DMS November Bulletin
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Official Publication of The Denver Medical Society

November 2019
Disappointed Docs Say: MIPS Is Not Worth It!
Elizabeth Woodcook - Medscape - Aug 20, 2019
"It's simply not worth it."

These words-spoken by an attendee at a program practice expert, Elizabeth Woodcock, MBA recently gave on navigating the Merit-based Incentive Payment System (MIPS) - hung in the room. Soon, the physician was joined by more attendees expressing similar consternation after hearing the government's announcement that MIPS bonuses would be, at best, 1.68% for those who demonstrated exceptional performance.

For all the work involved in reporting for MIPS, many physicians and practice managers across the country are coming to recognize that the 1.68% bonus given from the government's payment program may not be worth the time and resources required to participate, according to Woodcock. 

The Quality Payment Program (QPP), the "corporate" name given to the federal government's program, includes MIPS as well as participating through an Advanced Alternative Payment Model. The dual-track QPP was formed by merging three programs created under the Obama administration. These included the EHR Incentive Payment System (fondly known by its fundamental requirement, "meaningful use"), the Value-based Payment Modifier, and the Physician Quality Reporting System. 

The problem is no one is losing. 

The problem is no one is losing, which would be exactly what the government wants. And it's no surprise, as doctors are, by nature, uber-competitive.

The budget-neutrality aspect of the program means that participating physicians are getting paid ridiculously low bonuses. In July, the government announced that those with perfect scores - 100 points- were getting a 1.68% bonus. This is applied to Medicare Part B.

In a typical practice, Medicare Part B reimbursement hovers around $50,000. Of note, the payments vary, especially by specialty. And arguably, that's a fairly high number, as Medicare Advantage products pick up speed in the market and cannibalize Medicare Part B.

Payment is Bare Bones

Beacuse Medicare Part B is the basis for the incentives paid by the QPP, this dynamic is important to recognize. CMS has declared that "...whether and how the MIPS payment adjustments might affect an MAO's [Medicare Advantage Organization] payments to its contract clinicians are governed by the terms of the contract between the MAO and the clinician." The commercial payers administering these Medicare Advantage plans aren't shelling out extra in non-mandated government bonuses. 

The bonus, therefore, is at best $840, paid in pennies and dimes throughout the year. And, if history repeats itself, that figure will drop before any payout is made. Last year, the promise of a 2.05% bonus was whittled down to 1.88% after the government had processed all appeals. 

When the QPP launched, a separately funded pool of money that would allow special bonuses - up to 15% this current performance year - was to be paid out to exceptional performers. (The threshold for exceptional performers was 70 points last year, and 75 this year.) Yet, even those with perfect scores got 1.88% last year, and received word that 1.68% was all that was in store for the next payout. 

But despite all the downsides and all the costs, it's critical that you participate in the program!

That's because the penalties are significant. While there are hopes of gaining $840, there are realities of losing more than 7% in 2021 (the impact year for the current performance year of 2019, as the program runs in 2-year cycles). 

See how you can participate without spending thousands of dollars here.
DMS and CMS Physicians Meet with Rep. Diana DeGettte
Drs. Sami Diab, CMS President-elect, Deb Parsons, CMS Immediate Past President, David Downs, Rep. DeGette, Tamaan Osbourne-Roberts, Jeremy Weiss, DMS Treasurer, and Chris Unrein.

New Colorado “Surprise Bill” Legislation Takes Effect
January 1st, 2020

CO All Payer Claims Database will help determine payments

Surprise bills for out-of-network services can negatively impact the financial well-being of Coloradans. In an effort to curb the impact of these bills on patients and the health care system, HB 19-1174 was passed this year specifying how much insurers and patients should pay for different types of out-of-network services. HB 19-1174 includes the Colorado All Payer Claims Database (CO APCD) in the bill as the source of information for understanding regional and statewide commercial health insurance payments.

Center for Improving Value in Health Care (CIVHC) and the Division of Insurance (DOI) have been working together to determine the specific methodology that will be used to calculate payments using the CO APCD. As we’re working through the details, we’ve put together some Frequently Asked Questions that can help provide some guidance to payers and providers.

Click here to check out all of the FAQs. If you have additional questions about CIVHC’s role in HB 19-1174, please email

Electronic Health Records Continue to Lead to Medical Malpractice Suits
Darrell Ranum, JD, Vice President of Patient Safety and Risk Management

For 8 years, claims in which the use of electronic health records (EHRs) contributed to patient injury have been on the rise. 

The Doctors Company’s analysis of claims in which EHRs contributed to injury show a total of 216 claims closed from 2010-2018. The pace of these claims grew, from a low of 7 cases in 2010 to an average of 22.5 cases per year in 2017 and 2018.  EHRs are typically contributing factors rather than the primary cause of claims, and the frequency of claims with an EHR factor continues to be low (1.1 percent of all claims closed since 2010). Still, as EHRs approach near-universal adoption, they may become a more prevalent source of risk. 

The EHR-related claims closed from 2010-2018 were caused by either system technology and design issues or by user-related issues. 

*Note that the percentages are of the total number of electronic health record claims (n=216).

Find the full article here.


Hosted by:

Denver Medical Society & Aurora-Adams County Medical Society 

Bring a guest and enjoy an evening of complimentary food, drinks, and live music at the Curtis Ballroom in Denver Tech Center. Catch up with your colleagues and take in the beautiful view from the rooftop deck.
We'll recognize our physicians who have been practicing for 50 years and the Presidents of Denver Medical Society and AACMS. 

Make sure to enter the raffle to win great prizes!


5345 Landmark Place
Greenwood Village,CO

RSVP Here!
SoPE Colorado: Lessons Learned from a Lifetime of Entrepreneurship
November 7, 2019


Shawn Owen is a serial entrepreneur with experience in management and ownership of enterprise operations with a passion for systems development, business operations, product delivery, and client service. Shawn has proven to be a dynamic and energetic entrepreneur with 25 years in business operations and has a proven track record of investing in progressive graduation of growth, both personal and professional. He also frequently speaks and writes on Blockchain technology and digital currencies, another passion of his that he is excited about!

Shawn became involved with blockchain technology through his advocacy of bitcoin in early 2011. He has since co-founded a blockchain-backed fintech company, SALT Lending, and presently serves as the CEO and Founder of Equa, his newest venture. Equa is a company, based also on blockchain technology, that provides stakeholders within businesses of all sizes the tools to easily navigate and maintain essential corporate documentation including capitalization tables, equity voting, and corporate governance and other potential applications in healthcare. Equa reduces the time and expense of organizational record keeping by leveraging backend blockchain technologies for their client base. The result is a single source of truth that protects clients from unnecessary bureaucracy while supporting accelerated productivity.

Timed Agenda
7:00am-7:30am Networking
7:30am-8:00am Introductions
8:00am-8:45am Guest Speaker
8:45am-9:00am Q/A
COPIC Insurance
7351 East Lowry Boulevard
Denver, Colorado 80230
Register Now
DMS Physicians Discuss Aid in Dying
Dr. Cory Carroll shared his experience in
assisting dying patients
Dr. Don Murphy poses a question to the group
Dr. Barbara Morris discussed her experience as a Centura physician
Mark Your Calendar!

Denver Medical Society Annual Member Social
Curtis Ballroom at Landmark,  5345 Landmark Pl, Greenwood Village, CO
Join colleagues for a fun complimentary evening of cocktails, buffet dinner and live music
6:00 PM

SOPE Colorado: Lessons Learned from a Lifetime of Entrepreneurship 
Guest speaker Shawn Owen, serial entrepreneur
7:00 AM - 9:00 AM
Breakfast included
Register here

Division of Workers’ Compensation
Medical Fee Schedule updates (Rules 16 & 18)
Webinar 2:00-4:00 PM
Register here. 

Denver Medical Bulletin: Alan E. Kimura, MD-President/Publisher / Elizabeth L. Lowdermilk, MD-Chair of the Board / Michael L. Moore, MD, President Elect / Jeremy L. Weiss, DO, Treasurer / Kathy Lindquist-Kleissler, Executive Director. The Bulletin is the official publication of the Denver Medical Society, established April 11, 1871, as the first medical society in the Rocky Mountain West. Published articles represent the opinions of the authors and do not necessarily represent the official policy of the Denver Medical Society. All correspondence concerning editorial content, news items, advertising and subscriptions should be sent to: The Editor, Denver Medical Bulletin, 1850 Williams Street, Denver, CO 80218.
Phone (303) 377-1850.
Copyright © *2019* *Denver Medical Society*, All rights reserved.

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