The Myths About MIPS: Recent Episodes

View Details

MIPS is a Quality Payment Program payment track that determines how Eligible Medicare providers get reimbursed.  But can participating in this program be affected by other aspects of a medical practice that aren’t related to Medicare?  Our team of experts break down whether or not third-party payers have any impact on how practices perform in MIPS.  They also ascertain what, if any, truth there is to how claims data might be relevant to performance and what differences Electronic Health Record technology makes in achieving successful outcomes.

Important points of view discussed are:

• What claims data and EHR data have in common with MIPS
• Whether or not one methodology of collecting data for MIPS is better than another
• If and when does patients’ insurance make a difference in MIPS performance and reimbursement

This episode features Quest Quality Consulting experts, Erika Krivenko, Julia Zieger, and Carrie Shepard

View Details

You don’t want to miss the Quest Quality Improvement experts dialogue about the cost of participating or not participating in MIPS.  They examine when it may or may not be economically beneficial to participate in MIPS and discuss the time/value of participating to achieve the optimum results.  Together, they explore examples of when a practice may return sizable gains by participating effectively and what hurdles and setbacks practices might expect by not managing their performance well.  There may be a cost to participating in the MIPS program, but in this episode, they take a closer look at when that cost might actually be a return on investment.

Important points of view discussed are:

• The cost/reward of effective and ineffective time management
• How a MIPS score can actually affect the reimbursement cost/benefit to a practice
• When patient satisfaction plays into MIPS performance for greater reward

This episode features Quest Quality Consulting experts, Erika Krivenko, Julia Zieger, and Carrie Shepard.

View Details

"MIPS is going away” is an ongoing rumor among healthcare professionals following the tumultuous year 2020 hurled at us. Today’s podcast examines why MIPS is such a burden and causes so many different dilemmas in healthcare.  We scrutinize how the federal budget, legislation, the growing number of Medicare beneficiaries and growing number of reduced resources are confounding a system already in disarray. We address the common -that it would be easier to get rid of a program that causes so much confusion and seems to benefit so few.

Important points of view discussed are:

• The increase in the number of patients eligible for Medicare
• Legislation setting the standards for performance
• The correlation between performance and monetary resources available to eligible clinicians
• Why investing in strong performance in MIPS will be a value in the future

This episode features Quest Quality Consulting experts, Erika Krivenko, Julia Zieger and Carrie Shepard

View Details

Today’s podcast will weigh how Electronic Health Records rely on the involvement of personnel to completely and accurately obtain the necessary information for the Merit-Based Incentive Payment System. The myth, “Our EHR does MIPS for us” examines the relationship between technology and human interaction. We address the physical attributes of data collection, personnel training, and marked improvement to understand how EHRs and clinical staff rely on each other to meet the ever-changing requirements of participating in the Quality Payment Program.

----more----

Important points of view discussed are:

• Selecting metrics for MIPS
• Monitoring ongoing improvement of those metrics
• Managing the constantly changing requirements, scoring, and deadlines
• Clinical staff engagement in obtaining critical data for performance

This episode features Quest Quality Consulting experts, Erika Krivenko, Julia Zeiger, and Carrie Shepard.

View Details

Welcome to The Quest podcast series Myths about MIPS, where we will be discussing the most common misconceptions the healthcare community has about the merit-based incentive payment system.

I'm Carrie Shepherd and I'm a healthcare, performance and quality improvement manager.

Hi, I'm Julia Zieger and I'm a health care quality and improvement manager.

We're glad you are interested in this podcast. We hope it helps you and your practice.

----more----

Host

Erica, I see at Quest you have taken on this wonderful role in you, and I were talking earlier about your previous involvement with one of our other hosts with Doctor Paddle Asia and how cool small world that is. I'm wondering if you can give us a brief journey of how did you end up here hosting this show?

Erika Krivenko

Well, it is an interesting journey and it's not your typical one. I had always been in the medical field in mostly a business development capacity, and I did work with Doctor Alagia at a small startup company about 10-11 years ago and it was an extremely enlightening.

Stressful experience working for such a small company trying to find their way in the market and what after that?

Erika Krivenko

Company working there really opened my eyes to how difficult it is for stand-alone medical practices to serve.

Life he was able to be really successful with the product because we were able to demonstrate how it was going to help their business and optimize how they function and maybe even generate revenue.

When I left there, I had to really decide did I want to stay in business development, or did I want to?

Take this opportunity to help providers run their businesses better. I started from Ground Zero again a whole new career and it was truly under Doctor Alagia’s direction. I wanted to go out and hit the ground running and be a consultant, then go and work for a hospital system first, or a health system. Get some operations experienced and go from there.

I ended up working with Florida Hospital in Orlando for five years, starting in acquisitions and primary care, and from there just kind of organically grew into roles that. Interestingly enough, kept aligning with quality, performance improvement, quality improvement, process improvement and looking at efficiencies and everything from inventory and money to expenses. And interestingly enough, an entity came along after those five years and asked to hire me as a consultant for their clients doing pretty much what I was doing for Florida hospital and while in that role.

Somehow it is actually through LinkedIn. Social media Quest found me and they were wanting to start this program around.

Medicare reimbursement value-based payments and really enhancing the business partnership with their clients in the healthcare community and so that was about four years ago.

There are a lot of aspects on the operations and administrative side to a medical practice that you can hear over and over and over again.

But until you actually sit in that chair and experience that experience, does it really, really dawn on you? How you can make a difference? And so being able to work in different roles in administration and in operations and in compliance really allowed me to put all those pieces together. To offer better solutions than I would have 10 or 12 years ago when I wanted to start this journey.

Carrie Shepherd

I got into the healthcare sector about 10 years ago. I went to school for medical coding and billing and while I was going to school, I was also working in a dermatology practice, and I crossed trained to learn more about the clinical side. I implemented their HR, and it got me into a position where it's helping with various programs such as meaningful use and PQRS and value-based modifier, which those three programs later became MIPS, which is what I consult on.

To this day I worked in the medical practice for about 6 1/2 years before I worked in the lab sector, and then I did that for. Two and a half three years and then moved on to Quest, and I've been here for just over a year and a half now.

Host

I believe I would think the lab part would be kind of fascinating, kind of like sleuthing to me where you're always trying to solve mysteries.

Carrie Shepherd

Definitely. There's always a curveball or a challenge, but that's what makes it fun and exciting. And being that I came from working in a medical practice, when I go into offices, I not only know, you know the clinical administrative side of things, but I also know the lab perspective as well. And it gives a “I've been there, done that” sort of feel for the clients and it really reassures them that I know what they're going through.

Julia Zieger

I know what their day-to-day is like so my journey is pretty similar to Carrie's. I started in the medical field a little over 10 years ago. I worked at a pediatric office for about a year. I switched over to dermatology. I worked there for about 7 years, working my way up to be the supervisor of all the medical assistant. And one day the doctor came over to my desk and she put a piece of paper on my desk and said figure this out.

I want to do it and it was about PQRS at the time, which now is the quality section of myth and I think I wore 10 or so different hats in the office. I helped with the issues and if the bathroom was dirty, or if the patient was complaining and anything that was going on around the office, it was my responsibility to fix it and make sure everything ran smoothly. So when she put this piece of paper on my desk, I read through it and I didn't quite understand what it meant. Then I went to the website and read into it even more and got even more confused. Then I tried to figure out how to do it in her HR and that was like reading another language because it's completely different. So somebody actually came into our office, and he was a consultant and he helped us out.

And from that moment on, I think that that's when I made a decision to pivot my career into what he did, because I know what it feels like to be in a very busy office and have a billion different responsibilities and different things going on all day long and have somebody come in and just take this one responsibility off.

For me, to be able to just come in and tell me what to do versus me having to figure out time to carve into my schedule to research it. I just wanted to give that back to other people. It was so stressful because it's such a big responsibility in the office and the doctors' payments depend on it and you have to just do it the right way. And so just have somebody take that responsibility. Just come in and tell me so. I don't have any problems training and I will tell everybody what to do once we figure it out.

But yeah, it was definitely a big relief to have somebody come in and help us from that office. I actually started working at a different lab for about two years before coming to Quest Diagnostics, and now I do the consulting for Quest and I've been here for about two years now.

Host

What are you hoping that people listening to this podcast will take away from it?

Erika Krivenko

That you can still successfully on and operate a medical practice without being a part of a larger system. That there is help out there for you from people that really understand how to make it work and kind of make it work successfully.

Carrie Shepherd

I believe the start of the talk of a podcast was really to find some sort of a tool that could help train our internal teammates. Basically, because they're on the road so much in between seeing clients, and wouldn't it make sense? You know they're always listening to their own podcasts and listening to audible? Why not tune into something that'll also train them and teach them something.

That's pretty much how the podcast dreams started, and then I hope that folks take away from this just a little bit of what's going on our end when it comes to helping practices and answering some of those unknown questions because there's so much that goes into what we do, and so much goes into helping our practices.

Is it would be nice to share that with other people so we're breaking it down step by step to bust some myths, because there's a lot that surrounds the program.

Julia Zieger

I think the biggest thing that I would like other people to get from this podcast would be definitely so learn anything new from here and to know that people are there to help you, but also if they believe any of them, let's hope that they do not believe it after they listen to one of our episodes because to this day we've run into people who talk about these myths, and that's kind of why we've brought them into the podcast just to clear the air and make sure everybody knows what's true and what's not.

Host

I'm very glad you're taking that approach. I think it's going to be very welcomed for anybody like you were saying Erica at the beginning that independent offices. They don't have to be big. They don't have to be part of something big to be successful.

But part of it is having trusted resources, so I'm grateful to have all three of you, Erica, Carrie, and Julia as the host of the myths about MIPS.