CMS release final rule for year 2 of Quality Payment Program rule (QPP)

By ASN Staff

Please read the full article on the American Journal of Managed Care (AJMC) website.

“Following the transition year and ahead of the full implementation in year 3, CMS made provisions to the Quality Payment Program to make it easier for clinicians to participate in the program, reduce burden, and to get clinicians ready for full implementation.

The program will exclude eligible clinicians with less than or equal to $90,000 in Medicare B allowed charges, or less than or equal to 200 Medicare B patients. Final scores of small practices will receive an additional 5 points. Small practices and solo practitioners will have the choice to form or join a Virtual Group to participate with other practices.

The program will also provide 3 points for small practices even if they submit quality measures below data completeness standards. A new hardship exemption will be added for the Advancing Care Information performance category.

Currently, the performance category weights for the MIPS final score are: 60% quality, 0% cost, 15% performance activities, 25% Advancing Care Information. Next year will see a change with quality being weighted at 50% and cost being weighted at 10%.

For the 2018 performance period, Medicare Spending per Beneficiary and total per capita cost measures will be used to calculate Cost Performance category. The performance threshold will be increased from 3 points in the transition year to 15 points in Year 2, and the program will continue the phased approach to public reporting QPP performance information on Physician Care.

The final rule will allow the use of the 2014 edition and/or the 2015-certified electronic health record technology (CEHRT), and will give a bonus for just using the 2015 CEHRT. An additional 5 points will also be added to the final score for treating complex patients.

For physicians and practices affected by hurricanes Irma, Harvey, and Maria, and other natural disasters, the Quality, Advancing Care Information, and Improvement Activities performance categories will automatically be weighted at 0% of the final score”.

Please read the full article on the American Journal of Managed Care (AJMC) website.

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Please read the full article on the American Journal of Managed Care (AJMC) website.

“Following the transition year and ahead of the full implementation in year 3, CMS made provisions to the Quality Payment Program to make it easier for clinicians to participate in the program, reduce burden, and to get clinicians ready for full implementation.

The program will exclude eligible clinicians with less than or equal to $90,000 in Medicare B allowed charges, or less than or equal to 200 Medicare B patients. Final scores of small practices will receive an additional 5 points. Small practices and solo practitioners will have the choice to form or join a Virtual Group to participate with other practices.

The program will also provide 3 points for small practices even if they submit quality measures below data completeness standards. A new hardship exemption will be added for the Advancing Care Information performance category.

Currently, the performance category weights for the MIPS final score are: 60% quality, 0% cost, 15% performance activities, 25% Advancing Care Information. Next year will see a change with quality being weighted at 50% and cost being weighted at 10%.

For the 2018 performance period, Medicare Spending per Beneficiary and total per capita cost measures will be used to calculate Cost Performance category. The performance threshold will be increased from 3 points in the transition year to 15 points in Year 2, and the program will continue the phased approach to public reporting QPP performance information on Physician Care.

The final rule will allow the use of the 2014 edition and/or the 2015-certified electronic health record technology (CEHRT), and will give a bonus for just using the 2015 CEHRT. An additional 5 points will also be added to the final score for treating complex patients.

For physicians and practices affected by hurricanes Irma, Harvey, and Maria, and other natural disasters, the Quality, Advancing Care Information, and Improvement Activities performance categories will automatically be weighted at 0% of the final score”.

Please read the full article on the American Journal of Managed Care (AJMC) website.

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Saturday, November 4, 2017