2017-11-08 16:36:33 UTC

Quality Payment Program Reporting for 2018 Raises the Bar

Nov. 8, 2017

But, there's still time to avoid a payment penalty for the 2017 reporting year.

CMS released the final rule updating the calendar year (CY) 2018 Medicare Quality Payment Program (QPP) that was established under the Medicare Access and CHIP Reauthorization Act (MACRA) and includes the Merit-Based Incentive Payment System (MIPS).
 
AGA will provide additional information and materials in the coming weeks to ensure your practice is prepared for the 2018 performance year. 
 
What should I do right now? 
Make sure your practice is prepared for the 2017 performance year. If you are eligible to participate in 2017, but choose not to, your rates will decrease by 4 percent in 2019. The AGA MACRA Resource Center provides customized advice based on your practice situation to get you on track. Get started now
 
Key changes for 2018
  • MIPS participation requirements increase for 2018, but a phased approach remains.  
    • Cost Performance category = 10 percent of your final score.
    • Quality Performance category = 50 percent of your final score, but will be more difficult to earn. 
      • Fewer points will be awarded for measures that don’t meet data completeness requirements.
      • Data completeness requirements increase to 60 percent.
    • A higher final MIPS score will be needed to avoid a payment penalty.
  • Exemptions from MIPS participation were expanded by increasing the low-volume threshold to $90,000 or less in Part B allowed charges or 200 or fewer unique Medicare patients per year.
  • CMS will continue to accept 2014 edition Certified Electronic Health Record Technology (CEHRT).
  • Eligible clinicians can earn bonus points for:   
    • Caring for complex patients.
    • Using 2015 edition CEHRT exclusively.
    • Improvement in quality and cost performance.
  • Small practices benefit from increased flexibilities, including: 
    • A new hardship exception for clinicians in small practices under the Advancing Care Information performance category.  
    • Bonus points to the final score of clinicians in small practices.
    • Three points awarded for measures in the Quality Performance category that don’t meet data completeness requirements.
 
 
When do changes take effect?  
Changes take effect with the performance period that begins on Jan. 1, 2018. Performance during 2018 impacts payment for services in 2020. 

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