4 big business benefits of MIPS participation

When Medicare created the Merit-based Incentive Payment System, its goal was to drive improvements in patient health outcomes. Today, however, it’s not just patients who are benefiting from MIPS—providers are reaping gains from the program as well.

Even better, among those providers, physical therapy practices in particular have found that MIPS can help boost the bottom line. We reached out to one of those practices—Physical Therapy Central in Oklahoma—and spoke with chief executive officer Janie Taylor, PT, CPT, OCS, about the impact the program is having on her business.

1. MIPS payments are a bonus.

Physical Therapy Central, like many PT practices, has voluntarily opted to participate in MIPS since 2019. So why would any clinic choose to take part in a program that usually requires additional record-keeping and reporting? One reason has to do with reimbursement, Taylor says.

At one point in 2020, she explains, there was fear that the final 2021 Medicare Physician Fee Schedule would include a 9 percent cut to payments for physical therapy services. That cut was eventually reduced to something closer to 3 percent, but either way, the message was clear and consistent with what the agency had been saying for years: Medicare is moving toward value-based payment models, and fee-for-service care is on its way out.

With MIPS, Taylor’s practice is eligible to earn a Part B payment adjustment of up to +9 percent. Participation has meant they’ve had to show they’re providing great care while controlling costs, she says, “but this is how we’re going to keep our doors open—by accepting accountability for our patients and their outcomes.”

2. Participation is good practice for future value programs.

While MIPS participation makes financial sense now, it’s also an easy and low-risk way to see what value-based care is all about. The program is just one of many similar payment initiatives launched by public and commercial payers in recent years, and now a growing number of self-funded employers are joining the rush as they try to control their own healthcare costs. By mastering the “value mindset”—and data-collection and reporting—required for success in MIPS, Taylor notes, her practice is gaining a world of experience it’s going to need later in other value programs.

3. It helps improve everything from workflows to recruiting.

While Physical Therapy Central has had to invest in a number of digital tools to participate in MIPS, these solutions have more than paid for themselves. “Technology isn’t a solution for everything, but used in the right way, it can be a big help,” Taylor says.

Their patient engagement platform, for example, allows the practice to communicate with clients when they’re not in the clinic. That’s improved compliance with home-exercise programs, but it’s also helped them keep appointment slots filled. Likewise, because they’re tracking outcomes, now they can see when a clinician could use coaching or additional training in a particular aspect of care. And finally, their MIPS success is a selling point to new recruits—a clear signal to potential hires that the practice is a leader in the profession.

4. MIPS is a magnet for new business.

The data they’re pulling from their practice for MIPS has also helped Physical Therapy Central’s cause with other providers. They send referring physicians an annual report that highlights how they’ve done in the MIPS performance categories, for example, and they include outcome-measure scores on all formal interdisciplinary communications.

Such efforts go a long way toward spreading the word about their business, Taylor explains. It does take time and it is more work, but like MIPS itself, they know it will pay off.

“This is where healthcare is going,” she says, “and it’s exactly where we want to be.”