May 2, 2017
A new Medicare quality reporting program designed to reward performance and reduce financial penalties for physicians launched in January 1, 2017. Medicare’s current quality reporting systems are being updated and reorganized to form a new merit-based incentive payment system, or “MIPS.” This streamlined system will provide greater opportunity for physicians to earn bonus payments and place a lower cap on the negative payment adjustments that physicians may previously have been subjected to.1
MIPS will introduce a new Quality Payment Program that repeals the Sustainable Growth Rate (SGR) formula and combine previous features of the existing Medicare Meaningful Use (MU), Physician Quality Reporting System (PQRS), and Value-Based Modifier (VBM) programs.2 In addition, MIPS will provide incentive payments for participation in Advanced Alternative Payment Models (APMs).
An important goal for physicians and other clinicians this year is to gain a deep understanding of the MIPS Clinical Practice Improvement Activities, or CPIA, a new performance category under which clinicians are evaluated for activities such as care coordination, beneficiary engagement, and patient safety.
Private practice physicians need a clear grasp on Clinical Practice Improvement Activities to be prepared to meet MIPS requirements. Although CPIA will not be required to receive a positive reimbursement in 2017, by 2019 they will represent 30% of points physicians can earn for their MIPS performance scores. The current breakdown of MIPS performance categories allots 60% of 100 available points to Quality, 25% to Advancing Care Information, and 15% to Clinical Practice Improvement Activities.3 Fortunately, MIPS allows clinicians to choose the activities and measures they are assessed on to provide a demonstration of performance that is meaningful and relevant to their specific practices.
CPIA options range from shared decision-making and use of safety checklists to depression and diabetes screening. It is important for physicians to begin to familiarize themselves with the CPIA so they can strategize about how choosing and meeting CPIA requirements will impact their workflow. While there is always a learning curve with new regulations, MIPS will have a beneficial impact overall because it will reduce penalties and give physicians the authority to showcase relevant data – and be assessed on standards they have selected themselves.
MIPS will encourage active reporting throughout the year and will provide simple reporting options for clinicians new to the system.
ChartLogic’s EMR and PM systems will be updated to make incorporating CPIA an easy and intuitive transition. Physicians should find that with the right tools, incorporating CPIA will only serve to strengthen the efficacy of their practices.
Since Medicare reporting was still operating under Meaningful Use Stage 1, ChartLogic has maintained its preparedness for every new performance reporting stage and program. The MACRA and MIPS legislation is no different – we can meet the needs of clinicians who choose any level of participation in the new Quality Payment Program.