Accessing Your Performance Feedback
Clinicians and groups will need an Enterprise Identity Management (EIDM) account to access their 2017 MIPS performance feedback on the QPP website. For any providers participating in a MIPS Alternative Payment Model (APM) last year, such as a Medicare Shared Savings Program or Next Generation Accountable Care Organization (ACO), your performance feedback is available directly to the APM on the QPP website. If you don’t have an EIDM account, the CMS Guide to Obtaining an EIDM Account provides instructions on how to create one.
Your performance feedback will include the following information:
- 2017 final score
- 2019 MIPS payment adjustment
- Final performance category scores and weights
It is important to note CMS will not be sending out penalty letters this year, so you should log into the QPP website to learn about any payment adjustment you will receive in 2019.
Understanding Your MIPS Score
You will receive between 0 and 100 points for your 2017 final MIPS score. The score is based on your performance in 3 MIPS categories, with each performance category having a different weight: Quality (60%), Advancing Care Information (25%) and Improvement Activities (15%). The weights can vary in some circumstances if a clinician met the criteria to qualify for reweighting (e.g., hospital-based MIPS clinicians, non-patient facing MIPS clinicians, approval of a hardship application, etc.).
How Your MIPS Payment Adjustment is Calculated
The MIPS payment adjustment factor for 2017 ranges from -4% to +2% based on your final MIPS score. Since the law requires CMS to implement MIPS payment adjustments in a budget-neutral manner, the highest upward adjustment is 2% instead of +4%. MIPS eligible clinicians and groups had to earn at least 3 MIPS points to avoid the 4% penalty in 2019. If you earned over 3 MIPS points, you could become eligible for a positive adjustment (the more points you earn, the higher possible adjustment you will receive).
Requesting a Targeted Review
If you believe an error was made in the calculation of your 2019 MIPS payment adjustment, you can request a targeted review from CMS via your EIDM account on the QPP website. Providers should request a targeted review at the same level as they reported for MIPS (individual or group).
CMS is encouraging MIPS clinicians and groups to submit a request if they can provide supporting documentation that a targeted review is warranted. A few examples of who may wish to request a targeted review from CMS include:
- A MIPS eligible clinician or group has supporting documentation indicating that certain errors were made, such as eligibility being wrongly assigned to the MIPS eligible clinician or group (e.g. the MIPS eligible clinician or group fell below the low-volume threshold and should not have received a payment adjustment).
- A MIPS eligible clinician has supporting documentation indicating that they should qualify for automatic reweighting of performance categories due to the 2017 policy for extreme and uncontrollable circumstances.
- A MIPS eligible clinician has supporting documentation indicating that they were erroneously excluded from the APM participation list and should have been scored under the APM scoring standard.
Targeted reviews can be submitted until October 1, 2018. However, CMS strongly encourages providers to obtain the necessary EIDM credentials no later than July 31, 2018, and submit a request as soon as possible.
Next Steps
Clinicians and groups should log into the QPP portal and review their 2017 MIPS performance feedback. If you believe there are errors in your final score or payment adjustments, you should request a targeted review from CMS. Additional information on MIPS feedback reports and the targeted review process can be found on our website by clicking here. While some MIPS reporting requirements have changed for 2018, understanding your 2017 performance can offer valuable information on how you can make improvements for the new reporting year. If you have any questions regarding your 2017 feedback reports or need help with your 2018 MIPS reporting, please contact MDinteractive.
MIPS 2017 MIPS Payment Adjustment 2017 MIPS Final Score Targeted Review
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