What to Fix Now Versus What to Leave Alone

Why Smart MIPS Strategies Focus on Leverage, Not Activity

There is a point in every reporting year when healthcare organizations realize they are running out of time.

For some, that realization happens in October. For others, it arrives during submission season. The most proactive organizations reach that conclusion in June.

That timing matters.

Mid-year is often when leadership teams begin reviewing performance and asking a familiar question: What should we be doing right now to improve our MIPS results?

It is an important question. It may not be the most valuable one.

The better question is this:

What should we fix, and what should we stop worrying about?

One of the most common mistakes organizations make during the second half of the year is confusing activity with progress. Once leaders recognize that performance may not be where they want it to be, there is a natural temptation to launch new initiatives, revisit old projects, modify workflows, retrain staff, and scrutinize every measure simultaneously.

The intention is understandable.

The outcome is often disappointing.

The reality is that not every performance issue deserves the same level of attention. Some problems can still be influenced meaningfully before the end of the reporting year. Others are unlikely to change regardless of how much energy is invested. The organizations that perform best under MIPS are often the organizations that understand the difference.

The challenge is that healthcare leaders are trained to solve problems. When a metric appears weak, the instinct is to intervene. What separates high-performing organizations from everyone else is their ability to determine whether an intervention will produce meaningful results within the time that remains.

This is where scoring thresholds become particularly important.

CMS does not reward effort. It rewards performance. More specifically, it rewards performance relative to established scoring methodologies, benchmarks, measurement specifications, and thresholds. By mid-year, some performance challenges remain highly responsive to operational improvements. Others have become mathematically difficult to move.

Understanding which is which can save organizations enormous amounts of time and frustration.

Documentation is a good example.

If documentation workflows are inconsistent today, there is still time to improve them. Better documentation can strengthen audit defensibility, improve coding accuracy, support quality performance, and reduce reporting risk. Unlike some performance measures that rely on outcomes accumulated over the year, improvements in documentation can begin generating benefits almost immediately.

Care gap management presents a similar opportunity.

Many organizations still have enough time to influence patient outreach, preventive screenings, chronic disease management activities, and follow-up processes. While not every gap can be closed before year-end, there is often a significant opportunity to improve performance if workflows are addressed early enough.

Attribution reviews also deserve attention.

One of the most overlooked causes of performance confusion is inaccurate assumptions about the patient population being measured. Mid-year attribution validation can reveal unexpected shifts, provider changes, panel movement, and workflow issues that affect performance calculations. These discoveries frequently create opportunities for improvement that organizations did not realize existed.

At the same time, some issues may not justify aggressive intervention.

Organizations occasionally become consumed with measure performance that has remained stable for months despite repeated efforts to improve it. They continue investing resources because the measure appears weak, even though the likelihood of meaningful movement before submission is limited.

That approach can create an expensive distraction.

Every hour spent chasing marginal gains is an hour that cannot be invested in areas where improvement remains achievable.

This is why the strongest organizations focus on leverage.

They ask where a single operational improvement could positively affect multiple performance areas at once. They prioritize workflow integrity over isolated metrics. They strengthen documentation processes instead of chasing individual charts. They evaluate governance structures rather than responding to every data anomaly independently.

The goal is not to ignore problems.

The goal is to identify which problems still matter.

One of the most valuable exercises leadership teams can conduct at mid-year is a simple categorization process. Every performance concern should be placed into one of two groups.

The first group contains issues that remain actionable. These are problems where intervention can realistically influence outcomes before year-end. The second group contains issues that should be monitored, documented, and incorporated into future planning, but are unlikely to yield meaningful improvement in this reporting cycle.

This distinction creates clarity.

More importantly, it creates focus.

Focus is one of the most underrated advantages in healthcare reporting. Organizations that attempt to improve everything often improve very little. Organizations that identify the handful of operational areas with the greatest impact frequently produce stronger results with fewer resources.

As MIPS continues to evolve and scoring thresholds become increasingly competitive, strategic prioritization may be more important than ever. Success is no longer determined by how many initiatives an organization launches. It is determined by whether leaders can identify the initiatives that actually matter.

That is why mid-year reviews are so valuable.

They provide an opportunity to step back from daily operations and evaluate performance through a different lens. Not a lens focused on activity, but a lens focused on leverage.

The organizations that finish the year strongest are rarely the organizations doing the most.

More often, they are the organizations doing the right things at the right time.

Not sure where to focus your efforts before year-end?

Download Chirpy Bird's MIPS Recovery Roadmap to identify which performance challenges remain actionable, where operational improvements can create the greatest impact, and how to prioritize resources before reporting timelines become compressed.