New MIPS Submission APIs: What does this mean for you?

One of the lesser-known parts the new Quality Payment Program is CMS’s massive effort to overhaul how MIPS data will be submitted. The changes bring significant benefits for clinicians participating in MIPS, but most of the work is happening in the background.

Able Health is thrilled and honored to participate as an alpha testing partner with CMS to test the new submission mechanisms, and we will be fully utilizing the new, modern technology being used for data submission this year.

But what does it mean for you? We will describe three key advantages of the CMS API, but first…

What is an API?

An API, or Application Programming Interface, allows software systems to communicate with each other. In this case, CMS is providing a set of tools for submitting MIPS data that gives our developers all the building blocks necessary to automate submission of MIPS performance data from our system to CMS’s system, and also to exchange information in both directions on an ongoing basis. Compare this with the often manual, one-time bulk data submission used in the past for programs like PQRS–the new way is more flexible and less error prone.

What kind of information is being exchanged through this API?

Registries, QCDRs, and EHR vendors can use the API to submit MIPS performance data, such as “Performance Met” or “Performance Not Met” results for Quality measures, or Yes/No attestation for Improvement Activities and Advancing Care Information attestation measures. We are able to submit this data on an ongoing basis to verify that submissions are correct and able to be accepted by CMS.

Even more groundbreaking, Registries and vendors are able to receive back scoring data from CMS in real time. This means that we can send performance results and immediately receive scoring information throughout the performance year.

What this means for you

1. More transparency

Because scoring can be performed in real time throughout the performance year, you can have accurate feedback from CMS always at your fingertips, so you will be much less likely to face surprises a year down the road when you receive your final MIPS score. Unlike in the PQRS program, where all data was submitted in bulk at the end of the year and you didn’t know your score until you received your QRUR a year later, the feedback loop for MIPS will be much tighter.

2. Better performance, lower costs

The data submission format used for PQRS (XML) is a less flexible and older method of data transfer. With the API submission mechanism, companies like Able Health will be able to build connectors with CMS in the same way that companies like Google or Salesforce build connectors, powering a much higher quality product at a lower cost…and therefore a lower price for you!

3. Up-to-date information

APIs are a flexible way to give and receive information, and CMS is expanding the types of information it is exposing through this mechanism. CMS has already rolled out an API with measure descriptions, as well as a way to access measure performance benchmarks through the API. As measure specifications and benchmarks are updated, these updates will be available through the API and will flow directly into any product that is utilizing the API. This will ensure that the information you are seeing is always up to date.

Learn more about our QCDR offering, or sign up for our newsletter to stay up to date on QPP news.


Further reading:
Avoiding a penalty in 2018 MIPS: the nuts and bolts
Radiology & MIPS Reporting: Everything You Need to Know

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