The Merit-based Incentive Payment System (MIPS) continues to evolve in complexity and impact, especially for specialty providers like gastroenterologists. As 2025 unfolds, practices must be more vigilant than ever in navigating the latest requirements, ensuring accurate reporting, and avoiding costly penalties.
In this post, we explore the top challenges gastroenterology practices face in MIPS reporting and provide practical solutions to streamline compliance and optimize performance, drawing from both national trends and real-life scenarios.
Understanding the 2025 MIPS Landscape for Gastroenterologists
The 2025 MIPS requirements include several updates that directly affect how gastroenterologists report and perform. From increased data submission thresholds to shifting benchmark scores, providers need to adapt quickly.
Key updates impacting gastroenterologists in 2025:
Stricter performance thresholds to avoid penalties.
Emphasis on interoperability and cost measures.
Requirement to report a full year of data for Quality and Cost categories.
Expanded use of electronic Clinical Quality Measures (eCQMs).
Understanding these nuances is essential for maintaining compliance under MACRA (Medicare Access and CHIP Reauthorization Act) and ensuring financial sustainability.
Challenge 1: Choosing the Right Quality Measures
One of the most difficult aspects of MIPS for GI doctors is selecting measures that are both clinically relevant and high-performing. Many providers inadvertently select measures with limited applicability or low benchmarks, which can reduce their overall performance score.
Solution:
Work with MIPS consultants to evaluate the most relevant MIPS quality measures for gastroenterology, such as:
Colonoscopy and biopsy follow-ups
Hepatitis B and C screenings
Care coordination and patient education metrics
Using a partner like TriumpHealth ensures you choose optimal measures based on your clinical data, patient mix, and reporting capabilities.
Challenge 2: Incomplete or Inaccurate Data Capture
Many practices struggle with inconsistent documentation or missing data that leads to failed submissions or audit risks. With the transition to eCQMs and API-based data exchanges, practices must ensure their EHR systems are fully integrated and data-ready.
Solution:
Invest in automated tools and data validation protocols. TriumpHealth’s MIPS solutions ensure seamless integration with your EHR, accurate data mapping, and pre-submission audits to flag any inconsistencies before CMS submission deadlines.
Challenge 3: Avoiding Common MIPS Reporting Errors
Mistakes like submitting incorrect measure codes, reporting for ineligible clinicians, or using outdated templates can lead to performance degradation or outright disqualification.
Solution:
Avoid these pitfalls with real-time validation, ongoing staff education, and expert oversight. As noted in the CMS Medicare Learning Network, documentation accuracy and coding compliance are foundational to successful MIPS performance.
Real-World Example: How TriumpHealth Helped a GI Practice Boost Its MIPS Score
A gastroenterology practice in Texas struggled in 2023 with a poor MIPS score due to incomplete documentation and poor measure selection. With TriumpHealth’s tailored MIPS consulting, they:
Identified better-performing GI-specific measures
Automated their data submissions
Completed accurate year-end attestation
By 2024, the practice improved its score by 34%, qualifying for a positive payment adjustment and avoiding penalties—setting a strong foundation for 2025 success.
Challenge 4: Staying Updated with Ongoing Policy Changes
MIPS is dynamic. Regulatory updates, changing benchmarks, and new interoperability rules can quickly derail unprepared practices.
Solution:
Subscribe to industry alerts and stay connected with trusted resources like:
Additionally, partner with consultants who keep their clients updated and aligned with shifting MIPS regulations.
Final Thoughts: Staying Ahead in 2025
Gastroenterologists face a unique set of challenges when it comes to MIPS reporting in 2025—from selecting the right measures to maintaining accurate data capture. The complexity is real, but with the right guidance, success is within reach.
TriumpHealthoffers comprehensive MIPS support for specialty practices, ensuring GI doctors not only remain compliant but thrive in this new performance-driven environment. Don’t wait until penalties stack up—optimize your MIPS strategy now. Contact Us Today at 888-747-3836 X0 | or email us at sales@triumphealth.com.
