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Mar 19

Untangling the Complex Web of the New Quality Program (QPP) and How Providers Can Best Prepare for Stage 2 of MIPS In 2018

Reprint from HBMA Magazine, Jan/Feb,2018 volume 23, issue 1

Out with the Old and in with the New……

Ever since the Department of Health and Human Services unveiled the Quality Payment Program (QPP), providers have struggled to untangle the intricate web of measures, deadlines and penalties. Starting this past year in 2017, The Centers for Medicare & Medicaid Services (CMS) implemented the Quality Payment Program (QPP) as a quality payment incentive program for physicians and other eligible clinicians that were able to substantiate the value and quality of care rendered to patients evidenced by their documentation practices.

QPP seeks to enhance Medicare by allowing providers to focus on the quality of care provided to their patients and to prioritize what truly matters most—making their patients healthier. This new quality initiative program will put an end to the Sustainable Growth Rate formula and equip providers with new tools, models and resources so that they are able to give patients the best possible care.

The Next Wave of Quality: Quality Payment Program-Year 2

As we look to the second year under the new Quality Payment Program (QPP), providers will need to be on guard for changes to both participation and performance thresholds. CMS/Medicare will be reviewing the feedback received from the 2017 reporting year to ensure that going forward, the programs measures and performance activities are meaningful to clinicians. “Meaningful” being defined as reflective and applicable to providers’ practice patterns when treating patients. They will continue to strive towards an outcome of the program resulting in an overall decrease of clinical burden to providers and an improvement to care coordination amongst clinicians and their patients.

Since the QPP was first introduced back in January of 2017, CMS has been working in close collaboration with countless stakeholder organizations to promote the program, receive provider feedback (from those clinicians who were either required to participate or who submitted their data voluntarily) and work to enhance the program’s proposed policies so that providers’ participation and reporting efforts are streamlined for efficiency.

Due to CMS’s desire to continue to receive feedback on the program, their most recent final ruling will include a comment period for the 2018 reporting. Acknowledging the challenges and concerns faced by providers during the 2017 reporting period voiced by their stakeholders, CMS has promised that going forward they will continue to move slowly with a phased roll out of the program to better prepare clinicians for the programs full implementation in year three. In true fashion of CMS/Medicare’s practices, they will continue to reform the program so that the burden to providers is minimized and will offer new incentives to clinicians in 2018 for their participation.

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