MIPS Qualified Registry and QCDR: Understanding the Differences

Introduction to MIPS Qualified Registry

In the landscape of the US healthcare system, only a select few agencies achieve the status of a MIPS qualified registry. Clinicians can choose from seven MIPS submission methods, each offering distinct advantages. However, healthcare organizations and physicians frequently confuse MIPS qualified registries with Qualified Clinical Data Registries (QCDR). This confusion is particularly evident among physicians who may lack comprehensive knowledge of the MIPS 2019 reporting process, making it challenging to determine the best submission strategy.

P3Care’s Expertise in MIPS Reporting

P3Care has been recognized as a MIPS qualified registry for three years, providing valuable expertise in navigating various submission methods. Below is an overview of the two terms that often lead to confusion within the MIPS Quality Payment Program (QPP).

Defining MIPS Registry and QCDR

MIPS Registry Explained

A MIPS registry is responsible for reporting clinical data on behalf of eligible clinicians or healthcare organizations.

Understanding QCDR

In contrast, a Qualified Clinical Data Registry (QCDR) is a CMS-approved entity that collects clinical data for the Centers for Medicare & Medicaid Services (CMS) on behalf of physicians. Unlike MIPS registries, QCDRs are typically not individually managed and provide a broader scope of data submission measures. They can also include non-MIPS measures approved by CMS.

Categories for QCDR Reporting Measures

The measures reported by QCDRs can be categorized as follows:
– National Quality Forum (NQF) endorsed measures
– Current 2019 MIPS measures
– Measures from regional quality collaborations
– Other measures approved by CMS
– Measures endorsed by boards or specialty societies
– Clinician and group consumer assessment of healthcare providers and systems (CAHPS), reported by CAHPS certified vendors
– Registries endorsed by national specialty societies

Reporting Mechanisms for MIPS

Submission Types and Performance Categories

Depending on the reporting type and category, physicians can submit data individually, as a group, or within a virtual group. The four performance categories for reporting are:
– Quality
– Improvement Activities (IA)
– Promoting Interoperability (PI)
– Cost

For the cost category, no data submission is required; instead, CMS will utilize administrative claims data. Both MIPS qualified registries and QCDRs can report up to six measures and all-cause readmission measures for groups with sixteen or more clinicians.

Choosing the Right Submission Method

Factors to Consider

When selecting a reporting method, the decision should not be based solely on the number of available measures. Instead, it should focus on maximizing the final MIPS score in healthcare. Consider the following points before making a decision:
– Relevance of measures to your practice
– Benchmarks for available measures in each submission method
– Achievable performance rates for selected measures
– Availability of bonus points for the chosen measures
– Identification of topped-out measures

Making an informed decision is crucial, as it can significantly impact the potential for incentives and bonuses, ultimately enhancing revenue cycle management.

Conclusion

As medical practices enhance the quality of healthcare services, MIPS QPP serves as a benchmark for measuring progress. Whether utilizing a MIPS qualified registry or another submission method, it is essential to clarify your objectives, weigh the pros and cons, and strategize effectively for reporting clinical data to MIPS through the most appropriate method.