It’s the Final Countdown – Don’t Miss Out on MIPS

It’s not too late to start preparing! October 2nd, 2017 is the last day to begin a 90-day reporting period for the 2017 Merit-based Incentive Payment System (MIPS) performance year. For MIPS eligible clinicians (ECs) trying to avoid a 4% penalty on their Medicare Part B claims, it is important to determine what quality measures, Advancing Care Information measures and Improvement Activities will be reported on and the ideal reporting period to demonstrate performance. While data will not be submitted to CMS yet, having a well-structured plan in place will assist when the data submission window opens January 1st, 2018. If you are unsure of your participation status, you may look this up via NPI number on the CMS Quality Payment Program website – https://qpp.cms.gov/participation-lookup.

For the 2017 MIPS transition year, ECs and groups have several reporting pace options to choose from, depending on their desire to earn a positive payment and overall comfort with the various performance categories.

  • Crawl (or test pace) – report on the minimal amount of data to avoid a negative payment adjustment. The minimum amount of data may be: one quality measure for at least one patient for a single instance (we highly recommend reporting on at least 20 patients if possible to ensure you have adequate data to support the selected measure); the base required Advancing Care Information measures for at least 90-days; or a single Improvement Activity for at least 90-days. ECs and groups selecting the Crawl pace that will be reporting on a single quality measure for a single instance have until December 31st, 2017 to collect the necessary data.
  • Walk (partial year) – by earning 4-69 performance points, you qualify for a small positive payment adjustment. Report on six quality measures, including at least one outcome of high priority measure for 90-days to a full calendar year; at least the base required Advancing Care Information measures for at least 90-days; and one to four Improvement Activities for at least 90-days.
  • Run (full year) – by earning 70 plus performance points, you qualify for a moderate positive payment adjustment and the opportunity to receive a portion of $500 million set aside as an exceptional performer bonus. Report on six quality measures, including at least one outcome of high priority measure for 90-days to a full calendar year; at least the base required Advancing Care Information measures for at least 90-days; and one to four Improvement Activities for at least 90-days.

Unsure of where to start? Review our Reporting Ready Toolkit for steps to help with creating your reporting plan.

Having trouble identifying appropriate quality measures or Improvement Activities? Contact the New England QIN-QIO for assistance.