MIPS: Merit-based Insensitive Payment System

The establishment of MIPS provides an opportunity to revise, rework and improve the existing Medicare programs focused on quality, costs, and use of electronic health records to improve their relevance to real-world medical practice and reduce administrative burdens for physicians.

Medicare's legacy quality reporting programs were consolidated and streamlined into the Merit-based Incentive Payment System, referred to as "MIPS." This consolidation reduced the aggregate level of financial penalties physicians otherwise faced, and it also provides a greater potential for bonus payments.

Summary

MIPS reporting refers to the submission of performance data to Medicare by eligible clinicians. Clinicians report for three of the four performance categories: Quality, Promoting Interoperability, Improvement Activities and Advancing Care Information.

FIGmd is a CMS-approved Qualified Clinical Data Registry (QCDR) in collaboration with the American Society of Clinical Oncology (ASCO) and a Qualified Registry (QR). FIGmd operates on cutting-edge 2015 ONC HIT certified platform and caters to solo and multi-specialty practices. FIGmd MIPS gives clinicians the flexibility to report on the activities and measures that most accurately demonstrate the performance of their practice, including both individual providers and provider groups.

More About MIPS

Product owners were getting many complaints from the customer for the existing product, so they wanted to redesign the product to give a smooth MIPS reporting experience.

The Merit-based Incentive Payment System (MIPS) is one of the two tracks of Centers for Medicare & Medicaid Services’ (CMS) Quality Payment Program (QPP). It is a performance-based payment system for Medicare Part B eligible clinicians, comprising of four categories - Quality, Promoting Interoperability (PI), Improvement Activities (IA), and Cost with category weights 45%, 25%, 15%, and 15%, respectively. Practice administrators and clinicians can choose measures that are most relevant to their practice.

MIPS final score of an eligible clinician or group is calculated by combining the individual scores in all four weighted performance categories. This score is used for determining the Medicare Part B payment adjustments during the payment period. Eligible clinicians who do not participate in MIPS will receive a negative 7% payment adjustment on Medicare Part B reimbursements.

User Analysis

Target Audience

This case study is intended for all MIPS user interface users. It describes/illustrates all scenarios of default MIPS configurations. Registry administrators can customize/remove any feature appearing on the dashboard based on the specifications and requirements of the registry. Hence, certain configurations may not be displayed on your dashboard.

User Roles and Permissions

The MIPS UI performance dashboard provides role-based access control to display the most relevant features and screens based on your roles.

Registry Administrator

- Is responsible for configuring the MIPS user interface as per the registry specifications. This is done through a configuration file and not through the dashboard.

- Can view, edit, and track the progress of all practices associated with the registry.

Multi-Practice Administrator

- Can view, edit, and track the progress as well as submit data for MIPS reporting on behalf of those groups and clinicians who are aligned with them.

Clinician

- Can report to the MIPS program either individually or as a group.

- Have access only to their own data.

Single Practice Administrator

- Can view, edit, and track the progress as well as submit data for MIPS reporting on behalf of those groups and clinicians who are aligned with them.

Persona(synthesis)

We kicked off the project by running multiple UX workshops with the stakeholders in order to gain a deeper understanding of problems and close the knowledge gap regarding its market, customers, and broader product strategy. A goal-setting session to make sure we were on the same page in terms of high-level direction and objectives; a persona workshop to understand the target audience.

Coordinator’s Persona

Name : Sophia Chen

Age : 40

Designation : Individual Doctor

About

Dr Sophia is a 40 years old individual doctor who lives in Washington. She has her own clinic, she thinks continuously monitoring your performance is a very important factor to provide quality treatment to patients.

Goal

1. An easy way to moroor her performance

2 Save time in reporting MIPS and eam a good incentives

Frustrations

1. MIPS reporting a very complicated print

2. Lots of data to report which a time-consuming process

Coordinator’s Persona

Name : William Braunwald

Age : 35

Designation : Admin, SF Hospital

About

Mr Willam is 35 years old administrator at SF Hospital where more than 20 doctors work and he is responsible for organizing and overseeing daily activities of a hospital. managing staff and communicate between departments, also he is responsible for reporting MIPS annually for all the service provider, at his hospital, he thinks accuracy important for his job role

Goal

Accurate MIPS reporting on time for all the service provider along with his many other duties

Frustrations

1. Review service provider performance in sach MPS

2. Performance category and manage provider submission to Medicare

Discovery (research)

The first step in solving any problem is defining it and finding the roots of that problem. To do so, we decided to roll out a survey and interview people from the FIGmd user base who were using this product for a longer time as well who had signed up but never made their reporting.

We asked them about the reasons why they had started to use the product in the first place, the expectations they had, their first impressions, and overall experience with the product.

Furthermore, we also conducted user tests with the existing platform, testing people that corresponded to Polaris target audience but who had never used the product before to get a better sense of the problems that may arise when using Polaris for the first time.

Define

Created affinity mapping for grouping data gathered during research, It helped to gather large amounts of data and organize them into groups or themes based on their relationships and find the pain points, also conducted task prioritization activity.

Throughout this process, we made valuable discoveries, such as the following :

  • Overall Ul is too cluttered for users, which were increasing cognitive load.
  • The display of all measures, even those which are not applicable to the user.
  • The settings questions were the biggest hurdle. They are not well labelled and not easy to locate.
  • Selections were lost when changing screens. 5. It was not really apparent where to click to view Quality, Pl and IA once someone logs in.
  • Users had to go through multiple screens if they wanted to submit or resubmit their report every time even after saving their data. and many more pain points.

Attestation and Signatures

Data Release Consent Form (DRCF):

The DRCF is an agreement between the registry and clinicians, wherein the latter grants permission to the registry to transmit data to CMS on their behalf. The authorized signatories can sign the agreement copy electronically using digital signature tools such as DocuSign, EchoSign or RightSign, which is embedded within the agreement PDF.

The agreement signing process uses an embedded functionality for electronically signing the document using tools such as DocuSign, EchoSign or RightSign. Registries can select any of the signing tools that best suit their practices.

MIPS Reporting

MIPS landing page displays two options: Individual or Group, depending on the type of reporting, i.e. if you want to report a single NPI under a single TIN or you want to report multiple NPIs reported under a single TIN.

Individual Reporting:

Group Reporting:

Performance Categories

The performance category is comprised of Quality, PI, and IA parameters that enable you to select measures/activities and enter their corresponding values and durations for MIPS submission.

1. Quality

The Quality category consists of the quality of the care you deliver, based on performance measures created by CMS as well as medical professionals and stakeholder groups. To meet this requirement, most emergency physicians will have to report on six measures over a 12-month period. The Quality category will count for 40 percent of your total score in 2021. One great way to meet the Quality requirement is by reporting through a qualified clinical data registry (QCDR). ACEP has developed its own QCDR, called the Clinical Emergency Data Registry (CEDR).

60

Maximum Points

45%

Category Weight

1 Year

Performance Period

Red /Green validation indicator icons :

  • Red validation indicator icon indicates that the required criteria are not met. By default, the validation indicator icon is red.
  • Green validation indicator icon indicates that the required criteria are met.
  • The number in the indicator denotes the number of measures selected.

2. Promoting Interoperability (PI):

This category includes measures and objectives related to the use of electronic health records (EHRs). Most emergency physicians are exempt from this category (formally known as the “Meaningful Use” program) because they are “hospital-based” clinicians who use their hospital’s EHR. CMS exempts groups from the Promoting Interoperability category of MIPS as long as 75 percent of individuals in the group meet the definition of “hospital-based”. The MIPS-PI module facilitates ongoing data entry to meet MIPS PI reporting requirements for submission at the end of the performance year.

100

Maximum Points

25%

Category Weight

90 Days

Performance Period

Measures are scored based on :

  • Numerator and denominator values.
  • The submitted responses.

Red /Green validation indicator icons :

  • Red validation indicator icon indicates the criteria are not met. By default, the validation indicator icon is red.
  • Green validation indicator icon indicates the required criteria are met.
  • The number in the indicator indicates the number of objectives which were met.

3. Improvement Activities

This category rewards participation in activities that improve clinical practice. There is a list of activities that are classified as either medium or high-weighted based on their value to patient care. To earn full credit in this category, participants must submit one of the following

  • Two high-weighted activities
  • One high-weighted activity and two medium-weighted activities
  • Four or more medium-weighted activities

40

Maximum Points

15%

Category Weight

90 Days

Performance Period

Prerequisites to enter IA data :

  • NPI must be validated.
  • At least one TIN should be associated with the NPI.
  • MIPS eligibility should be verified.
  • Settings form should be updated.

Red /Green validation indicator icons :

  • Red validation indicator icon denotes that the required criteria are unmet. By default, the validation indicator icon is red.
  • Green validation icon indicates that the required criteria are met.
  • The number in the indicator indicates the number of selected high or medium activities.

MIPS Data Submission

Design & Iterate

Iterative design allows designers to create and test ideas quickly. Those that show promise can be iterated rapidly until they take sufficient shape to be developed; those that fail to show promise can quickly be abandoned.

It’s a cost-effective approach that puts user experience at the heart of the design process.

Wireframes

For Web

Brand Identity Designs

Colour Palette

For Web

Action & Link

#2C78F8

Hover on Link or info icon

#014ECF

Header Background

#F8FAFF

Normal Text

#283E60

App Background

#F9FAFC

Header & Drop down menu

#8AA3C6

Row Background

#FBFBFC

Hover Background

#F3F3F6

Red Color for rejected note

#EF5849

Badge Background

#FDE6E4

Pending or alert messages

#FF8900

Light Green

#46BC6D

Dark Green

#009531

Badge Background

#E5F4EA

Row Separator Line

#EEF2FB

Font Description

Font : Roboto

Category : San serif

Classification : Neo-grotesque

Font Examples

almost before we knew it, we had left the ground.

ALMOST BEFORE WE KNEW IT, WE HAD LEFTTHE GROUND.

0123456789~!@#$%^&*()_+=-`[]\\\\\\\\\\\\\\\\;’,./{}:”?

Visual Design (VD)

We then used the paper sketches to create mock-ups of different screens in Adobe XD. Below you can see visual design of the key screens we designed in order to improve usability of the app according to the major pain points. We followed the existing branding and design of the NIVA Web app and tried using fresh and more approachable colour for Niva Mobile app, also tried to keep solutions as simple and effective as possible to align with the business goals.

For Web

Home