On November 1st, 2022, the Centers for Medicare and Medicaid Services (CMS) released its Medicare Physician Fee Schedule (PFS) Final Rule which makes changes to the Quality Payment Program (QPP) for 2023 and future performance years. The rule provides policy updates to the traditional Merit-based Incentive Payment System (MIPS) program, the new MIPS Values Pathway (MVPs) framework, Alternative Payment Models (APMs), and Accountable Care Organizations (ACOs). This article provides a summary of the key provisions in the Final Rule.
2023 MIPS Proposed Rule 2023 MVPs 2023 QPP Proposed Rule Medicare Physician Fee Schedule (PFS) Proposed Rule
The MIPS Promoting Interoperability (PI) category, which replaced the Meaningful Use program, establishes requirements that promote the electronic exchange of information using certified electronic health record technology (CEHRT). MIPS eligible clinicians and groups are scored on their performance on several PI measures. The last day to start a minimum 90-day reporting period to attest to PI is October 3, 2022. Making sense of all of the requirements can be challenging, so let’s examine how to report the PI category and the potential impact on the MIPS final score.
2015 Edition CEHRT MACRA MIPS PI Scoring Promoting Interoperability
The Centers for Medicare & Medicaid Services (CMS) has released the Merit-based Incentive Payment System (MIPS) performance feedback for the 2021 performance year, including MIPS final scores and associated payment adjustments. Clinicians, groups and Alternative Payment Model (APM) Entities that participated in MIPS and believe there’s an error in the calculation of their MIPS payment adjustment can request a targeted review until October 21, 2022 at 8:00pm EST. This article outlines how to check your performance feedback to determine if you are receiving a positive, negative, or neutral payment adjustment and what steps to take if you have any concerns.
2021 Final MIPS Score 2021 MIPS Payment Adjustment 2021 MIPS Targeted Review
The MIPS Improvement Activities (IA) performance category measures a clinician or group’s engagement in clinical activities that improve clinical practice, care delivery, and outcomes. This year clinicians will need to attest to the Improvement Activities category, alongside reporting other MIPS categories, to ensure they reach the new minimum threshold of 75 points needed to avoid a MIPS penalty. The last day to start a new activity for a minimum 90-day reporting period is October 3, 2022. This article provides an overview of the IA category and offers tips on selecting activities most relevant to a clinician’s practice.
Attesting to Improvement Activities Improvement Activities MACRA MIPS Reporting
Small practices could find it tougher to avoid a penalty under the Merit-based Incentive Payment System (MIPS) in 2022 due to a higher minimum performance threshold and an increased weight for the Cost category. Just over 9% of MIPS eligible clinicians in small practices received a negative payment adjustment for their 2020 MIPS reporting and this number could go higher this year. While special policies have been established to ease the reporting burden on small practices, it is more important than ever to start MIPS reporting early. Here’s what small practices need to know about the 2022 MIPS reporting requirements and steps they can take to get started now.
We have almost reached the halfway mark for the 2022 MIPS performance year, so clinicians should be actively collecting and reporting data on their Quality measures. Each year the Centers for Medicare and Medicaid Services (CMS) updates the list of Quality measures eligible clinicians and groups can report under the MIPS program. Some measures get added to or deleted from the inventory, while other measures go through substantial revisions. This article summarizes important changes to the 2022 Quality Measures so that clinicians can make sure their data collection and reporting is on the right track.
2022 Benchmarks 2022 MIPS Measure Changes 2022 MIPS Quality Measures
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.
ACO Reporting APM Performance Pathway CMS Web Interface MACRA MIPS
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.