At the risk of sounding like a broken record …
The second year of MIPS reporting – the Quality Payment Program (QPP) Year 2 – was just about to enter its fourth month as health care providers were hitting “submit” to meet the deadline for Year 1 QPP reporting. There are multiple ways to say it and the theme will be repeated often: Before Year 1 was done, Year 2 of the Merit-based Incentive Payment System (MIPS) was already here.
Keeping in mind that Year 2 has important changes from the fee-for-service to value-based care transition that began in Year 1, the Centers for Medicare and Medicaid Services recently updated the MIPS Participation Lookup Tool, which will now allow clinicians to enter National Provider Identifier information to check 2018 eligibility for MIPS.
CMS made changes to the low-volume threshold used to determine who is exempt from MIPS and its reporting requirements effective for the 2018 performance year (which dictates 2020 payment adjustments). Clinicians are now excluded from MIPS if they billed $90,000 or less in Medicare Part B allowed charges for covered professional services under the Medicare Physician Fee Schedule (MPFS) or furnished covered professional services under the MPFS to 200 or fewer Medicare Part B enrolled beneficiaries during the measurement period.
Notably, CMS states that the agency will be releasing an update to the lookup tool relevant to APM participants, such as ACOs, at a later time. NAACOS will alert members through our newsletter when this update has been made.
Apply to participate in ‘Study on Burdens’: Deadline April 30.
CMS is conducting the 2018 Burdens Associated with Reporting Quality Measures Study, as outlined in the QPP Year 2 final rule (CMS 5522- FC).
CMS is conducting the study to:
- Examine clinical workflows and data collection methods using different submission systems;
- Understand the challenges clinicians face when collecting and reporting quality data; and
- Make future recommendations for changes that will attempt to eliminate clinician burden, improve quality data collection and reporting, and enhance clinical care.
Clinicians and groups who are eligible for the Merit-based Incentive Payment System (MI) that participate successfully in the study will receive full credit for the 2018 MIPS Improvement Activities performance category. Applications for the study will be accepted through April 30 and will be notified in spring of 2018 if selected.
Who should apply?
MIPS-eligible clinicians participating in MIPS as an individuals or as part of a group. Clinicians do not need any outside knowledge of MIPS to participate in the study; rather the study team is interested in learning more about clinicians’ experience participating in MIPS.
A limited number of clinicians who are not eligible for MIPS in 2018 will also be included in the study. To check you participation status please see the QPP Website.
The study runs from April 2018 to March 2019. Study participants will have to meet the following requirements in order to complete the study and receive full Improvement Activity credit. For participants reporting as a group, their entire group will receive credit. For participants reporting as individuals, only the participating clinician will receive credit.
- Complete a 2017 MIPS participation survey in April/May 2018
- Complete a 2018 MIPS planning survey September/October 2018
- The Study team will invite selected participants to join a virtual 90-minute focus group between November 2018 and February 2019.
- Meet minimum requirements for the MIPS Quality performance category by submitting data for at least three measures in the MIPS Quality performance category, as required for 2018 MIPS participation. The data submitted must:
- Include one outcome measure;
- Be submitted to CMS by the final MIPS reporting deadline (March 31, 2019);
- Be submitted through any method accepted under MIPS for year 2 of the Quality Payment Program (2018).
Applicants will be notified by email of their status in spring of 2018.
Confused about this alphabet soup of QPP and MIPS? After all, Year 1 reporting in 2018 was for 2017 performance, and will affect reimbursement in 2019. Year 2 reporting in the first quarter of 2019, for all of 2018 – not just 90 days, which was an option for Year 1 – will affect reimbursement in 2020.
It can be dizzying, for sure. But not to worry. Primaris, a pioneer and leader in this journey from fee-for-service to value-based care has the answers as your partner in healthcare quality reporting. Give us a call or contact us today.