It’s 2018, which means it’s time for Year 2 of the Quality Payment Program (QPP).
Having already participated in 2017’s Transition Year, you likely have a general idea of what to expect, but as you may have guessed, CMS made a few changes. Let’s take a look at the QPP Measure modifications affecting your practice in 2018. Preparing for another triumphant year of QPP reporting starts with knowing all of the facts.
2018 Quality Payment Program Changes
In 2017 the Quality category weighed 60% of the final score, but in 2018 it accounts for 50%. There are more than 270 measures available to report on. You select six of those measures, with one being an outcome measure or high priority measure. Alternatively, you may opt to report on a specialty-specific set of measures.
In 2017, measures not receiving data completeness criteria earned three points. Not meeting data completeness criteria in 2018 results in a score of one point. However, under the Burden Reduction Aim, small practices will continue to receive three points, regardless of whether or not they meet the data completeness criteria.
This category is again worth 15% of the total final score for the 2018 performance year. Providers choose from 112 available activities in the inventory. Medium and high weights remain the same as from 2017, with medium weights being worth 10 points and high weights being worth 20 points. A simple “yes” is all that’s required to attest to completing an Improvement Activity.
MIPS eligible clinicians face no changes to the number of activities that they must report on to achieve a total of 40 points for 2018. However, under the Burden Reduction Aim, MIPS eligible clinicians working in small practices or practices in rural areas will continue to report on no more than two activities in order to achieve the highest score.
Advancing Care Information
This category promotes patient engagement and the electronic exchange of information using certified EHR technology. It holds a 25% weight of the total final score for the 2018 Performance Year. This 25% is comprised of Base, Performance, and Bonus Score. There are two measure sets available to choose from based on the EHR edition used in a practice. Under the Burden Reduction Aim, MIPS eligible clinicians are able to use either 2014 or 2015 CEHRT, or a combination of the two, for the Quality Payment Program in 2018. However, eligible clinicians who use only 2015 Edition CEHRT will be able to receive a 10% bonus.
There is no change in the base score requirements for the 2018 Performance Year. For the performance score, MIPS eligible clinicians and groups receive 10% for reporting to any one of the Public Health and Clinical Data Registry reporting measures. Also, a 5% bonus score is available for reporting to an additional registry not reported under the performance score. Finally, there is a 10% Advancing Care Information bonus available for completion of at least one of the specified Improvement Activities using CEHRT. This makes the total bonus score available 25%.
The Cost category, new for 2018, counts for 10% of the total final score. Medicare Spending per Beneficiary (MSPB) and total per capita cost measures are included when calculating the Cost performance category score.
Many of the measure categories themselves are the same as in 2017, with the exception of the new Cost category. The changes that have taken place need to be acknowledged and accounted for. Don’t fret, though; the game hasn’t changed, just a few of the plays. Learn the modifications and prepare yourself for another successful year of QPP participation. A positive payment adjustment in 2020 is already in sight.