Achieving Successful, Full Year MIPS Reporting as a Specialist

Long wait times in physician offices have been shown to be a major cause of dissatisfaction among patient populations. Such dissatisfaction can adversely affect patient volume as well as financial stability for an organization. Extended wait times and difficulty in managing office flow have been identified as areas for improvement at the Eye and Lasik Center in Greenfield Massachusetts, a group of 21 practitioners with eight practice sites. The data they collected showed the average patient wait time to be roughly 23 minutes, which was leading to disruptions in their overall workflow.

Tracy, the Practice Administrator, sought outside support to analyze and improve the current processes within the practice. As a result, a program called Visual Clinic was put into place, which enables the practice to monitor real-time patient flow through the clinic. Another tool, FOCUS, was incorporated into the electronic health record system which assists in further managing the patient flow and is directly linked to the billing and scheduling systems. The post-implementation data demonstrated a steep decline in the patient wait time by 30%, to an average of 15 minutes. With reduced wait time, patients reported improved care experiences and better quality of care.

With the introduction of the Merit-based Incentive Payment System (MIPS) the Eye and Lasik Center identified interest in reporting for a full year to maximize their positive payment adjustment and potential for part of the exceptional performer bonus. The group approached the New England QIN-QIO Massachusetts Quality Payment Program (QPP) team for assistance with selecting quality measures and improvement activities to support their MIPS reporting. The MA QPP team helped the group to identify appropriate improvement activities based on various clinical practice improvements they have already undertaken with workflow redesign, patient experience and engagement, which they continue to pursue. The MA QPP team reviewed the improved processes within the group and selected improvement activities that align well with each other, avoiding redundancy and waste. The MA QPP team further helped the practice to collect the supporting documentation needed for successful reporting.

Through the MA QPP team’s work with the group on selecting improvement activities, it was identified that there is concern related to low utilization of the group’s patient portal. The MA QPP team analyzed the current strengths and weaknesses of the existing patient portal and made recommendations regarding educating patients about the functions available through the portal, how to activate patient accounts as well as how to monitor utilization. Currently, the group is monitoring patient utilization and will be increasing marketing efforts as well as launching a program to have a staff member available in the waiting room to assist with account activation and navigation this summer. The group continues to monitor wait times, workflow and level of patient engagement using the FOCUS tool. They are regularly communicating with the MA QPP team and reach out for assistance and support when needed.

The success achieved by the Eye and Lasik Center can be attributed to several factors, which include: realizing the issues related to care delays, reaching out for help and implementing timely interventions. The willingness of the group to learn and incorporate new ideas into the workflow also led to accomplishing the desired results. Due to the partnership with the MA QPP team and hard work, the Eye and Lasik Center is on track to report for the full year of MIPS and receive a positive payment adjustment and likely an exceptional performer bonus.