QPP/MIPS Qualified Registry

GUARDIAN— is a robust health information exchange (HIE) clinical integration architecture that drives a comprehensive array of care coordination and care management programs and service delivery platforms, including a CMS approved Qualified Registry for the abstraction, documentation, verification, and reporting of the full spectrum of payment associated quality performance measures identified in the MACRA Quality Payment Program (QPP). We are your dedicated partner in achieving long-term success and independence under MACRA and the every changing value-based healthcare environment.


There are two tracks under MACRA, Merit-Based Incentive Payment Program Systems (MIPS) and Advanced Alternative payment Models (APMs).

MIPS

This program consolidates existing fee-for-service systems such as (Physician Quality Reporting System, Value-Based Payment Modifier, and Meaningful Use) into one budget-neutral program.

APMs

This program rewards providers with an annual bonus from 2019-2024, when they participate in alternative (transparency focused) payment models for their Medicare beneficiaries.

Guardian has the tools and support to ensure your success in the journey of MACRA—MIPS. We have a full portfolio of programs and platforms that are directly aligned with MACRA MIPS expectations.

qpp registry

CATEGORIES FOR MIPS REPORTING

Quality

Quality

Replaces PQRS

  • Care Gap Program for collection and documentation of MIPS measures
  • Qualified Registry for compliance audit , review and reporting of MIPS to CMS
  • Identify process improvements to capture MIPS measures within existing workflow
  • Qualified Physician Care Managers to assist practices capture MIPS measures
  • Guardian Connect mobile HIPAA compliant app for secure communications

Improvement Activities

Improvement Activitie

New Category

  • Centralized referral management program to improve care coordination
  • Transitions of care program to ensure continuity and coordination of care
  • Care plan development and monitoring
  • MINI-CAHPS program to gauge patients experience
  • AWV, Population health and Medication Management programs

Advancing Care Information

Advancing Care Information

Replaces the Medicare EHR Incentive Program also known as Meaninful Use

  • Clinical Integration through interfaces with EHR
  • Health Information Exchange based patient portal
  • Innovative Patient care using Telehealth and Telemedicine
  • State Health Information Exchange access using the Guardian HIE
  • Exchange Clinical data with hospitals and specialists using Guardian HIE

Cost

Cost

Replaces the Value-Based Modifier

  • Alternative cost effective and high quality delivery platforms
  • Monitoring specialty based care episodes
  • Appropriate use of resources
  • Consensus treatment plans
  • Personalized Care Guardians to help patients navigate care

Guardian Qualified MIPS Registry Resources

MACRA QPP EXCLUDED: PROVIDERS

  • Newly enrolled Medicare Providers—Providers who are in their first Medicare Part B calendar year.
  • Providers below a Medicare patient volume threshold—Providers who:
    • Have recorded Medicare billing charges of less than or equal $30,000.
    • Providing care to 100 or fewer Part-B enrolled Medicare beneficiaries.

Provider subject to MACRA participation in the 2017 transition year include:

  • Physicians (MDs and DOs)
  • Physician Assistants (PAs)
  • Nurse Practitioners (NPs)
  • Clinical Nurse Specialists (CNS)
  • Certified Registered Nurse Anesthetists (CRNAs)