A MIPS: Quality Payment Program Report

Percentage Clinicians Might Lose for Failure to Report





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4 Responses

  1. 88% of Practice Leaders Say MIPS/APMs Is the Biggest Regulatory Burden

    MGMA recently released results from their 2018 Regulatory Burden Survey. Here are some key findings from the report:

    • 86% of group practice leaders say regulatory burden has increased this year.
    • Prior authorization was rated as extremely burdensome by 82% of practice leaders.
    • 2 in 3 say the MIPS program does not support their clinical quality priorities.
    • 88% say the Medicare Quality Payment Program is the biggest regulatory burden.

    Source: MGMA, October 4, 2018


  2. CMS Finalizes 2019 Rules

    CMS has added an additional low-volume threshold exemption to MIPS for next year. To be excluded, providers or groups need to meet at least one of the following conditions:

    • Have $90,000 or less in Medicare Part B allowed charges for covered professional services.

    • Provide care to 200 or fewer Part B-enrolled patients.

    • Provide 200 or fewer covered professional services under the PFS.

    The minimum period for each performance category remains unchanged, so quality and cost stay at 12 months while improvement activities and promoting interoperability remain at a continuous 90-day period.

    Source: Todd Shryock, Medical Economics [11/2/18]


  3. CMS: Most Providers Avoided MIPS Cuts In 2017, Bonuses Small

    CMS says about 93 percent of eligible providers in the Merit-based Incentive Payment System received a bonus for their 2017 performance and the vast majority avoided a pay cut — though CMS Administrator Seema Verma says in a blog post that she expects performance in the program will change as the thresholds are harder to meet.



  4. CMS created a revenue-chasing game

    It’s called MIPS.

    In 2018 97.6% of physicians met the quality metrics necessary to receive a performance bonus. There’s one problem – the program is budget neutral. The more physicians that qualify, the smaller the merit payment for their efforts to gather meaningless quality data.

    Dr. David E. Marcinko MBA


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