Radiology practices using AI and NLP to boost MIPS payments

Positive or negative Medicare payment adjustments in 2019 will depend on performance to quality and other measures in 2017 under a new program called the Merit-based Incentive Payment System. Doing well on quality measures is important because they comprise 60 percent of a provider's total MIPS score – possibly 85 percent for certain specialties such as radiology. Most of the quality measures in MIPS are based on face-to-face patient encounters and are not particularly applicable to radiology. "We had to take full advantage of the few quality measures that were suitable to us," said Cheryl Sullivan, clinical workflow analyst at RadNet. "Our coding system was only partially effective in retrieving the necessary information for measures and needed to be checked frequently against the clinical record for accuracy. Manual coding is slow, expensive, and still must be checked for accuracy."