With talk around MIPS only getting louder, there are a lot of PTs left wondering what all the commotion is about. Afterall, for over 90 percent of physical therapists, reporting for MIPS in 2019 was optional. You could chalk up the program as just another reporting burden, but the question remains, is that wise?
Given that you can participate in MIPS as long as you meet one of its three key thresholds (care for at least 200 Medicare beneficiaries; have $90,000 in allowed charges for covered services; or provide at least 200 such services under the Medicare Physician Fee Schedule), what do you stand to lose by not opting in?
Here are our top three reasons to participate in MIPS – even if you’re not required.
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MIPS provides you a chance to improve your practice and patient care.
Most PTs are in the profession for a reason: to make a real difference in patients’ lives. On top of everything else, participation in MIPS incentivizes providers to take a critical look at their practice and the assumptions they’ve made about how it should run. Think of MIPS as a push in the right direction—toward efficiency and quality, but also toward things like better patient engagement, and even toward administrative improvements like better data collection.
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It provides an opportunity to prepare for the shift to advanced payment models.
Plain and simple, by the year 2022 all Medicare providers will be required to participate in the Quality Payment Program (QPP). MIPS is designed as a hybrid program — a combination of fee-for-service with quality incentives. The long-term goal of CMS, however, is to move all providers to alternative payment models (APMs) where reimbursement depends entirely on care quality and cost-efficiency. PTs who decide to not participate in MIPS may miss their only chance to make that transition gradually.
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Your MIPS score can earn you a role in the self-insured market.
More and more employers are taking part in the self-insured market as it gives them flexibility in customizing plans to meet the specific healthcare needs of its workforce, among other benefits. With low back pain so prevalent in America’s workforce, many employers are looking to physical therapists in their communities to provide care to their employees and prevent both absenteeism and presenteeism in the workplace. How are employers choosing the physical therapists for their provider networks? Through available data like MIPS scores which can indicate the PTs who provide the most effective care. Decide to sit on the MIPS sidelines and you could be missing out on this huge opportunity.