MACRA

Cost is the fourth performance category under the MIPS program and makes up 15% of your total MIPS score for 2019 (up from 10% in 2018 and 0% in 2017). This category will steadily increase to 30% by the year 2022 when it will have the same weight as Quality. If CMS is unable to calculate a Cost score for a clinician, the category will be reweighted to Quality. While clinicians can relatively quickly change their MIPS Quality score by tracking some specific outcomes (e.g., track smoking status and give cessation advice), Cost is more challenging. It is more complex with many different variables, so monitoring Cost becomes important as it contributes more towards your final MIPS score. MDinteractive can help you access your CMS performance feedback reports which will provide your Cost score from prior MIPS reporting years.  In this article we will explore the different cost measures, how they are scored and the potential impact on your practice.

With another MIPS performance year behind us, it is not too early to start thinking about a reporting strategy to ensure MIPS success for 2019. This year CMS is providing new flexibility to report quality measures through multiple submission methods which can help improve MIPS scores and increase incentive payments. In this article we demonstrate how combining registry and EHR measures will help specific clinicians with their MIPS reporting. The strategy would not only boost their MIPS scores, but it would also increase their Medicare payments by thousands of dollars.

CMS has updated the Quality Payment Program (QPP) Participation Status Tool for clinicians to check their final 2018 eligibility status for the Merit-based Incentive Payment System (MIPS). Clinicians can enter their individual National Provider Identifier (NPI) here to learn if they are required to report MIPS for 2018. It’s important for them to check their eligibility status now to determine if they must report.  MIPS eligible clinicians who do not report MIPS this year will receive an automatic negative 5% penalty on their Medicare Part B payments in 2020.

The wait is over - the Centers for Medicare and Medicaid Services (CMS) has finally released the 2019 Quality Payment Program Final Rule  which takes effect on January 1, 2019. There are several changes to MIPS for the 2019 performance year. While providers are still working to complete their 2018 reporting requirements, it’s a good idea to become familiar with some of the changes ahead and understand how you might be impacted.

As we head into the final stretch of Year 2 of the Merit-Based Incentive Payment System (MIPS), clinicians can finally see the finish line approaching for the 2018 performance year. This year MIPS is made up of 4 components: Quality, Promoting Interoperability (formerly ACI), Improvement Activities and Cost. The Quality category accounts for the most at 50% of your total MIPS score. While many clinicians have already collected data throughout the year, it’s not too late to develop a strategy to successfully report Quality and potentially maximize your Medicare reimbursements in 2020.

Before you begin your 2018 MIPS reporting, the first step you should take is to determine if you are required to report this year by checking your participation status on the CMS website. The Quality Payment Program (QPP) Participation Status tool allows clinicians to view their status for each performance year for both the Merit-based Incentive Payment Program (MIPS) and the Alternative Payment Model (APM). Keep in mind if you are not exempt from MIPS participation in 2018, failing to report will result in a 5% penalty on your Medicare Part B payments in 2020.

Are you a solo practitioner or small practice struggling to understand MIPS requirements? When it comes to MIPS reporting, small practices face unique challenges that can make compliance seem like a daunting task. Choosing not to report could be a costly mistake, though, since the penalty for not reporting in 2018 has increased to 5% of your Medicare Part B reimbursements. Fortunately, CMS has taken several steps to provide relief to small practices so they can successfully participate in MIPS for the 2018 performance year.

CMS announced it exceeded its year one participation goal for the Quality Payment Program. According to CMS Administrator Seema Verma, 91% of eligible clinicians participated in the Merit-based Incentive Payment System (MIPS) in 2017. Submission rates for Accountable Care Organizations (ACOs) were 98% and rural practices were 94%.

CMS announced it will release MIPS Final Scores and Feedback for the 2017 Performance Year in July. Clinicians can view their preliminary performance feedback now on the Quality Payment Program website. However, the scores can change between now and July based on a few different factors.