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.

The Centers for Medicare and Medicaid Services (CMS) Primary Care First (PCF) program is a new alternative payment model designed to support the delivery of advanced primary care. The program began in 2021 and it will examine whether financial risk and performance based payments that reward primary care clinicians will lower Medicare costs and improve health care quality. PCF participants must annually report data on specific quality measures, including the quality measure Advance Care Plan (ACP) which requires a Qualified Registry or QCDR vendor for reporting since it is not an EHR reportable measure. As a CMS Qualified Registry, MDinteractive can support practices participating in the program by reporting this measure on their behalf.

Please note: Cohort 1 practices must report ACP using a Qualified Registry or QCDR for PY 2021; Cohort 1 practices that fail to do so will not be eligible for a positive performance-based adjustment (PBA) in PY 2022.

You can finally breathe a sigh of relief that the 2020 MIPS reporting season is over! Now it’s time to turn your attention to 2021 MIPS reporting so you don’t get behind the curve.  This year reporting will be more complex and require early planning to meet the new requirements.   Developing a reporting strategy now will ensure you are better prepared for a successful outcome.  

The Centers for Medicare and Medicaid Services (CMS) will delay the requirement that Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) begin reporting all-payer Quality data through the new APM Performance Pathway (APP). ACOs will have the option to continue submitting data via the CMS Web Interface through the 2024 performance year. ACOs will have to report all three APP Quality measures (CQMs or eCQMs) beginning in 2025. In this article, we highlight the implications for ACOs, including the new APP quality measure set and strategies for successful reporting in future years.  

On December 1, 2020 the Centers for Medicare and Medicaid Services (CMS) released its 2021 Final Rule for the Quality Payment Program (QPP) with changes to the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). Here is a look at some key highlights of the QPP changes and how they could impact your practice.

The clock is ticking for clinicians and groups who want to report MIPS. MDinteractive can report all available registry and EHR MIPS Quality measures and is here to help, whether you have been collecting data throughout the year or are just getting started. In this article we explain how to choose your Quality measures, and the benefits of using a registry like MDinteractive. With the end of the 2020 performance year getting closer, there’s still time to choose measures to report and start gathering your data.