QPP Reporting for Hospitals & Health Systems

Under the Quality Payment Program, clinicians are reimbursed for Medicare Part B services based on their participation in the Merit Based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs). Performance under both tracks can result in a positive or negative payment adjustment to reimbursement rates for Medicare Part B services.

Hospitals and Health Systems face especially unique challenges when navigating these new requirements. The reimbursement of Medicare Part B services depends directly on the performance of each eligible department, clinic, and clinician. Accessing multiple Electronic Medical Records or billing software to get the right data from the right providers is another challenge, but crucial to successful reporting.  Hospitals must also critically assess reporting options, determine clinician eligibility, and make the decision about whether to report as an individual or as a group, as these factors will impact the ease of reporting and overall reimbursement.

Real-time Dashboards

Identify & respond to the data you capture & maximize your reimbursement

All MIPS Categories

MIPSPRO supports all specialties & all measures for all MIPS components.   We optimize  your score through our up-to-date  rules engine.

Adapt to your practice

Whether you are a hospital or a small family practice, MIPSPRO scales to meet your needs

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2017 CMS MIPS Qualified Registry

Data Validation & Support

Our quality experts validate your data before submission to CMS to ensure your reporting success

Choose your pace

Whether you are reporting to achieve maximum incentives or just avoid the penalties, MIPSPRO is as flexible as you

Integrated data

Sending us your data is easy with our API, data upload, and transmission services.  No manual entry needed.

Multiple EHRs? No problem!

Healthmonix has provided streamlined reporting options as a CMS Qualified Registry since 2009. From solo providers to large Health Systems, we provide unmatched support and adaptable reporting plans to meet your goals.  In 2017, we successfully submitted data from 24,000,000 patient visits and 233 different EHRs, leading to a 98.6% Customer Satisfaction Rating for our MIPSPRO Registry.  Our new platform, ACO PRO, allows Accountable Care Organizations to track and report 15 CMS Web Interface (WI) quality measures.


Should you opt for Facility-Based Scoring?

Hospitals and Health Systems should also consider the pros and cons of facility-based measurement, a participation option launched by CMS in their 2019 MACRA final rule that offers certain groups of facility-based clinicians the option to be scored based on their hospital’s overall performance. If these clinicians additionally decide to report MIPS quality measures in the standard way, CMS will award them the higher of the two scores.

Under facility-based measurement, individual clinicians can avoid reporting their own Quality measures but have no control over what measures and score they will ultimately receive, and less influence over facility-level performance improvement. Clinicians focused on MIPS incentive maximization should therefore choose a reporting mechanism that better enables performance improvement, like a Qualified Registry or QCDR.

MIPS Educational Resources 

The Overview of MIPS Reporting fact sheet condenses the most important information to know when you are starting to formulate your MIPS plan. This sheet can act as a quick-reference guide for performance category weights, the payment adjustment schedule, and eligibility requirements.  

Our Client Services Sheet provides a comprehensive overview of our list of services including assigned account management and in-depth account setup support for clients reporting for 100+ clinicians.

The Data Integration Product Sheet details our Data Integration Services.  Getting the right data from the right providers for successful reporting can be incredibly challenging, especially when navigating multiple EMRs.  Our data integration services streamline and expedite the process by accepting information from your EMRs and storing it all in one place.  This product sheet reviews the necessary codes, as well as the different types of data integration to help you determine which method is best for you.

MIPSPRO System Information