Back in 2017, the Centers for Medicare and Medicaid Services (CMS) introduced the Merit-Based Incentive Payment System (MIPS) as a part of the Quality Payment Program (QPP). MIPS aims to replace the outdated payment formula and create a performance-based model.
Rather than paying the providers based on the number of services they provide, Medicare now adjusts payments based on the quality, efficiency and outcomes of care.
For healthcare providers, this shift has brought new opportunities and new challenges. MIPS consulting firms can help them overcome the challenges. However, choosing the right one is key. That’s why, in this blog, you’ll get to know the questions that you should ask your MIPS consulting firm.
But first, let’s look at what MIPS consulting firms do and how they help you.
What Does MIPS Consulting Firm Do?
A MIPS consulting firm helps healthcare providers (doctors, hospitals, or clinics) stay on track with Medicare’s MIPS program. The firms that offer MIPS consulting solutions guide the healthcare providers through each step, making sure their data is complete, accurate and submitted properly.
Through their MIPS quality measures consulting services, they help healthcare providers avoid any penalties and improve their chances of earning bonus payments from Medicare.
Top 7 Questions to Ask While Looking for MIPS Consulting Firm
MIPS can be complicated, and it affects how much money doctors and healthcare providers get from Medicare. That’s why many clinics and hospitals choose to work with MIPS consulting firms for help.
But with so many firms out there, it can be hard to know which one to choose. So, ask the following seven questions when deciding which MIPS consulting firm is best for your practice.
1. What is your experience with MIPS and CMS programs?
Ask about their track record with both traditional MIPS and the newer MIPS Value Pathways (MVPs). Also, make sure to ask them about the different MIPS eligible providers they’ve worked with and how long they’ve been involved with CMS programs. This helps you know whether they understand the specific challenges your practice may face.
2. How do you stay updated on the latest CMS regulations and guidelines?
MIPS rules and guidelines can change every year. Ask how the firm stays informed, whether through industry updates, policy briefings or direct CMS communication. You should pick a consulting firm who is aware about the current market’s news and information.
3. How do you ensure accurate and comprehensive data collection for MIPS?
Accurate data is essential to performance. Inquire what tools or technology they use for MIPS score tracking, to collect, check and prepare your data for submission. Do they integrate with your Electronic Health Records (EHR)? How do they handle data verification?
4. How will you help us improve our quality of care and maximize our MIPS score?
You’re not just looking for a firm that files reports; you want one that helps you do better year after year. Look for a firm that knows what steps they take to identify performance gaps, how they will lead to better patient outcomes and how they will increase your MIPS score.
5. What is the total cost-including implementation, support, and hidden fees?
Request a detailed breakdown of all costs, not just the base price but also any additional fees for onboarding, data submission, audit support or extended consulting. Knowing the full cost upfront helps you plan your budget more effectively.
6. What are your security protocols for handling protected health information (PHI)?
MIPS reporting services involve managing sensitive patient data. Ask how the firm protects this information. Are they HIPAA-compliant? What security measures are in place to prevent breaches? Review their data security measures because data protection should be non-negotiable.
7. Can you provide examples of successful MIPS projects you’ve managed?
This is a great way to evaluate a firm’s real-world impact. Ask for examples of providers they’ve helped, what their challenges were, what improvements were made and what outcomes were achieved.
Wrap Up
Finding the right MIPS consulting firm is more than choosing just a vendor. It’s about choosing a long-term partner for your success. These questions will help you find a consulting partner who has the right expertise, will work well with your team and can help your practice move forward.