Optimize Reporting to Maximize Reimbursements for 2019 MIPS Reporting


MIPS requires providers to transition from a volume to value-based care model or face significant financial penalties and even reputational harm.  The stakes have been raised every year and the final ruling for the 2019 reporting period is even more complex than it has been in the past, further increasing the stress, burden and financial risk for a healthcare practice. To be specific, failure to comply or earn enough points for the 2019 reporting period will result in an automatic 7% penalty on every Medicare Part B claim paid in 2021 – this equates to a minimum of a $6,300 per provider hit to the bottom line, and the penalty will increase to a minimum of $8,100 per provider for the 2020 reporting period.

Penalties 2018-2020.png

Needless to say, given the financial risk, all health systems, regardless of size or specialty, must evolve the way they approach handling compliance in order to assure their financial viability. There are many commonly misunderstood aspects and nuances with the MIPS program, particularly in how points are earned.  For a healthcare practice it can be challenging to know exactly what you need to do to earn points, optimize your score, and protect your Medicare reimbursements.  

MIPS Points to Avoid Penalty Full 100 Pts 2018-2021.png

One tangible way a practice can impact their MIPS performance is by selecting the right reporting method. Therefore, it’s very important to understand the various reporting methods and the differences between them so you can choose the best methodology, and partner, for both tracking and reporting.

When choosing a method, know that CMS is continuing to incentivize practices to use technology (i.e. software) also known as a CEHRT (i.e. an end-to-end electronic solution) for reporting. Using a CEHRT improves efficiency and effectiveness in reporting for MIPS as CMS has determined that the data submitted via technology is more complete and accurate. Reporting via a CEHRT is the best approach because it also optimizes the points that could be earned and therefore, maximizes Medicare reimbursements. Health eFilings, a CEHRT, has proprietary ONC certified software that fully automates the tracking and reporting of MIPS for any size practice or healthcare organization regardless of specialty.

The 2019 reporting period is coming to a close, but there is still time to comply and avoid penalties, however you must act quickly.  Health eFilings is here to help.



MIPS Accelerator with Tag 9-13-17.png
QM Accelerator with Tag 9-13-17.png

When you work with Health eFilings, you get the benefits of:

  • ONC certified software that integrates directly with your EHR or billing system

  • No software to download and no workflow changes

  • Compliance for all MIPS categories

  • Proprietary algorithms that benchmark and select your best measures to optimize scores

  • Earning bonus points in Quality category and satisfying all Improvement Activities requirements