ImagineSoftware recently partnered with Guidance Analytics to present a comprehensive webinar, "Last Chance for a 2024 MIPS Head Start on 2025," where industry experts Dr. Brian Gale, Gary Gerber from Guidance Analytics, and TJ Applegate from ImagineSoftware shared strategies for optimizing MIPS (Merit-based Incentive Payment System) reporting and avoiding penalties. Focusing on how radiology practices can leverage advanced analytics, the session addressed the evolving MIPS landscape and the benefits of forward-thinking reporting solutions.
The Challenge: Traditional Registries Falling Short
TJ Applegate, ImagineSoftware’s Director of Business Development Operations, began by addressing the limitations of traditional MIPS registries, particularly for radiology practices. "Radiology clients have shifted from receiving bonuses to facing penalties, despite using the same registry," he noted, underscoring how CMS's changing standards—such as the removal of essential quality measures—require a more sophisticated approach. To meet these needs, ImagineSoftware has partnered with Guidance Analytics, whose Velocity MIPS Reporter provides seamless, daily automated data transmission.
"Guidance Analytics integrates effortlessly with Imagine,” Applegate explained, “eliminating the need for manual data management or extracts, which saves our clients time and minimizes errors.
Applegate addressed the growing complexity of MIPS reporting as CMS continues to evolve its guidelines and remove or alter specialty-specific measures. "The elimination of critical measures that once allowed radiology practices to perform well in MIPS creates a significant challenge," he said. As the standards become more stringent, practices need a solution that is both comprehensive and adaptable. Through the integration with Guidance Analytics, ImagineSoftware ensures that its clients can access up-to-date, accurate data at all times, helping practices stay ahead of compliance changes. This partnership not only automates the process of MIPS reporting but also provides real-time insights, giving practices the ability to make informed decisions quickly. With this seamless integration, radiology practices can streamline their reporting, reduce the risk of penalties, and focus on what matters most—delivering excellent patient care.
Understanding MIPS Changes for 2024–2025
Dr. Brian Gale, founder of Guidance Analytics, highlighted recent changes making traditional MIPS measures increasingly challenging for radiology practices. “CMS has phased out many radiology-relevant measures and raised performance benchmarks to nearly unattainable levels,” he explained. Compounding these shifts, CMS introduced a cost category for radiologists, increasing penalty risks. This shift makes it crucial for radiologists to explore QCDR (Qualified Clinical Data Registry) measures, which offer scoring tailored to their specialty. “Exploring QCDR measures can provide radiologists with a strategic advantage,” Dr. Gale said, emphasizing how these specialized measures can buffer radiologists from punitive adjustments.
In addition to the changes in performance benchmarks and the introduction of the cost category, Dr. Gale pointed out that the removal of several radiology-specific measures has left many practices without sufficient scoring opportunities. "Radiology practices now find themselves with fewer relevant measures to report on, and those that remain often require near-perfect performance to avoid penalties," he said. This shift puts added pressure on radiologists to find alternative ways to improve their scores. By adopting QCDR measures, practices can take advantage of more relevant and achievable metrics, ensuring that they are accurately reflecting the quality of care they provide. Dr. Gale stressed that leveraging QCDRs is no longer just a strategic choice but a necessary move to stay competitive and avoid financial setbacks under the evolving MIPS framework.
QPP vs. QCDR: Understanding the Difference
The Quality Payment Program (QPP) offers standard measures across specialties, but QCDR options are tailored, CMS-approved measures designed specifically for unique fields like radiology. "Only CMS-approved QCDRs can provide these customized measures," Dr. Gale pointed out, explaining how these alternatives can drastically impact outcomes. As an example, he shared comparative scores: a practice relying solely on MIPS measures would score around 70.3—potentially triggering penalties—while those using QCDR measures achieved scores closer to 98. “QCDR reporting can be the difference between a positive and negative payment adjustment,” he emphasized, advocating for the enhanced, specialty-specific approach.
Dr. Gale also highlighted the flexibility of QCDRs, noting that they offer practices the ability to track and report on measures that directly align with the nuances of radiology. This customization not only increases accuracy but also ensures that practices can highlight their strengths while addressing specialty-specific challenges.
By incorporating QCDR measures, radiologists gain the opportunity to improve their scores in areas where traditional MIPS measures may not fully capture their performance or quality of care.
Additionally, the enhanced data captured through QCDR reporting provides a more comprehensive picture of a practice’s overall performance, enabling radiologists to make more informed decisions that lead to better compliance and more favorable financial outcomes. Ultimately, QCDRs empower radiology practices to optimize their reporting for maximum success under the MIPS program.
Automation and AI: The Future of MIPS Reporting
Gary Gerber, COO of Guidance Analytics, introduced the Velocity MIPS Reporter and the Data Lux dashboard, both powered by next-generation AI for a fully automated MIPS reporting experience. "We’ve harnessed AI to handle every aspect of scoring and reporting," Gerber shared, "so practices can focus on enhancing their scores rather than managing data.” The tools’ daily data transfers from ImagineSoftware ensure that MIPS reporting remains current, comprehensive, and free from manual data errors.
The Velocity MIPS Reporter and Data Lux dashboard not only automate MIPS reporting but also offer real-time performance tracking and predictive analytics. These tools leverage AI to continuously analyze data, identify trends, and forecast potential outcomes, helping practices make data-driven decisions throughout the reporting year. With daily updates, the system provides an up-to-date snapshot of performance, enabling practices to adjust strategies quickly and address any emerging compliance gaps. By eliminating the need for manual data entry and error-prone processes, these AI-powered tools streamline MIPS reporting, giving radiologists the freedom to concentrate on patient care and practice growth, while the technology handles the complexities of compliance and scoring.
Real-Time Insights and Continuous Optimization
Guidance Analytics’ Data Lux dashboard offers a cutting-edge solution for real-time MIPS performance tracking. Through this dashboard, practices gain detailed insights into individual provider scores, measure-specific performance, and projected year-end outcomes. “We designed Data Lux to be intuitive and actionable,” Gerber explained. “With color-coded visuals that highlight areas needing improvement and an interactive heat map tracking daily measure performance, practices can easily identify trends and make proactive adjustments.”
A standout feature of Data Lux is its integration with Guidance Analytics’ MACRA optimization sessions. In these regular sessions, experienced consultants develop personalized action plans using Data Lux insights to improve MIPS scores systematically. The platform’s real-time data access allows practices to model score changes, helping them prioritize high-impact actions with immediate results.
This data-driven approach keeps practices agile, enabling them to adapt their strategies based on up-to-date performance metrics.
The dashboard further enhances MIPS planning by displaying each measure's performance across providers, allowing targeted, data-driven interventions. By identifying and addressing specific compliance gaps, practices can elevate their MIPS scores strategically and continuously. With these advanced analytics tools, Guidance Analytics enables radiology practices to create a clear roadmap for sustainable MIPS success.
Bridging the Gap with Personalized Support
Guidance Analytics complements its technology with dedicated, hands-on support, offering monthly or biweekly consulting sessions to help practices meet their MIPS goals. “These sessions go beyond score tracking,” Gerber said. “They include in-depth reviews, actionable performance plans, and updates to ensure practices stay aligned with their targets.” This collaborative approach provides radiologists with the guidance needed to improve their MIPS scores over time, allowing them to focus on high-impact areas without overwhelming their resources.
In addition to personalized score reviews and performance tracking, Guidance Analytics’ consulting sessions also focus on strategic planning for long-term MIPS success. During these sessions, expert consultants analyze a practice’s historical data and performance trends to identify patterns and potential areas for improvement. By focusing on both immediate actions and long-term strategies, Guidance Analytics ensures that practices not only meet short-term MIPS goals but also build sustainable, high-performing practices over time. This proactive approach empowers radiologists to stay ahead of regulatory changes, optimize their performance efficiently, and ultimately secure better financial outcomes through positive payment adjustments.
In-Depth Features: Practical Support and Strategy Tools
In the webinar, Gerber highlighted the user-friendly features of the Data Lux dashboard, including an easy-to-access overview of each measure's descriptions, compliance rates, and procedural data. These features simplify consulting sessions by making it easy to identify improvement strategies and compliance gaps. Gerber gave an example involving measure “MSN 13,” which had a 20% compliance rate and scored one point. By completing an additional 16 addenda, a practice could boost this score from one to ten points. Data Lux supports this process with filtered lists of procedures requiring addenda, enabling targeted action to improve scores efficiently.
The dashboard’s “Measure Atlas” consolidates every MIPS measure, allowing users to filter by criteria such as SHP measures and view detailed eligibility requirements. Each measure includes a breakdown of denominators, numerators, and documentation needs, with downloadable templates available to streamline reporting and minimize the need for additional addenda. By offering a centralized resource for MIPS compliance, Data Lux simplifies the process and empowers practices to take action quickly.
Score Modeling and Strategic Planning
Guidance Analytics’ score modeling tool empowers practices to analyze potential score improvements by simulating changes based on performance adjustments. This feature helps radiology practices target lower-performing measures that require fewer addenda, maximizing their score gains with minimal additional effort. Through regular consulting sessions, Guidance Analytics offers expert guidance on setting achievable goals and tracking progress, ensuring that practices improve their MIPS scores without overwhelming their staff.
By combining advanced score modeling with strategic consultations, Guidance Analytics positions radiology practices for financial success within the MIPS framework. This approach enables practices to adapt quickly, refining their strategies to maximize positive payment adjustments year after year.
Full-Cycle Support Beyond Data Processing
Guidance Analytics extends its support beyond data processing, offering end-to-end MIPS services from eligibility assessments to score tracking and financial forecasting. Their consultants provide strategic advice on navigating CMS rulings, such as disaster-zone exemptions, and assist with any disputes on CMS scoring through a targeted review process. With continuous monitoring of CMS updates, Guidance Analytics ensures clients are always informed about new compliance requirements or regulatory changes.
The webinar concluded with an overview of recent CMS rulings for 2025, including adjusted benchmarks for specific measures and simplified improvement activity requirements. Additionally, SHP 436—a commonly used radiology measure—will be retired, emphasizing the need for proactive compliance monitoring. Guidance Analytics’ comprehensive support helps practices stay ahead of these regulatory changes, enabling them to maintain high MIPS scores while adapting to new standards.
Closing the session, TJ Applegate summarized the advantages of consolidating all MIPS resources through Guidance Analytics and ImagineSoftware: "With efficient score monitoring, easy access to templates, and streamlined tracking for continuous improvement, our solution equips practices with everything they need to succeed in MIPS.”
Ready to Take Your MIPS Performance to the Next Level?
Don’t wait until the last minute to optimize your MIPS scores. Start today by leveraging the advanced tools and personalized support offered by Guidance Analytics and ImagineSoftware. Whether you’re looking to improve your current scores, streamline your reporting process, or get expert guidance on navigating the evolving MIPS landscape, we’re here to help.