Assistance is available to help prepare for MIPS and APMs.  Please contact info@apollohit.com for further information and a free initial consultation.

MIPS and APM Readiness Preparation - MACRA University macra training/implementation/optimization

MACRA University mips readiness and optimization

​​MACRA University

5 Recommended Immediate Steps


  1. Focus on ICD-10-CM coding accuracy, using codes that are the most specific for each condition.  This will have the immediate benefit of helping to reduce denials in October of 2016, when Medicare (and likely other payers) will end their period of ICD-10-CM coding "relaxation."   
  2. Focus on capturing all relevant diagnoses during each encounter using fully specified ICD-10-CM codes that accurately reflect the patients condition.  The number of diagnoses a patient carries and their levels of severity are used to determine risk adjusted scores.  These in turn are used to determine whether or not an outcome (like a readmission to a hospital) was an expected outcome.  Medicare relies on claims data almost exclusively to make these determinations.  The level of severity of patient illnesses will be used to help determine the cost component of the MIPS Composite Performance Score. 
  3. Focus on attaining the highest possible PQRS scores for each measure.  MIPS and APMs represent a significant change in the importance of the numerator for measures.  The higher the numerator the higher the quality score. 
  4. Identify measures in the proposed rule that are a good fit for your practice that you are not currently using for PQRS.  Establish workflows that help to achieve the highest possible scores, so you are best prepared for 2016. 
    • Modify EHR content, flowsheets and/or other data capture and reporting tools as needed.
  5. Identify practice improvement activities in the proposed rule that offer greatest benefit to patients and a good fit for your practice