It’s time to get cracking on reporting data to Medicare’s Merit-based Incentive Payment System (MIPS), said David Barbe, MD, president of the American Medical Association (AMA), in an interview with FierceHealthCare.
Dr Barbe reminded physicians that they must start collecting performance data by October 2 to be eligible for a 2019 bonus under MIPS. If doctors and other eligible clinicians want to avoid a reduction in their Medicare reimbursement in 2019, he also pointed out, they must, at a minimum, report data on one quality measure for one patient by the end of the year.
The other option for physicians in 2017, the first performance measurement year under MIPS, is to report for the full calendar year. Physicians who have been reporting since January 1 are eligible to receive the maximum bonus if they do well in the program.
Only eligible clinicians who score above average in the combined quality, practice improvement, and advancing care information (ACI) categories will get a bonus in 2019. The other reporting physicians will receive a downward payment adjustment. Quality accounts for 60% of the total score; improvement counts for 15%; and ACI, the successor to meaningful use, counts for 25%.
The upward or downward payment adjustment will be 4% in 2019 and 5% in 2020, with greater incentives for exceptional performers.
Despite robust efforts by AMA and other medical associations, Dr Barbe noted in the interview, many doctors and healthcare organizations are still unfamiliar with the Medicare Access and CHIP Reauthorization Act (MACRA), which authorized MIPS and another Medicare payment program for advanced alternative payment models.
In an AMA-sponsored survey released in June, most doctors said they were not well prepared to meet MIPS’s quality reporting criteria in 2017. To remedy that lack of awareness, the AMA recently issued an enhanced tool kit that includes an action plan and a video showing how to avoid a financial penalty in 2019.
About a third of physicians were exempted from MIPS this year because they didn’t meet the program’s low-volume threshold. In the Centers for Medicare & Medicaid Services (CMS) proposed rule for its Quality Payment Program in 2018, that threshold was raised to exempt about another third of doctors.
Ironically, because some practices hope to profit financially from MIPS, the AMA has asked CMS to consider letting practices that fall below the higher threshold to opt into the program. CMS is considering this request and has asked for public comments before it issues its final rule this fall.
How to Report
Individual physicians and practices have several options for reporting the performance data for 2017 by March 31, 2018. Individuals can use the same claims-based method that CMS required for its earlier Physicians Quality Reporting System; report the quality data directly from their electronic health record (EHR), or use a Qualified Clinical Data Registry (QCDR) or another CMS-approved registry. If the clinicians belong to an accountable care organization, and that organization reports quality data to the Medicare Shared Savings Program, that quality information will be used in MIPS as well.
CMS also allows practices to report quality data to MIPS on behalf of their doctors. The options for groups are a QCDR, a qualified registry EHR, and the CMS web interface (for groups of 25 or more providers).
ACI data and improvement activities can be reported by individual clinicians or groups through attestation, QCDR, a qualified registry, or directly from an EHR. Groups of 25 or more can use the CMS web interface.
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