Nearly 134,000 additional clinicians will be excluded from MIPS next year.
Recently, the Centers for Medicare and Medicaid (CMS) released 1,000+ pages of proposed changes to the 2018 Quality Payment Program (QPP), which relax MACRA quality measures for Medicare Part B clinicians. Many of these changes, if enacted, may or may not impact you. The key changes, however, are to the MIPS track for the performance year 2018.
The proposal gives us some insight on how the program will evolve, addressing providers’ concern with minimized thresholds, reporting burdens, and assistance for small providers, among a host of other considerations. If you’re among the majority participating in MIPS, watch for these important updates:
Low-Volume Threshold
One of the noteworthy changes under the 2018 proposed rule concerns the MIPS low-volume threshold. For 2017, the low volume threshold was $30,000 in Medicare Part B charges and 100 or less Part B patients. For 2018, the threshold is $90,000 or less in Part B allowed charges and 200 or less Part B patients. CMS estimates that raising the low-volume threshold will exclude approximately 134,000 more clinicians from MIPS next year.
MIPS Scoring
If you are still eligible to take part in MIPS next year, your clinic will be scored based on how you perform in the same four categories — Quality, Advancing Care Information (ACI), Improvement Activities (IA), and Cost. These categories will retain the same weight (60, 25, 15, and 0 percent, respectively), if finalized.
Virtual Group Reporting Option
If you have 10 or less practitioners working in your group (or even a solo practitioner), you may have an option to join others in that size-set to form a larger “virtual” group.
Small Practice Bonus
Small practices, with 15 or fewer individual NPI numbers and a group TIN, will automatically earn 5 bonus points in their final score if they submit data in at least one performance category.
Expansion of MIPS to Include Facility-Based Measurement
A new reporting option, if finalized, would allow hospital-based clinicians to use their facility’s value-based purchasing measure results.
Flexibility to Use EHR certified to 2014 Edition
Clinicians who are eligible for MIPS can continue using EHR technology certified to the 2014 Edition for next year. However, if you use the 2015 Edition, you will be eligible for a 10-point bonus (25% of your total MIPS score) under Advancing Care Information (ACI). The 2015 edition will become mandatory in 2019.
These proposed changes will make the requirements simpler in the coming years. Please note, though, that 2018 will be the final transition year before full implementation. You can’t afford to stay behind the MACRA curve.