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St. Louis Metropolitan Medical Society

The Greater St. Louis Medical Group Management Association is pleased to launch a partnership with the St. Louis Metropolitan Medical Society (SLMMS).  This partnership will feature the sharing of information in publications and on our websites.  

Thanks to Greater St. Louis MGMA Director at Large, Derrick Weisbrod for sharing the following article.

Navigating MIPS in 2018

The Medicare Access and Chip Reauthorization Act (MACRA) was passed in 2015, and since then, providers have navigated a new system of collecting and reporting data. If you see a portion of your patients through Medicare, the Merit-based Incentive Payment System (MIPS) is the best way to ensure you are not losing money in the process. Based on their 2017 data, providers could see their Medicare payments increase or decrease starting in 2019. It’s important to not let this long lead-time breed complacency. This system is currently working to determine how much you will get paid based on how well you collect and report your data—don’t leave money on the table by ignoring it until the last minute.

To learn more I spoke to Kyle Haubrich, an attorney with Sandberg Phoenix who focuses his practice on assisting providers in navigating government programs like MIPS. I asked what he felt the biggest hurdle for providers was in adapting to MIPS. The answer lies in collecting and reporting data that MIPS uses to generate a score that determines what a provider will be paid.

Mr. Haubrich stressed that most doctors and providers rely on their Electronic Health Record (EHR) program to collect their data. Most EHRs have well designed dashboards that spell out what must be done to report each activity. However, the problem is when a provider relies solely on this system, and it falls short. Some EHRs are not updated enough to encompass all the quality measures available, which can present a problem if an EHR only collects data on quality measures that might not apply to a specific provider or specialist. Because of this, it is important to check and see what is and is not being tracked by your EHR.

MIPS requires a commitment of time and resources. Mr. Haubrich notes that over the last year, some providers only did the bare minimum of reporting required, but in reality they were doing more than enough in their practices to increase their score and secure a positive payment adjustment—they just failed to report on those activities.

The most important thing for providers to know in 2018 is that they cannot fully rely on their EHR system. Providers who do this tend to fail because the EHR doesn’t report and monitor everything correctly, is not updated, or doesn’t train staff on how to report. Your staff must be informed on what is and is not reported through the EHR and find ways to close the gap through other reporting measures. The best way to do this is to assign one person on staff to monitor reporting and ensure that all aspects of MIPS are being fulfilled, or to hire an outside source to help you achieve that. Through diligent reporting providers can see up to a 9% increase in Medicare payments through this system by the year 2022, starting with a 4% increase or decrease in 2019. Not reporting on actions you are already taking is leaving money on the table, and though it may be difficult to navigate at first, learning this system will help your practice achieve better results and returns in 2019 and beyond.

Derrick Weisbrod is a founding advisor at Healthcare Technology Advisors, where he provides expert support and guidance for medical providers in the areas of information technology, security, and HIPAA compliance. He is Director at Large of the St. Louis and Southeast Missouri MGMA, and can be reached at or (314) 312-4701.


The following articles also appeared in the St. Louis Metropolitan Medical Society's newsletter:

Surviving the Stress: Malpractice Risk Reduction by Diane Robben, Greater St. Louis MGMA VP Business Partners

View from the Inside by Kathleen McCarry, Greater St. Louis MGMA VP Advocacy

Filling the Gap: How Physicians and Aspiring Medical Students Learn from Each Other by Julie Guethler, Greater St. Louis MGMA Past President

What the "Soft Market" Means for Physicians by Monte Shields, The Keane Insurance Group

A Tale of Two Practices by Julie Guethler, MGMA of Greater St. Louis President

Physicians Beware of Referrals for Home Care and Potential Fraud Charges by Diane Robben, JD, MGMA of Greater St. Louis VP Business Partners and Denise Bloch, JD

MGMA of Greater St. Louis: Committed to Developing Strong Practice Managers by John Marshall, MGMA of Greater St. Louis Director at Large

Finding Good Employees by Chris Keefe, CPA, CMPE, MGMA of Greater St. Louis President-Elect

Workplace Wellness: Start Small to Improve the Health of Your Employees  by Chris Keefe, MGMA of Greater St. Louis President-Elect

Carrots and Sticks in Coding: Why Good Documentation Matters by Kathleen McCarry, MGMA of Greater St. Louis VP Advocacy

 Introduction to MGMA: Can Your Practice Afford to be "Left in the Cold?"  by Jim Kidd, MGMA of Greater St. Louis President






MGMA of Greater St. Louis
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