Switching EHR Software Vendors? Here is How to Protect Your MIPS Score – Cost Category
Posted On: August 23, 2021
Series 4 of 4
Switching EHR (Electronic Health Record) software vendors can be expensive and stressful. Users need to be trained on the software, electronic devices need to be integrated, patient data needs to be transferred from your former software, learning curves must be overcome, and everything must be accomplished with minimal impact to patients and scheduling. During this hectic time, your MIPS score for the year might be the furthest thing from your mind. However, if you are not properly prepared when it comes time to report your MIPS data to CMS, the repercussions can be devastating from both a financial and stress level standpoint.
In this four-part series, Clinical Quality Experts provides important tips for each of the four MIPS performance categories when planning to switch EHR software vendors. This is the final part of the series: the Cost Category.
When it comes to the Cost Category, it’s all about coding and billing. That’s because CMS tracks the category by claims. Here are some things to keep in mind to protect your MIPS Cost Category score when you switch to a new EHR.
- Consider activating MACRA patient relationship codes from the beginning of using the new EHR. This helps ensure that the appropriate clinician is correctly attributed to a Cost category episode. If you implement the MACRA patient relationship codes, don’t forget that you can use this as an Improvement Activity!
- For the first month or two after starting your new EHR, review your Medicare billing statements for coding accuracy as it pertains to any applicable Cost measures. You can download the latest measure specifications from The Quality Payment Program (cms.gov). Pay particular attention to the current year’s Cost Measure Code List. Once this is downloaded, you can navigate to an applicable measure and open the Excel file. You can verify a measure’s timing parameters by looking at the Episode Window on the Overview tab. Also, check out the Attribution tab and the Exclusion Details tab in the Excel document to cross-check your coding accuracy. It’s a good time to correct any coding/billing mistakes now so you can avoid the hassle of “unlearning” incorrect workflows later.