MIPS Resources

Update | November 2, 2018

CMS Releases 2019 MPFS/QPP Final Rule — Impact on LTC for Year 3 of MIPS

Yesterday, the Centers for Medicare & Medicaid Services (CMS) released the 2019 Final Rule updating the Medicare Physician Fee Schedule (MPFS) and the Quality Payment Program (QPP), which encompasses the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). The rule makes changes to Year 3 of the Quality Payment Program (2019) and incorporates changes to the Medicare Shared Savings Program (MSSP ACO’s), Telehealth/Remote Patient Monitoring, and Evaluation and Management Provisions.

GPM is in the process of analyzing the final rule for impact to LTC providers and to our software product. We strive to actively support and improve your workflow, while ensuring that we continue to capture the required information to maintain compliance and quality reporting requirements.

AVAILABLE NOW: Overview of 2019 Finalized Changes

COMING SOON:

  • 2019 MIPS PLANNING and SCORE CARDS: In the coming weeks, we will share options for how LTC providers in Small or Large Groups can achieve a bonus eligible score.
  • WEBINAR: Also, stay tuned for an upcoming webinar with highlights, additional information, and what to expect for Year 3 of MIPS.

 

Clarify your path to success with MACRA/MIPS support from LTPAC leaders.

As the stakes get higher and the program increases in complexity, GEHRIMED has made MIPS as easy to understand as possible. Picking the best strategy for your practice can be confusing. We understand that every practice has an optimum participation pace, and we will provide MACRA/MIPS support that helps you become more successful at reporting quality and obtaining the highest scores under the MIPS program. From avoiding penalties, to earning incentives, we’re here to help.

Read the latest MIPS news from our blog

  • MIPS is complicated. We make it easier.

    Navigating MIPS can be stressful, even if you’re a seasoned LTPAC practitioner. Here are some basics to get you started.

  • What is MIPS?

    The Merit-Based Incentive Payment System (MIPS) program leverages and augments PQRS, Value-Based Modifier (VBM) and Meaningful Use requirements into a cohesive program. MIPS will also include the introduction of a new reporting category, Improvement Activities.

  • When will the payment adjustments from MIPS begin?

    The payment adjustments will begin in 2020; however, the payment adjustment schedule will be based on 2018 performance scores (scores will be positive, zero, or negative).

  • How is the budget supported for MIPS?

    MIPS is a budget-neutral program. The incentives are funded by the penalties incurred by other eligible clinicians.

  • What are the MIPS Components and Weights?

    MIPS will become increasingly more difficult in the subsequent years. While Improvement Activities and Advancing Care information weights remain constant, Quality decreases and Resource Use weight increases significantly over time.

     

    Year: 2020*

    • Quality: 50%
    • Resource Use: 10%
    • Improvement Activities: 15%
    • Advancing Care Information: 25%

    *Based on calendar year (CY) 2018 participation

     

    Year: 2021**

    • Quality: 30%
    • Resource Use: 30%
    • Improvement Activities: 15%
    • Advancing Care Information: 25%

    **Based on CY 2019 Participation

  • What is the Advancing Care Information (ACI) hardship exemption?

    If clinicians face significant hardship and are unable to report ACI measures, they can apply to have their ACI performance category score weighted to zero. However, doing so will increase the Quality component weight from 50% to 75%.

  • Are the MIPS performance scores made publically available?

    Yes. The MIPS Eligible Clinician’s performance scores are publicly available on the CMS Physician Compare website.

  • What are the requirements for end-to-end electronic reporting?

    • Use a CEHRT to recorded the measure’s demographic and clinical data elements.
    • Export and transmit the measure data electronically to a third party. The third party, such as a registry, uses automated software to aggregate the measure data, calculate measures, perform any filtering of measurement data, and submit the data electronically to CMS.

     

    GEHRIMED is both a Qualified Registry and a QCDR.