We guide you every step of the way. Navigate by scrolling or using the menu to get up to speed about what it will take to succeed with MIPS in 2021.

Have questions? Give us a call at 1-866-359-4458 9:00 AM to 5:00 PM ET, Monday through Friday to walk through the process with one of our friendly consultants or use the chat tool in the bottom-right hand corner of the website.

Your MIPS Success

Thank you for choosing Mingle Health. This guide will help you understand what to focus on to maximize your MIPS participation. We also have several live and recorded webinars and educational opportunities throughout the year to educate you about specific components of the MIPS and QPP.


Make a Plan

Meet with your Mingle Consultant to learn all that you need to know, set goals, and create a project plan to participate in all categories of MIPS. Be sure to share important deadlines and milestones with stakeholders in your organization such as clinicians, billing team, and anyone else who assists with quality management efforts.

Mingle Health is dedicated to helping you succeed with MIPS and we are proud to have been recognized as a top performer by KLAS for Quality Management.

As a Mingle Health customer, you have access to our tools and our knowledgeable Consultants. When you subscribe, you’ll be assigned a Consultant who will serve as an advisor, coach, and project manager for your success.

What can you expect from your assigned Consultant?

Your consultant’s continued attention and focus will be on your organization for the duration of your subscription. Our process is designed to help you achieve your selected goals with support and guidance. Your consultant will provide a framework for us to establish your goals, offer expertise, bring new perspectives and recommendations, and make sure you meet the requirements of the MIPS program.

Your Consultant’s expertise will be paired with our web-based software that will help you get the most out of the data and systems you have in place.

What will your consultant expect from you?

Your consultant will be meeting with you and/or your team. You’ll serve as the champions for your practice improvement. Due to the remote nature of our work, this team should be familiar with attending online meetings and be able to use e-mail, Excel, and our web-based software.

These individuals will act as a liaison to coordinate with internal system vendors such as EHRs and billing systems. Team members will ensure that all necessary files will be provided according to Mingle specifications (see resources below).

The team will be essential in helping to spark engagement and excitement for your entire clinical and operational staff.

How often will you meet?

Our goal is to be a partner of your practice, helping to navigate challenges and maintain steady progress along the way.

We’d like to meet with you at least quarterly, with more frequent meetings if warranted. Your consultant will start with a kick-off meeting where they will learn about your organization. After that, each consecutive meeting will be scheduled as prior action items are completed. Each meeting will include a discussion of your latest performance as new data comes in with recommendations for next steps, carefully designed to help you move forward toward better results at a manageable pace.

What if you need extra sessions?

Between meetings, if you need to ask questions, bounce around ideas, or talk about new challenges that have arisen, know that your consultant is available all year for your practice. We can also set up additional time whenever you have agenda items to discuss. Between meetings, you are free to email them directly, or if you need immediate assistance with your Mingle dashboard, you may use our online chat feature or give us a call.

Set a Goal for your MIPS Participation

Take a moment to think about your past performance, systems, and recent submission. Having a realistic goal for your organization’s participation in MIPS and the QPP will help your Mingle Consultant guide you in the program and provide feedback to you. Here are some common goals:

  • Avoid a penalty: protect your Medicare payments from the -9% payment adjustment.
  • Maximize score and positive adjustment: track your score at least quarterly and work to improve your score (and your positive adjustment).
  • Prepare for APM participation & improve year-over-year performance: Alternative payment models typically have quality metrics and financial goals that you must make progress on. Tracking and improving year-over-year performance is important in any payment model.

MIPS 2021 Project Plan

Our goal is to support your organization in earning the highest MIPS score possible and maximize the ROI for participation. When you work with Mingle, not only do we help you avoid the 9% penalty, we pair you with a knowledgeable and friendly Mingle Health “coach” to guide you every step of the way through the program.

Completing the actions by the dates listed below gives you the best chance of driving your practice quality toward your goals and gives the greatest visibility for monitoring your MIPS score.

 

Date Action/Milestone
April 15, 2021 Send Q1 Billing Data

Adjust clinicians to be included in quality measure calculations (purchase additional providers, if applicable)

May 1, 2021 Select Measures
May 15, 2021 Send Q1 Numerator Data

Adjust clinicians to be included in quality measure calculations (purchase additional providers, if applicable)

May 30, 2021 Review Initial PI Performance

Select Initial IA Projects

June 15, 2021 Review Initial Quality Measure Performance
July 15, 202 Send Q2 Billing Data

Adjust clinicians to be included in quality measure calculations (purchase additional providers, if applicable)

August 15, 2021 Send Q2 Numerator Data

Review Quality Measure Performance

October 15, 2021 Send Q3 Billing Data
November 15, 2021 Send Q3 Numerator Data

Review Quality Measure Performance (after numerator data is processed)

January 15, 2022 Send All End-of-Year Data

Enter PI and IA Final Attestations

Finalize clinicians to be included in CMS submission (purchase additional providers, if applicable)

Complete Permission Forms

January 30, 2022 Review Final Performance Scoring
February 11, 2022 Send Validation and Audit Documentation (if selected for audit, as required by CMS)
January 4, 2022 – March 31, 2022 Submit Data to CMS
Q1 2022 Plan 2022 QPP Participation

If you have begun working with us after some of these dates have passed, we will assess together how to best mitigate the risks to your MIPS reporting. Download a copy of the MIPS 2021 Project Plan here

Establish a Quality a Quality Reporting Rhythm

Upload your billing and performance data as soon as possible so you know your data process is working and you understand your current scores. Plan to send data and review your scores at least quarterly.

Take a moment to plan out how you will send data on a regular basis to Mingle Health for analysis. You’ll also want to think about how you share your measure performance with your team.


Review Past Performance

Analyzing your past performance is one of the best ways to understand how you are scoring under MIPS.

Take a moment to pull together prior reports and data to understand what worked well and areas for improvement including data capture, workflows, and EHR vendor requirements.

Make sure to download your most recent CMS Feedback Report which includes a breakdown of your past MIPS scores, including the MIPS Cost category. CMS typically publishes Feedback Reports for the prior performance year in July.

Questions to ask:

  • How did you score in each category?
  • Are those scores aligned with your goals?
  • What are your areas of strength? What could be improved this year?

Make sure to share your questions, responses, and prior year performance reports with your Mingle Consultant.

Make sure your have access to the CMS QPP Portal

You’ll need a CMS HARP account to access the QPP Portal. This is where you’ll view and download your prior year CMS Feedback Report and more.

Here’s the CMS resource on how to register for an account


2021 Scoring and Changes

For 2021, Quality is now 40% (down from 45% in 2020) and Cost is now 20% (up from 15% in 2020). Cost is scheduled to increase to 30% of your MIPS score in 2022.

Importantly, the threshold to avoid a penalty has increased to 60 points for 2021, up from 45 points in 2020. This means that it’s getting harder to avoid the 9% penalty under MIPS.

Because MIPS is getting harder, we advise our clients to monitor their MIPS performance throughout the year. This means estimating your scores at least quarterly so you have the opportunity to spot gaps and areas for improvement and make changes before the end of the year.

MIPS Resources by Performance Category

Category Resources
Quality 2021 MIPS Retired Quality Measures
Cost Webinar: An Introduction to the Cost Category
CMS: Cost Quick Start Guide
Promoting Interoperability 2021 PI Guide & Requirements
Improvement Activities CMS: Improvement Activities Quick Start Guide

 


Webinar: Succeed with MIPS in 2021

You’re invited to watch our recent webinar to understand what you should focus on for MIPS/QPP success. The session is presented by Brigid Whitney Gallagher, Manager of Client Services at Minge Health. Brigid is a MIPS expert and has helped hundreds of practices succeed with the program.


Download the Slides


MIPS Eligibility

Eligibility is managed by CMS and there are no major changes for 2021 under MIPS. Eligible Clinicians include physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists. Clinical psychologists and therapists were added in 2019. Use the CMS NPI lookup tool to verify MIPS eligibility at the individual and group level.

For clinicians that fall under the low volume threshold and still want to participate, they can opt in to the MIPS reporting and receive incentive payments based on success within the program.

Clinicians are exempt for any of the following reasons:

  • Qualifying participant in an Advanced APM
  • Low volume threshold:
    • Treat ≤ 200 Medicare patients
    • OR have ≤ $90,000 in Medicare Part B allowable charges
    • OR provide ≤ 200 Medicare Part B services
  • First year provider in Medicare Part B PFS
  • Significant Hardship Exemption OR Extreme or Uncontrollable Circumstances (EUC)

CMS updates eligibility and special statuses at two points in the year called the “MIPS determination Periods:”

  • 1st Determination Period: 10/1/19 – 9/30/20
  • 2nd Determination Period: 10/1/20 – 9/30/21

Visit the CMS NPI Eligibility Look Up Tool here


Resources & Further Reading

Thank you for choosing Mingle Health. We’re proud to be your partner in the transition to value-based care and help you succeed with quality management and MIPS.

Here are additional resources to assist you with MIPS and the QPP:

New to MIPS? Have questions?

We’re here to help. Please reach out to your Consultant or use the live chat to ask your questions. You can also call M-F 9am – 5pm ET: 866-359-4458