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Value-Based Care News

91% of Eligible Clinicians Participated in 2017 MIPS Reporting

CMS exceeded its goal of having 90 percent of eligible clinicians participating in 2017 Merit-Based Incentive Payment System (MIPS) reporting.

Merit-Based Incentive Payment System (MIPS) reporting, eligible clinicians, and the Quality Payment Program

Source: Xtelligent Media

By Jacqueline LaPointe

- Approximately 91 percent of all eligible clinicians participated in 2017 Merit-Based Incentive Payment System (MIPS) reporting, exceeding the CMS goal of 90 percent participation in the first year of the Quality Payment Program, the federal agency recently announced in an official blog post.

The federal agency also pointed out that accountable care organization (ACO) and rural clinician participation rates were 98 percent and 94 percent, respectively.

“What makes these numbers most exciting is the concerted efforts by clinicians, professional associations, and many others to ensure high quality care and improved outcomes for patients,” wrote CMS Administrator Seema Verma.

Over 418,000 Medicare providers had to participate in the 2017 MIPS reporting period to avoid a negative payment adjustment in the 2019 payment year, the Healthcare Financial Management Association (HMFA) reported.

For the first Quality Payment Program performance year, eligible clinicians only had to submit data on one quality measure, Improvement Activity, or four or five Advancing Care Information measures to meet MIPS participation requirements and avoid a penalty.

CMS allowed flexible MIPS reporting for the program’s first year to help eligible clinicians adjust to the Quality Payment Program. And their efforts may have paid off with over 90 percent participation.

Verma attributed the high MIPS reporting rate to the clinicians, industry groups, and other stakeholders who provided clinicians with Quality Payment Program resources and learning opportunities.

In particular, she highlighted the work of the Small, Underserved, and Rural Support initiative, Quality Innovation Networks, and the Transforming Clinical Practice Initiative. CMS created these groups to provide free technical assistance to eligible clinicians.

Despite the high MIPS reporting rate, the federal agency does not consider its job done. In the blog post, Verma reiterated the agency’s commitment to reducing regulatory burdens on clinicians, particularly those who must partake in the new Quality Payment Program.

“After only eight months, we’ve made significant progress through our Patients over Paperwork initiative: streamlining our regulations, increasing efficiencies, and improving care for patients,” she wrote. “At the same time, we continue to put patients first by protecting the safety of our beneficiaries and strengthening the quality of healthcare they receive.”

CMS plans to further decrease regulatory burden in MIPS, she added. Notably, the federal agency already decreased the number of Medicare clinicians required to participate in MIPS.

The final 2018 MACRA implementation rule increased the MIPS participation threshold, disqualifying even more Medicare clinicians from participating in the value-based purchasing program. In 2018, CMS will exclude clinicians if they have $90,000 or less in Medicare Part B allowed charges (up from $30,000 or less), or they treat 200 or less Part B beneficiaries (up from 100 beneficiaries).

In addition, the final rule extended the “Pick Your Pace” reporting options, allowing eligible clinicians to earn just 15 points in 2018 to avoid a penalty.

CMS also developed the following policies for MIPS participation in 2018 that aim to reduce burden, increase flexibility, and allow clinicians to spend more time with their patients:

• Added additional bonus points for clinicians who work in small practices, treat complex patients, or use 2015 Edition Certified EHR Technology (CEHRT)

• Increased the chances of clinicians earning a positive payment adjustment

• Continued to offer free technical assistance in the program

The Bipartisan Budget Act of 2018 also granted CMS additional authority to maintain a gradual implementation of the Quality Payment Program, Verma noted. This authority allows the federal agency to further eliminate regulatory burdens in MIPS for another three years.

“While we’re proud of what has been accomplished, there is more work to be done,” Verma concluded. “CMS remains committed to listening to the healthcare community and exploring ways to reduce clinician burden, strengthen quality, introduce new payment models, develop meaningful measures including for patient safety, and promote interoperability. We look forward to continuing to hearing from you to make sure that we focus on patients, not paperwork.”

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