As most regular readers of this column know, I have dedicated a great deal of space to venting our collective frustrations with the Medicare Access and CHIP Reauthorization Act (MACRA) and the many hoops that practicing dermatologists must now jump through—or risk financial penalties. I’ve also given advice on how to test the waters along with other tips on how to make MACRA work for your practice.

In this month’s column, I will be doing something different. I will be spotlighting a success story so that we can all learn from it.

By way of background, MACRA shifts physician payment so that it rewards value and quality over volume via the creation of the Quality Payment Program (QPP). The QPP offers two pathways for reimbursement: MIPS and Advanced Alternative Payment Models (APM).

Most dermatologists will not participate in the APM pathway so MIPS is the route for us as it is for Windsor Dermatology’s David Nieves, MD.

Here, Dr. Nieves shares the secrets to his success in his practice.


A Success Story

Basic Practice Information. Windsor Dermatology is a multi-physician dermatology practice in East Windsor, NJ. The practice has a 30-year history and comprises eight providers specializing in medical skin conditions and cosmetic skin enhancements with a research center.

MIPS Score. The 2017 MIPS performance score was 96.6 percent and the 2018 score was 100 percent. By contrast, the 2017 overall national mean for MIPS eligible clinicians was 74.01 percent.

Years Reporting MIPS Data. This is the third year we plan on reporting for MIPS.

Secret to the Practice’s Success. Our electronic health record (EHR), EMA from Modernizing Medicine, makes a potentially painful process far less painful. It helps us provide a high-quality patient experience, streamline internal workflow and remain compliant under MIPS. For example, it enables me to:

  • Have staff collect and enter MIPS-related background information, such as smoking and flu vaccination status, before I enter the exam room to streamline efficiency.
  • Format each patient’s medication status for dose, frequency, route of administration, etc.
  • Automate high-priority follow-ups for patients with severe conditions like melanoma.
  • Seamlessly collect and tabulate behind-the-scenes data for MIPS-targeted critical patient information/profiles such as avoiding the prescription of sedating medications to elderly patients.

Most Valuable Measures for the Practice. Tasks like entering patient histories and current medications in our EHR can easily be collected by the wider team before an exam, allowing me to focus my attention on my patient’s current concerns/reasons for visiting.

Tips for Other Dermatologists on the Fence about MIPS or Who Scored Worse. Modernizing Medicine has a built-in MIPS solution, which helps our practice remain compliant under these new standards, without sacrificing patient care. I am able to collect pertinent information and MIPS data throughout the flow of the exam seamlessly, without added work or additional clicks, which can otherwise detract from my one-on-one time with my patients. Plus, the company’s MIPS Advisory services are a valuable investment.

MIPS 2019 Dates to Note

October 3, 2019

  • Last Day to Start a 90-day Performance Period for Promoting Interoperability and Improvement Activities

December 31, 2019

  • Performance Year 2019 Ends
  • Quality Payment Program Exception Applications Window Closes

January 2, 2020

  • Submission Window Opens for Performance Year 2019

March 31, 2020

  • Submission Window Closes for Performance Year 2019

July 1, 2020

  • Performance Feedback Available