From reporting to results: Rethinking MIPS in senior care

The Merit-based Incentive Payment System (MIPS) has become a high-stakes mandate that could determine the financial survival of modern practices and the physicians who care for long-term care residents. While the Centers for Medicare & Medicaid Services quality program has existed for years, a "perfect storm" of increasing penalties and a national push toward value-based care is forcing post-acute providers to better support active clinical participation — and to form more meaningful partnerships between SNF operators, PAC physician practices and value-based care model entities such as ISNPs, hospital-based ACOs and PAC-centric ACOs. "There's this sort of perfect storm of confusion happening between different CMS programs that a patient may be attributed to... that the practice now has to keep track of somehow," says Steve Buslovich, chief medical officer for senior care at PointClickCare. In the latest episode of the Market Leaders podcast, McKnight’s Long-Term Care New Senior Editor Kimberly Marselas sits down with Buslovich and Tom Haithcoat, vice president of government affairs with Care Connect MD and president of Ceptor Consulting. Together, they decode how MIPS is influencing care — and coordination — at the bedside, as well as the friction between traditional primary care metrics and the unique realities of the geriatric population. They also explore why stronger alignment and collaboration across SNFs, physician groups and value-based entities is becoming essential to succeed under evolving CMS models. Penalties for non-compliance or poor reporting can now slash Medicare reimbursement by up to 9%, often representing the difference between a practice being "in the black or in the red,” Buslovich says. But often, Haithcoat adds, failure to capture care may be a reflection of missing or misaligned technology rather than lapses in patient treatments. Listen in to learn why practitioners often struggle to capture quality measures across fragmented systems, and how the MIPS measures themselves may be a mismatch for today’s skilled nursing and senior living residents. If you need a full breakdown on helping reduce the burden for your community’s physicians and clinicians as they navigate MIPS pathways, this is the episode for you. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.