CMS releases Quality Payment Program results: 5 takeaways

CMS released preliminary second-year participation data for the Quality Payment Program on July 11.

Five things to know:

1. There are two pathways for eligible clinician participation in the Medicare Access and CHIP Reauthorization Act's Quality Payment Program: the Merit-based Incentive Payment System, or MIPS, and the Advanced Alternative Payment Model, or Advanced APM.

2. CMS said 98 percent of clinicians eligible to participate in MIPS did so in 2018, up from 95 percent in 2017.

3. Nearly 90 percent of clinicians in small practices participated in MIPS in 2018, up from 81 percent in 2017. "Primary flexibilities introduced in the Physician Fee Schedule rule for the 2018 performance year were increases in the Medicare patient count and Medicare Part B allowed charges required to participate in MIPS, which meant that fewer clinicians in small practices were required to participate, but results show they elected to do so anyway," CMS Administrator Seema Verma wrote in a blog post July 11.

4. The number of physicians participating in Advanced APMs nearly doubled year over year, increasing from 99,076 in 2017 to 183,306 in 2018. CMS attributed the increase to new participation opportunities in 2018, particularly through ACOs in the Medicare Shared Savings Program.

5. Under MIPS, performance is measured through the data clinicians report in four areas: quality, clinical practice improvement, interoperability and cost. Based on performance in 2018, 97 percent of clinicians participating in MIPS will earn a positive payment adjustment in 2020. Ninety-three percent of clinicians earned a positive payment adjustment based on MIPS performance in 2017.

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