Final 2019 MIPS Report Review

Your Final 2019 MIPS Group and Individual Reports have been created to correspond to your Organization Tax Identification Number(s) (TIN) and for each provider’s individual National Provider Identifier (NPI) associated with the TIN. These reports include the data that will be submitted to CMS pending certification of your reporting type. The Final 2019 MIPS Reports should be reviewed carefully to confirm your reporting type and your intent for Keet Health to submit your MIPS data to CMS on your behalf for the 2019 performance year. 

To finalize your 2019 MIPS submission, review the Final 2019 Group and Individual MIPS Reports provided to you. Once complete, submit the 2019 MIPS Reporting Confirmation form to certify your reporting type and intent for Keet Health to submit your MIPS data to CMS.

Report Components & Definitions 

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Component Definition
Meet Case Req For the 2019 performance year, a minimum of 20 cases are required per measure. True indicates that the 20 case minimum requirement was met for the measure. False indicates that the 20 case minimum requirement was NOT met for the measure. A minimum of 6 out of the 10 measures need to be identified as True, or having met the 20 case minimum requirement, either as a Group or by Individual provider. Please note that if you do not meet the Minimum Case Requirement at an individual provider level, the only option would be to report as a group.
Final 2019 MIPS Group Report This report includes the overall 2019 performance data at the Organizational TIN level.  This data will be submitted to CMS if you select the following reporting types: Group or Both.
Final 2019 MIPS Individual Report This report includes the 2019 performance year data for each Individual NPIs associated with your TIN. This data will be submitted to CMS if you select the following reporting types:  Individual or Both.
TIN 9-digit Tax Identification Number.
NPI 10-digit numeric National Provider Identifier for individual clinicians.
Performance Year Performance period during which data was collected.
Compliance Rate Proportion of eligible patients that were evaluated for MIPS reporting. For the 2019 performance year, Medicare requires that a minimum of 60% of eligible patients be reported.
Measure Acronym for the patient reported outcome (PRO) measure and the measure's corresponding pain scale. 
Measure ID Established CMS MIPS quality measure number.
Strata Reporting segment. Overall indicates all data is included specific to the report, either group or individual.
Eligible Population Number of patients who were evaluated for the corresponding measure and were 18 years or older during the performance year.
Eligible Population Exclusion Number of eligible patients who completed less than 2 PRO surveys for the corresponding measure. 
Eligible Population Exception

Number of eligible patients identified as disqualified in accordance with the CMS guidance criteria

Progressed Population Number of patients who met the measure Minimal Clinically Important Difference (MCID).
FTP Population Failed to Progress (FTP) - number of patients who failed to meet the measure MCID.
FTP Rate Proportion of patients who failed to meet the measure MCID. The FTP rate will be compared to the established benchmark for the measure. 

 

Review Your Final 2019 MIPS Reports

Review the following steps for both the Group and Individual reports to determine your reporting type for the 2019 performance year.

Is the 60% Compliance Rate requirement met?

  • Indicated by a value >60.0 in the Compliance Rate report field. 
  • If reporting as a group or by individual provider, a compliance rate of greater than 60% must be achieved to satisfy the minimum reporting requirement. 
  • If the 60% compliance rate requirement was not met for the group you may not receive a MIPS bonus and could receive a penalty. In that scenario, review the compliance rate for each provider to determine their individual reporting compliance. 
  • If individual providers meet the minimum reporting requirements they should be considered for MIPS submission.

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Is the 20 Case Minimum requirement met?

  • If reporting as a group or by individual provider, a minimum of 6 out of the 10 available measures must have 20 or more cases to meet the case minimum requirement. 
  • Indicated by True in the Meet Case Req report field. 
  • Note: Some clinics may not meet this requirement at an individual provider level but they will at a group TIN level. Please review this carefully to ensure you choose the correct reporting type based on your actual performance.

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How is scoring impacted if the 60% Compliance Rate or 20 Case Minimum requirement is not met? 

Outlined below are the 3 scenarios used to calculate the scoring for each outcome measure:

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IMPORTANT REMINDER

If you do NOT meet the compliance rate requirements or the case minimum requirements you can choose to not submit any MIPS data and receive a neutral payment adjustment (no bonus and no penalty). This option was only recently put forth by Medicare in response to COVID 19.

 

Determine Your 2019 Report Type

Review this article for information on the individual, group, or both reporting type options. Additionally, find more information on reporting types at the Quality Payment Program website.

 

Confirm Your 2019 MIPS Reporting

Following review of your 2019 Final MIPS reports, submit the 2019 MIPS Reporting Confirmation form to confirm your intent for Keet Health to submit your MIPS data to CMS. Please note, if you are submitting data for multiple TINs, a separate 2019 MIPS Reporting Confirmation form must be completed for each distinct TIN.

 

2019 Final MIPS Report FAQ

Does this report the FTP benchmark? 

No, Medicare will calculate the benchmark for 2019 after all data has been submitted. 

 

Why is each PRO measure listed twice by TIN and Individual NPI?

The PRO measure is listed twice once for the PRO measure and again for the corresponding PRO numeric pain scale rating (NPRS). 

  • KOS - IROMS 11
  • KOS NPRS - IROMS 12
  • LEFS- IROMS 13
  • LEFS NPRS- IROMS 14
  • NDI- IROMS 15
  • NDI NPRS- IROMS 16
  • MDQ- IROMS 17
  • MDQ NPRS- IROMS 18
  • DASH- IROMS 19
  • DASH NPRS- IROMS 20

What Improvement Activities are reported? 

Keet helps you achieve the maximum available points for the Improvement Activities category by satisfying and reporting on the following measures:

  • Participation in a QCDR, that promotes the use of processes and tools that engage patients for adherence to treatment plans.

  • Collection and follow-up on patient experience and satisfaction data on beneficiary engagement.

  • Participation in a QCDR, that promotes the use of patient engagement tools.