Accountable Care Organizations participating in the APM Performance Pathway (APP) must meet annual quality data reporting requirements. Quality data must be submitted to the Centers for Medicare and Medicaid Services (CMS) in a specified format which may be a challenge for some Accountable Care Organizations (ACOs). If your electronic health record (EHR) system is unable to aggregate all eligible patients and de-duplicate them at your ACO Entity ID level or if you need to aggregate data across more than one EHR, MDinteractive can help by converting your quality data into the acceptable format for submission to CMS. 

Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program will have new reporting requirements beginning in 2025. The Centers for Medicare and Medicaid Services (CMS) has established a multi-year transition period to change the data that these organizations must report and how the data gets submitted. The changes are intended to reduce reporting burdens and improve patient outcomes. Partnering with a CMS Qualified Registry like MDinteractive can ease the transition for ACOs and help them meet their data reporting needs. 

The 2022 MIPS reporting period is in full swing. This year it’s more important than ever to start planning and reporting early due to significant changes that could impact MIPS scores and associated payment adjustments. Postponing reporting to later in the year could be a costly mistake. This 2022 MIPS Reporting Checklist will help clinicians get started now so they can prepare for a successful reporting year. 

Practices participating in the Primary Care First (PCF) program must meet annual Quality data reporting requirements. Quality data must be submitted to the Centers for Medicare and Medicaid Services (CMS) in a specified PCF QRDA III format which may be a challenge for some practices. If your electronic health record (EHR) system is unable to aggregate data at the practice site level or if you need to aggregate data across 2 different EHRs, MDinteractive can help by converting your Quality data into the acceptable format. You can find more information about the PCF QRDA III format here.

On November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) issued the Final Rule for the 2022 Medicare Physician Fee Schedule (PFS) which includes several changes to the Quality Payment Program (QPP). The Rule makes significant revisions to the existing MIPS program and outlines a timeframe for transitioning to the new MIPS Value Pathways (MVPs). Here are the key takeaways that will have a major impact on the future of clinician reporting.  

The Centers for Medicare and Medicaid Services (CMS) recently announced it has reopened its reweighting request period for the 2020 MIPS performance year due to the ongoing impact of the COVID-19 pandemic. Clinicians, groups, virtual groups, and Alternative Payment Model (APM) Entities may request MIPS performance category reweighting for 2020 under the Extreme and Uncontrollable Circumstances (EUC) policy now through November 29, 2021, at 8 p.m. ET.  All clinicians should carefully review their final individual and group-level MIPS scores and payment adjustment information as some clinicians are receiving a penalty if their practice coded Medicare Part B claims in 2020.

Technology has transformed how consumers perform a variety of daily activities and transactions. With a computer or smartphone, they can buy tickets and book travel, access their bank accounts, use GPS map assistance and so much more. Unfortunately, they don’t have the same flexibility when it comes to healthcare. This is changing, however, with the development of a new standard for exchanging electronic healthcare information called the Fast Healthcare Interoperability Resource, or FHIR (pronounced “fire”).  

2020 MIPS performance feedback reports, which include MIPS final scores and payment adjustment information, are now available. Clinicians and groups should carefully review their reporting results. Any positive or negative payment adjustment will apply to their 2022 Medicare Part B payments for covered professional services. A targeted review can be requested until November 29, 2021, if clinicians believe an error was made in their 2022 MIPS payment adjustment calculation.

The MIPS Cost category weight is increasing to 20% of a clinician’s final MIPS score in 2021 and 30% in 2022. The increase reflects the priority that the Center for Medicare and Medicaid Services (CMS) has placed on controlling the cost of health care services as a component of the MIPS program. As Cost makes up a larger portion of the total MIPS score, it’s beneficial to understand how CMS measures Cost. Let’s review the basic components of the Cost category and examine strategies to manage and potentially improve performance.

CMS will sunset the Web Interface after the 2024 performance year, so this will no longer be a data submission option going forward for Accountable Care Organizations (ACOs). Beginning in 2025 ACOs participating in the Medicare Shared Saving Program (MSSP) will be required to report on all-payer eCQM/CQM MIPS measures established under the new APM Performance Pathway (APP). While these changes will present some challenges for ACOs, this article provides tips to help prepare for the end of the Web Interface and to support compliance with the new reporting requirements.