After two "easy" years for MIPS, CMS raises the bar on Interoperability Scoring by taking away the 50 point "gimme" for simply achieving a passing score. The basic result is that a 2018 PI score of 100 becomes a 50 in 2019.
Add in the requirement that everyone must submit more complex Stage 3 measures - meaning new EHR reporting and compliance processes - and most providers will see dramatically reduced PI scores. "Business as Usual" will reduce MACRA reimbursement for sure. (The hidden good news here is that lower scores across the country will increase the funding in MACRA revenue pools, and those providers who embrace the changes are likely to do better financially under MACRA than in prior years.)
The point is that success won't happen automatically. This year will require a dedicated monthly program of review, with aggressive mitigations for PI (and CQM as well!).
Even ACOs can't dodge the changes in PI. Since overall ACO scores depend on everyone suceeding (even smaller clinics, with modest resources) ACOs should expect to dedicate time, measurement and talent to PI in 2019.
Improving MACRA Metrics comes from a regular program, throughout the year. We get started as soon as a full month's data is available, and follow a regimen of extract, report, analyze and plan and act for every month thereafter. This is nowhere more true than with the challenges of PI in 2019!
C3 Partners, LLC 414-640-2817 28717 Blue Crane Court, Waterford, WI