How Does Post Acute Care Impact MIPS?

Post acute care (PAC) facilities provide essential health services to older adults who have recently experienced hospitalization. PAC's significance in the care continuum is evident in its direct impact on Medicare’s Merit-based Incentive Payment System (MIPS) scores, which determine payment amount and bonus opportunities.

Efficient, accurate, and structured reporting of PAC data is essential for providers to increase their MIPS scores, maximize reimbursements, and support high-quality care. This reporting relies on effective document management systems that meticulously record the events along the care continuum.

Understand Post Acute Care (PAC)

Post acute care refers to the medical and rehabilitation services provided to patients after a hospital stay. Older adults typically require more time in PAC following acute medical treatment, often due to coexisting illness and disability. 

In the U.S., there are a few different types of PAC:

  • Skilled nursing facilities provide integrated nursing and medical care to residents within nursing homes.
  • Home health aides provide skilled nursing care and rehabilitation in a patient’s home.
  • Inpatient rehabilitation facilities are for people who need several hours a day of rehabilitation after certain medical events like spinal injury or stroke.
  • Long-term care hospitals cater to individuals who have moved past the acute care stage but still need specialized treatment such as ventilator care or management of conditions like heart or lung failure. 

When PAC is implemented effectively, it can improve patient outcomes and reduce the rate of hospital readmissions. It is, therefore, an essential component of the healthcare continuum.

An Overview of MIPS (Merit-based Incentive Payment System)

An Overview of MIPS (Merit-based Incentive Payment System)

MIPS replaced the old Medicare system of physician reporting. Under the new system, doctors are less likely to face payment cuts and also have the opportunity to earn bonuses for meeting specific criteria, such as delivering quality care. 

This incentive system requires healthcare providers to report on activities across several categories, to which Medicare assigns a score that ultimately determines reimbursement levels. These categories generally include:

  • Quality and cost of patient care
  • Improvements to clinical care processes and patient engagement
  • Use of certified electronic health record technology (CEHRT) for the exchange of health information

Healthcare providers who receive high scores based on these indicators are expected to deliver high-quality care at a reasonable cost. Electronic health records play a crucial role in MIPS scoring and streamlining referrals to home health and other PAC services. 

The Impact of Post Acute Care on MIPS Scores

PAC providers can influence their MIPS scores by demonstrating their adherence to performance categories under MIPS. This includes improved quality of care, patient satisfaction, and care coordination.

A 2022 study revealed that physicians treating patients with complex health conditions often received lower MIPS scores despite providing high-quality care. Prioritizing reporting on PAC might help these providers demonstrate compliance with MIPS objectives. 

Leveraging Document Management in Post Acute Care for MIPS Improvement

In PAC settings, document management is crucial to ensure accurate reporting and timely communication between providers. Effective document management improves compliance and continuity in patient care. 

Document management solutions play a vital role in facilitating the smooth transfer of information between personnel. Integrations like WorldView and Care Coordinations enable seamless communication flow between patients, caregivers, and healthcare providers. The integration facilitates the delivery of quality care to patients at home, helping healthcare providers enhance their overall care standards and improve their MIPS scores.

Practical Steps for Post Acute Care Organizations

PAC providers can take these steps to improve their MIPS scores through effective document management:

  • Implement a secure and seamless document management system by partnering with a reliable service provider
  • Train staff on the effective use of document management technology, including how to properly log activities in accordance with MIPS objectives
  • Conduct an annual evaluation to assess the effectiveness of the document management system, evaluating its impact on MIPS scores and identifying areas for improvement

Enhance MIPS Scores with Document Management Solutions

Post acute care is an essential part of the care continuum, supporting patient recovery and reducing hospital readmissions after acute events. With an effective document management system, PAC providers can maintain data accuracy in reporting, leading to improved patient care and outcomes. This, in turn, results in higher MIPS scores and increased reimbursements for the practice.

Document management solutions such as WorldView can help healthcare organizations such as PAC providers achieve their MIPS goals through effective document management strategies. 

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