penalties or not seeing the results you know you should be on MIPS, invest in a solution like this,” Beer advised. “We found that this gave us a lot of confidence in our reporting outcome and freed us up to focus on other time-sensitive administrative tasks within the billing department.”

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com