In our latest webinar about MIPS, the QPP and future of physical therapy reimbursement, Keet’s President and GM, Holly Taylor, shared her knowledge on what therapists need to do now to take part in MIPS in 2021, set themselves up for success in future value-based programs, and compete on quality. 

[Missed it? Watch the recording here.]

She dove deep on key issues and participants questions alike, discussing:

  • What the proposed cuts in the Medicare Fee Schedule mean for the future of MIPS
  • Why MIPS has less to do with a Medicare bonus and more to do with a long term strategy to grow your practice 
  • Why suggesting MIPS is going away is harmful to our industry and your bottom line
  • How to implement changes focused on value in your clinic

While we’re all feeling the pinch when it comes to Medicare reimbursement, Holly highlighted that there are a number of ways to react. Here are four key takeaways from the discussion:

1. We must accept value-based payment models as the future. 

It’s no longer possible to survive off of the standard reimbursement increases through Medicare. It’s also no longer realistic (or honestly, acceptable) to decry CMS for halting regular reimbursement increases for healthcare providers. Healthcare costs in our country are rising at an untenable rate, and with our country only getting sicker, transitioning to a model that aims to improve the quality and cost-efficiency of care for patients is our only road ahead – plus it’s a good thing for everyone involved. 

Through the creation of the Quality Payment Program, Medicare has provided us with a path for the transition to fee-for-value and the first step of that journey is MIPS, which ties quality performance to reimbursement. By not participating in MIPS or another value-based payment program now, you are only setting yourself up for failure in the transition from fee-for-service to value-based care. If you delay participation, you are effectively robbing yourself of the time and assistance you need to successfully transition to value-based care.

2. What happened to my bonus?

At the risk of sounding cliche, the global pandemic really threw a wrench in things. 

One of those things was the bonus pool for the 2019 MIPS performance year. Right before healthcare providers were required to submit their 2019 data, Medicare provided unprecedented flexibility in helping out healthcare providers and essentially gave everyone a ‘get out of jail free’ card if they needed it. This made it incredibly easy for anyone who knew they wouldn’t perform well to back out – leaving an empty penalty pool. And because MIPS is revenue neutral, this meant there would be no money to fund any bonuses. The bonuses that were doled out for the 2021 payment year came from the exceptional performance pool, which is funded by Congress.  

3. What’s coming in 2021?

You might be pointing out that in years past, over 90% of MIPS participants still received a bonus from Medicare. But those years the performance threshold was much lower and Medicare is only stepping on the gas when it comes to MIPS. 

2021 marks the last year for the exceptional performance bonus, the first year that the performance threshold could split the bonus and payment pool in half, and, most importantly, the last year for voluntary participation in the QPP. 

Additionally, CMS is proposing making changes to the 2021 Medicare Fee Schedule and how the fee schedule adjustments are applied. Check out these slides (slides 9-12 in our deck) for more details. 

 

4. Physical therapists naturally deliver low cost, high quality care – and now we can prove it

Keet was proud to announce the results of our clients’ hard work in their 2019 MIPS participation. On average, our clients earned a MIPS score of 91.2, 98% of them exceeded the exceptional performance bonus threshold and 24% earned a perfect 100-point score.

2019 was a true learning year for all of us in outpatient rehab who chose to participate in our first year of MIPS eligibility – but boy are we glad that we did it. Granted, there was never a question in our minds that our clients wouldn’t perform well. Physical therapists are natural deliverers of high quality, low cost care – we’re just thrilled that now we have the results to prove it. 

I hope this overview proved helpful and you’ve gotten some useful information on the proposed rule for 2021 and how you can set yourself up for success in value-based programs. Have additional questions? Don’t hesitate to reach out today

P.S.: Missed the live webinar? Watch the recording here.