95% of physicians avoid MIPS penalties: 12 notes on QPP year 1

CMS released the first-year performance results of the Quality Payment Program's Merit-based Incentive Payment System, which will determine Medicare payment adjustments for clinicians in 2019.

Most participating clinicians were successful, though both positive and negative payment adjustments will be small. The first year of the program was designed to ease clinicians into the program, and CMS plans to gradually ramp up performance thresholds for "an evolving distribution of payment adjustments." 

"Admittedly, the MIPS positive payment adjustments are modest," CMS Administrator Seema Verma said in a statement about the results. "It is important to remember that the funds available for positive payment adjustments are limited by the budget neutrality requirements in MIPS, as established by law under the Medicare Access and CHIP Reauthorization Act of 2015."

Here are 12 notes on MIPS scores and payment adjustments from the 2017 performance year:

  1. The overall mean score for MIPS-eligible clinicians in 2017 was 74.01 points.
  2. The overall median score was 83.04 points.
  3. Mean and median scores were higher for clinicians participating in MIPS through an alternative payment model. MIPS clinicians participating through APMs earned a mean of 87.64 points (compared to 65.71 points) and a median of 91.67 points (compared to 83.04 points).
  4. Clinicians in small and rural practices performed well, according to CMS, but earned lower scores. Clinicians in rural practices earned a mean score of 63.08 points in 2017, while small practice clinicians earned a mean of 43.46 points.
  5. Most clinicians in MIPS — 93 percent — earned a positive payment adjustment.
  6. Most clinicians — 71 percent — earned a positive payment adjustment and a bonus for exceptional performance.
  7. The maximum positive adjustment was 1.88 percent.
  8. Just 2 percent of clinicians earned a "neutral" adjustment or no change to their payment.
  9. Only 5 percent of clinicians will have a negative payment adjustment.
  10. The maximum negative adjustment was -4 percent.
  11. More than 1 million clinicians participated in the QPP.
  12. Nearly 100,000 clinicians earned qualifying APM participant status.

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