Physicians Revenue Cycle Management
Doctors MACRA Services
Year-round MIPS support across quality, cost, improvement activities and promoting interoperability, from measure selection to accurate, on-time submission.
MACRA & MIPS
Turn everyday quality care into a stronger MIPS score
Under MACRA’s Quality Payment Program, eligible clinicians are evaluated through the Merit-based Incentive Payment System (MIPS). Your performance across quality, cost, improvement activities and promoting interoperability determines whether future Medicare payments are adjusted up, held neutral or reduced.
PRCM’s multi-disciplinary team supports practices across specialties, from solo practices to multi-specialty groups. We help you understand requirements, choose the right measures, track performance all year and submit accurate data on time.
The four MIPS categories
- Quality: measures that reflect the care you provide
- Cost: calculated from Medicare claims
- Improvement Activities: care process improvements
- Promoting Interoperability: use of certified EHR technology
Our services
Year-round MIPS support
Eligibility and reporting strategy
We confirm clinician eligibility and choose between individual and group reporting for the best result.
Measure selection
We choose measures that fit your specialty and patients, with realistic scoring potential.
Quarterly performance monitoring
We review performance through the year and help close care gaps while there’s still time.
Improvement Activities
We identify activities you already perform and help document them properly.
Promoting Interoperability
We help meet requirements, including the security risk analysis and EHR measures.
Accurate data submission
We validate data, submit each category and keep confirmation records.
Our process
How we manage your MIPS year
- Plan earlyEligibility, reporting level and measures chosen at the start of the year.
- Build workflowsEHR prompts and staff workflows that capture measure data during visits.
- Monitor quarterlyPerformance reviewed and care gaps closed throughout the year.
- Validate and submitData checked for completeness and accuracy, then submitted on time.
- Review feedbackFeedback reports analyzed to improve next year’s strategy.
Avoid penalties
Common MIPS mistakes we help you avoid
Most MIPS problems aren’t about the quality of care. They’re about planning, documentation and data. A year-round approach prevents last-minute surprises.
- Waiting until the submission deadline
- Choosing measures that don’t fit your patients
- Missing data completeness requirements
- Skipping the security risk analysis
- Attesting to activities without documentation
Questions
MACRA and MIPS FAQs
Who has to participate in MIPS?
Eligibility depends on clinician type and Medicare patient and service volumes. Some clinicians are exempt, and others may choose to participate. We check eligibility for each clinician.
Can small practices succeed in MIPS?
Yes. Small practices may have special scoring considerations, and categories like Improvement Activities offer achievable points with proper planning.
Do we need to submit data for the Cost category?
No. Cost is calculated from Medicare claims, but care patterns such as reducing avoidable hospitalizations can influence it over time.
When should we start planning?
At the beginning of the performance year. Early planning lets you choose measures, build workflows and monitor performance before it’s too late to improve.
Insights
Related reading
Protect your Medicare payments
Let’s review your MIPS strategy and build a plan for a stronger score.