Have you ever wondered: How do I meet the 2019 MIPS Minimum Threshold?

Hmmmmm…  what does that even mean: “Minimum Threshold?”  Simply put, it is the minimum amount of points a TIN needs to earn in order to avoid the negative payment adjustment in the MIPS program.  The good news is, meeting the minimum threshold in 2019, or what we at Patient360 call it- MIPS for Beginners- is really easy to do!

In the MIPS program, there are several categories where you can achieve percentage points toward a final score for the year.  The minimum threshold of points a TIN needs to achieve in 2019 is 30 points total and we assure you, meeting this minimum threshold is not an impossibility.  In fact, CMS has tried to be very flexible for folks getting started so there are a number of ways to very easily hit that Minimum Threshold of 30 points.  We’d prefer not to encourage mediocrity since the spirit of the program is to improve quality of care and improve performance, so you might even surprise yourself once you get started and end up earning far more than 30 points!  Let’s take a look at how you can report in 2019 to at least meet that Minimum Threshold.

MIPS Score Adjustments 2019

Report Quality Measures in the Quality Category (legacy program was PQRS):

Since this category (according to the above chart) is worth the most percentage points, you could choose to ONLY report on this category and easily achieve 30 points to have a neutral payment adjustment in 2019.

The requirements are:

  • Select 6 quality measures (one being an outcome or high priority where an outcome is not available.)
  • Report the 6 measures throughout the year on at least 60% of your patient encounters for each measure.

TIP: Try to pick measures that are benchmarked (each one in the Patient360 portal has clear designations of the benchmarks and how many possible points you can earn.)   For most measures that are benchmarked and not topped out, you can earn up to 10 points.  Some measures that are topped out or not benchmarked, you can only earn 3 or 7 points, so have a look at each measure as you are selecting it and it will tell you.  Of course it’s fine to pick one or two that are not worth 10 points, but you want to aim for measures that aren’t topped out and that you can use year over year to show improvement over time.  Bottom line for choosing to submit data for ONLY the quality category:

  • Submit all 6 quality measures with top performance at 10 points each
  • Submit all 6 quality measures and score at least 7 points on each measure and meet the Minimum Threshold.  Here is what those two calculations would look like:

MIPS Score Evaluation 2019

MIPS Score Evaluation 2019

The Promoting Interoperability Category (legacy program was Meaningful Use):

The great thing about this category in 2019 is that you can still achieve some points even if you don’t have all the “base score” requirements.  In previous years, there were certain “base score” measures you had to report on or the entire category would remain at 0 points.  For 2019 CMS dropped those requirements, so more folks will be able to participate in this category and get some points toward their final score.

Bottom line for choosing to submit data for the PI category:

  • Submit enough data in this category to achieve all 25 points available for PI and combine it with data from either the Quality Category or the IA Category to meet or exceed the 30 point Minimum Threshold.

The Improvement Activities Category:

This is a category everyone should do without hesitation!  It’s an instant 15 points (so that’s halfway to meeting the minimum threshold!)  It has loads of activities to choose from, and requires a very simple attestation (which Patient360 has made electronic).

Bottom line for choosing to submit data for the IA  category:

  • Submit enough data in this category to achieve all 15 points and combine it with data from either the Quality Category or the PI Category to meet or exceed the 30 point Minimum Threshold.

What about bonuses?  There are loads of them.  Complex patient bonus, picking more than one high priority measure bonuses, small practice bonus, end to end electronic reporting bonus…  the list goes on and on but if you are teetering at just under 30 points, chances are one of these bonuses (if applicable to your TIN), will end up getting you those extra points to meet the minimum threshold.

The great aspect of the Patient360 portal is that it displays your score in real time as you enter data – so enter early and often!  If you do, you will see immediately when you hit 30 points for your total.

MIPS Score Evaluation 2019 

You will surprise yourself that this will happen pretty quickly and you may want to just continue to submit data for a better score and potential bonus.  If this is the case, Patient360 makes it easy to shift to a full reporting option, allowing you to continue with your data to potentially achieve a positive adjustment (bonus) based on where your final score falls.

Questions?  We are here to help!  Contact us at Info@patient360.com