What are the reporting methods?
Reporting methods for individuals include: claims, qualified clinical data registry (QCDR), qualified registry, and electronic health records (EHR). The ACI and IA categories will include attestation options. There is no data submission for the cost performance category, as the Centers for Medicare & Medicaid Services (CMS) will calculate this for ECs based on Medicare claims data.
What are the reporting requirements under MIPS?
In the quality performance category, you must report at least six measures, including one outcome measure. Measures previously available under the PQRS program will be available in the quality category of MIPS. In addition to the six measures reported by ECs, CMS will calculate the all-cause hospital readmissions measures for groups of 16 or more ECs. This measure was previously included in the VBPM program.
What is the Merit-based Incentive Payment System (MIPS)?
The Merit-based Incentive Payment System (MIPS) consolidates three existing quality reporting programs: the Physician Quality Reporting System (PQRS), the Value-based Payment Modifier (VBPM), and meaningful use (MU). The system also adds a new performance category, called improvement activities (IA). Scores from the four categories are combined to establish a final score (0-100) that will be compared against a threshold.
What is the Quality Payment Program (QPP) and how does it relate to MACRA?
The Quality Payment Program (QPP) is the umbrella term used to describe the MIPS and AAPM tracks under MACRA.
Can I participate in MIPS without an EHR?
Clinicians without an EHR can still participate in MIPS, but will not be eligible for any of the points under the ACI performance category. Use of EHR technology that is not certified will result in a zero for the category. While still possible to participate in MIPS without an EHR, the reporting requirements will be more burdensome without the use of an EHR. The reporting mechanisms available to a practice without an EHR would be claims or qualified registry. However, use of the qualified registry option would require a manual data collection process. This would require reporting on at least 50% of the clinician’s denominator-eligible patients.
How will I be paid under MIPS?
Beginning in 2019, physicians participating in MIPS will be eligible for positive or negative Medicare Part B payment adjustments that start at 4% and gradually increase to 9% in 2022. Distribution of payment adjustments will be made on a sliding scale and will be budget neutral. Payment adjustments will be based on the following:
How is the payment adjustment applied?
Beginning in 2019, physicians participating in MIPS will be eligible for positive or negative Medicare Part B payment adjustments that start at 4% and gradually increase to 9% in 2022. Distribution of payment adjustments will be made on a sliding scale and will be budget neutral. Payment adjustments will be based on the following:
What if I change groups during the performance period?
Beginning in 2019, physicians participating in MIPS will be eligible for positive or negative Medicare Part B payment adjustments that start at 4% and gradually increase to 9% in 2022. Distribution of payment adjustments will be made on a sliding scale and will be budget neutral. Payment adjustments will be based on the following:
Are there any exemptions from MIPS?
Beginning in 2019, physicians participating in MIPS will be eligible for positive or negative Medicare Part B payment adjustments that start at 4% and gradually increase to 9% in 2022. Distribution of payment adjustments will be made on a sliding scale and will be budget neutral. Payment adjustments will be based on the following:
Beginning in 2019, physicians participating in MIPS will be eligible for positive or negative Medicare Part B payment adjustments that start at 4% and gradually increase to 9% in 2022. Distribution of payment adjustments will be made on a sliding scale and will be budget neutral. Payment adjustments will be based on the following:
Is the low-volume threshold calculated at the group or individual level?
Beginning in 2019, physicians participating in MIPS will be eligible for positive or negative Medicare Part B payment adjustments that start at 4% and gradually increase to 9% in 2022. Distribution of payment adjustments will be made on a sliding scale and will be budget neutral. Payment adjustments will be based on the following:
Waht makes your offering special?
Beginning in 2019, physicians participating in MIPS will be eligible for positive or negative Medicare Part B payment adjustments that start at 4% and gradually increase to 9% in 2022. Distribution of payment adjustments will be made on a sliding scale and will be budget neutral. Payment adjustments will be based on the following:
Hosting and Domain Servies?
Beginning in 2019, physicians participating in MIPS will be eligible for positive or negative Medicare Part B payment adjustments that start at 4% and gradually increase to 9% in 2022. Distribution of payment adjustments will be made on a sliding scale and will be budget neutral. Payment adjustments will be based on the following:
