BC Advantage - 2020 Issue 1
Risk Adjusted Coding: A Closer Look at MIPS Implementation in 2020
Subscribe or sign in to view the full article.
Article Overview
This article explains how 2020 MIPS implementation affects cost measurement and clinician attribution under CMS policy. It is aimed at clinicians, coders, and practice administrators who need a high-level understanding of the MIPS cost category, revised MSPB clinician methodology, facility-based scoring, and the broader categories of episode-based measures introduced for 2020. The discussion is framed around CMS’s final rule and the types of services and specialties considered in attribution and exclusion methodology, without going into premium-level operational detail.
Why This Topic Matters
Understanding these 2020 MIPS changes helps practices anticipate how cost performance is evaluated, how attribution works, and how revised measure structures may affect reporting and comparison among clinicians and groups.
Article Sections
-
MIPS program components and 2020 effective dates
Summarizes the major MIPS performance categories and identifies the rulemaking timeline for the 2020 performance period.
-
Cost category overview and total per capita cost methodology
Describes the cost component at a broad level, including how the article frames attribution, risk adjustment, and the overall purpose of the measure.
-
Attribution and primary care service methodology
Explains the general attribution framework for assigning beneficiaries to clinicians or groups and discusses the kinds of clinician categories referenced in the article.
-
Revised MSPB clinician measure
Covers the updated MSPB clinician concept, including the article’s discussion of episode types, comparative methods, and related risk-adjustment changes.
-
2020 episode-based measures
Introduces the new episode-based measures added for 2020 and notes the article’s summary of case minimum concepts.
-
Facility-based measurement scoring
Reviews the conditions under which facility-based scoring may apply to Quality and Cost categories.
What You Will Learn
- How MIPS is structured for the 2020 performance period
- How the article frames cost measurement and attribution
- What changed in the revised MSPB clinician methodology
- Which broad categories of episode-based measures were added for 2020
- How facility-based scoring can affect MIPS Quality and Cost categories
Who Should Read This
- Clinicians participating in MIPS
- Medical coders
- Practice administrators
- Reimbursement and compliance staff
- Healthcare consultants
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com