New Data Shows 93% of Eligible Clinicians Received MIPS Payment Under QPP Last Year

November 2018 ~

New data released by CMS shows 93% of eligible clinicians who participated in the Merit-Based Incentive Payment System (MIPS) under the Quality Payment Program (QPP) received positive payment adjustments for their MIPS performance last year.

In a CMS blog post, on November 8, CMS Administrator Seema Verma stated, “I’m pleased to announce that 93 percent of MIPS eligible clinicians received a positive payment adjustment for their performance in 2017, and 95 percent overall avoided a negative payment adjustment. CMS calculated that 1,057,824 MIPS eligible clinicians will receive a MIPS payment adjustment, either positive, neutral, or negative. Of that population, 1,006,319 MIPS eligible clinicians reported data as either an individual, as a part of a group, or through an Alternative Payment Model (APM) and received a neutral payment adjustment or better. Additionally, under the Advanced APM track, 99,076 eligible clinicians earned Qualifying APM Participant (QP) status.”

In the post, Verma called the MIPS positive payment adjustments “modest,” attributing the slight incentives to the budget neutrality requirements part of MIPS and to 2017 serving as a transition year to help ease clinicians into the program and encourage robust participation.

Verma continued, “The overall performance threshold for MIPS was established at a relatively low level of 3 points, and the availability of “pick your pace” provided participation flexibility through three reporting options for clinicians: “test”, partial year, or full year reporting.

This measured approach allowed more clinicians to successfully participate, which led to many clinicians exceeding the performance threshold and a wider distribution of positive payment adjustments. CMS expects that the gradual increases in the performance thresholds in future program years will create an evolving distribution of payment adjustments for high performing clinicians who continue to invest in improving quality and outcomes for beneficiaries.”

From a scoring perspective, according to CMS, the overall national mean (or average) score for MIPS eligible clinicians was 74.01 points, and the national median was 88.97 points. When broken down to the national mean and median:

• Clinicians participating in MIPS as individuals or groups (and not through an APM) received a mean score of 65.71 points and a median score of 83.04 points;
• Clinicians participating in MIPS through an Alternative Payment Model (APM) received a mean score of 87.64 points and a median score of 91.67 points;
• Clinicians in small and rural practices who were not in APMs and chose to participate in MIPS earned a mean score of 63.08 points; and
• Clinicians in small practices received a mean score of 43.46 points.

For clinicians with a negative payment adjustment, Verma stated CMS will offer customized technical assistance to clinicians who received a negative payment adjustment for the 2017 MIPS performance period.

CMS will also continue to support solo practitioners and clinicians in small and rural practices through its no-cost Small, Underserved, and Rural Support initiative, as well as continue to leverage the Patients Over Paperwork initiative to “review MIPS requirements and reduce administrative burden on providers where possible”.

“We’re still listening and looking for ways to improve the Quality Payment Program to help drive value, reduce burden, promote meaningful participation by clinicians, and improve outcomes for beneficiaries. We’ll continue to analyze the data from the 2017 performance year and share additional elements. We encourage clinicians, stakeholders, and others to send us their feedback to help identify areas of immediate need as well as shape the program for future performance years.”

Source(s): CMS Blog; EHRIntelligence; Healthcare Informatics; Medscape; RevCycleIntelligence;