If you are an eligible clinician planning to participate in the 2018 Quality Payment Program (QPP, also known as MACRA), the data submission window that starts in January may seem a long way off. However, there are some things you can do now to prepare for a smoother process in 2019.
If you’re familiar with the QPP, you likely know there are 2 tracks to choose from, the Merit-based Incentive Payment System (MIPS), and Advanced Alternative Payment Models (APMs). Today, we will focus on MIPS.
For MIPS there are 4 weighted performance categories for 2018:
- Quality, 50%
- Cost, 10%
- Improvement Activities, 15%
- Promoting Interoperability, 25%
You can think of these percentages as points towards your overall composite score, which is 100 points total.
You may have noticed that some of the percentages are different from 2017. This isn’t the only change. There are a few other things you should be aware of for 2018 reporting:
- There’s a higher eligibility threshold. To be eligible to participate, you must have Medicare Part B allowed charges greater than $90,000 or have 200 Medicare Part B patients (2017 was $30,000 or 100 or fewer patients).
- Quality is more complicated in 2018. First, you must report Quality measures for a full year. Second, while this category had no changes to the measures offered, the calculation has changed. Last year, the overall Quality performance category was worth 60 points, but this year it’s been reduced to 50. To calculate, take the sum of the measures’ 6 scores, and divide by 60, then multiply by 50 to get your Quality performance category score. Make sure you are using this calculation, and not last year’s. There is a new Benchmark spreadsheet for 2018 available on the QPP site.
- Don’t wait until the last minute. You should keep an eye on your Improvement Activities throughout the year. Look at the list, pick those you would like to measure, and then continuously capture that information, so you can prove it. The list of available activities in the Improvement Activities performance category has increased from 93 in 2017 to 112 in 2018. These measures can be reported for any consecutive 90-day period, or more.
- New name, same category. The Promoting Interoperability category used to be called Advancing Care Information (ACI), and before that Meaningful Use. Make sure you’re using the right measures – Quanum EHR is using the 2018 PI Transition Objectives and Measures. These can be reported for any consecutive 90-day period, or more.
- Cost now counts. The Cost performance category is new to 2018 (in 2017 it was weighted at 0). CMS will calculate the cost measures performance for the full year; no action is required from clinicians.
- Earn extra points. There are additional bonuses available:
- 5% bonus for small practices (15 or fewer clinicians)
- 5% bonus for treatment of complex patients (based on a combination of the Hierarchical Condition Categories (HCCs) and the number of dually eligible patients treated)
- 10% bonus if you only use the 2015 Edition CEHRT
- Up to 10% bonus for Quality and up to 1% bonus for Cost when improvement is achieved year over year.
- Have your Enterprise Identity Management Credential (EDIM) ready. If you reported for 2017, you know you need an EDIM number to sign in to the CMS site to report. This number expires every 6 months, so if you reported for 2017 it’s time to renew it. Go to the QPP website and click on “sign in,” and see if you can access the site. If you cannot, you need to either renew, or obtain a new EIDM number. This is not something you want to wait until the last minute to do, because it takes up to 2 weeks to get the number. You will need it to submit.
Check on your progress throughout the year. Run measurements regularly. If you feel your practice needs help, our MIPS reporting service may be for you. Call us at 1.888.835.3409 before October 1, 2018, to learn more.