Merit Based Incentive Payment System

Key Quality Payment Program Changes in 2022 PFS Proposed Rule

by Jill McKeon

If finalized, the Quality Payment Program (QPP) will undergo significant policy changes under the Medicare Physician Fee Schedule (PFS) proposed rule. Most notably, the rule introduced the first seven...

CMS to Reweight MIPS Cost Performance Category for 2020

by Jill McKeon

CMS announced it will be reweighting the cost performance category under the Merit-Based Incentive Payment System (MIPS) from 15 percent to zero percent for the 2020 performance period to provide...

What Drives Value in the Merit-Based Incentive Payment System?

by Jill McKeon

In a recent survey, physicians were asked if and how the four evaluation components of the Merit-based Incentive Payment System (MIPS)—quality, promoting interoperability, improvement...

CMS: Automatic Exception for MIPS Eligible Clinicians in 2020

by Jacqueline LaPointe

Individual clinicians who must participate in Medicare’s Merit-Based Incentive Payment System (MIPS) for the 2020 performance period will automatically have the extreme and uncontrollable...

CMS Releases Initial Quality Payment Program Results for 2019

by Jacqueline LaPointe

Eligible clinicians overwhelmingly participated in the Quality Payment Program despite facing challenges caused by the COVID-19 pandemic, according to preliminary data from CMS. CMS announced in a...

Clinicians Serving Socially At-Risk at a Disadvantage Under MIPS

by Jacqueline LaPointe

Clinicians who served more patients with social risk factors such as low income performed worse in the Merit-Based Incentive Payment System’s inaugural payment year, and therefore, received...

98% of Eligible Clinicians Avoided a MIPS Penalty in 2018

by Jacqueline LaPointe

About 98 percent of eligible clinicians avoided a penalty under the Merit-Based Incentive Payment System (MIPS) in 2018, and almost all of these clinicians earned a positive payment adjustment, CMS...

Clinicians to Earn MIPS Credit for Joining COVID-19 Clinical Trial

by Jacqueline LaPointe

Clinicians earning value-based reimbursement through the Merit-Based Incentive Payment System (MIPS) will be able to earn credit for participating in and reporting information on COVID-19 clinical...

CMS Relaxes Quality Reporting for Value-Based Purchasing Models

by Jacqueline LaPointe

Providers participating in some of Medicare’s largest value-based purchasing models will have some flexibility with quality reporting due to the ongoing COVID-19 pandemic, CMS announced last...

Advanced Alternative Payment Model Participation Rose in 2018

by Jacqueline LaPointe

Over 84,200 more eligible clinicians sufficiently participated in one of the Quality Payment Program’s Advanced Alternative Payment Models (APMs) in 2018 compared to the previous year, according...

Prior Authorizations, Quality Payment Program Burden Practices

by Jacqueline LaPointe

A vast majority of medical group practices experienced growing regulatory burden in the last year, with prior authorizations and Medicare’s Quality Payment Program topping their list of the most...

Unpacking Proposed Merit-Based Incentive Payment System Changes

by Jacqueline LaPointe

CMS is planning to overhaul reporting for the Merit-Based Incentive Payment System (MIPS) in order to make the pay-for-performance program less burdensome and more meaningful to providers, according a...

Advanced APM Participation Almost Doubled from 2017 to 2018

by Jacqueline LaPointe

Advanced Alternative Payment Model (APM) participation in the Quality Payment Program (QPP) nearly doubled from 2017 to 2018, increasing from 99,076 to 183,306 clinicians, CMS recently reported in an...

As MACRA Implementation Turns 2, Industry Leaders Call for Change

by Jacqueline LaPointe

For the past two years, MACRA has been shifting providers away from fee-for-service to value. But industry leaders still have reservations about MACRA implementation and the law’s value-based...

MIPS Participation Reached 95% in 2017, Exceeding CMS Goals

by Jacqueline LaPointe

Ninety-five percent of eligible clinicians avoided a negative payment adjustment through Merit-Based Incentive Payment System (MIPS) participation in 2017, of which 93 percent earned a positive...

Rural, Small Practice MIPS Performance Lagged Behind Large Peers

by Jacqueline LaPointe

Rural and small practices fared worse than their large peers in MACRA’s Merit-Based Incentive Payment System (MIPS) in 2017, new research shows. Nearly one in five small practices received a...

5% of MIPS Eligible Clinicians Earn a Negative Payment Adjustment

by Jacqueline LaPointe

Approximately 93 percent of eligible clinicians participating in MACRA’s Merit-Based Incentive Payment System (MIPS) in 2017 earned a positive payment adjustment, CMS Administrator Seema Verma...

Exploring Changes to the Quality Payment Program in 2019

by Jacqueline LaPointe

The final 2019 Medicare Physician Fee Schedule (PFS) rule contained a number of changes to evaluation and management (E/M) payment rates, site-neutral payments, and remote patient monitoring coverage....

Maximizing MIPS Scores Through Chronic Disease Prevention

by Jacqueline LaPointe

The healthcare industry is moving beyond a “sick care” system and shifting to chronic disease prevention to lower costs and improve quality. However, the healthcare payment system is just...

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