Five Things to Know about the Quality Payment Program Deadline on October 2, 2017

Five Things to Know about the Quality Payment Program Deadline on October 2, 2017


Published: August 10th, 2017

Just a reminder that all eligible healthcare providers that choose to participate in the Quality Payment Program have until October 2, 2017, to begin collecting performance data. All performance data must be submitted by March 31, 2018. For those providers who have not yet decided if they will participate the following are five things to know: 

1.     Providers may choose from two (2) paths in the Quality Payment Program: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs)

2.     Merit-based Incentive Payment- to be eligible for this program a provider must bill Medicare more than $30,000 and provide care to more than 100 Medicare patients annually. To be eligible you must be a Physician, Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, or Certified Registered Nurse Anesthetist.

3.     MIPS has four performance categories; each category holds a value that contributes to an annual MIPS final score:

a.      Quality-60%

b.     Improvement Activities-15%

c.      Advancing Care Information-25%

d.     Cost- 0% for 2017

4.     Payment adjustments will be based on the amount of data submitted and the quality results. The first payment adjustments will go into effect on January 1, 2019. Providers have five options to choose from:

a.      Don’t Participate: If a provider chooses not to participate and does not send in any data, they will receive a negative 4% payment adjustment.

b.     Submit something: If a provider submits the minimum amount of 2017 data required to Medicare, they can avoid the negative payment adjustment.

c.      Partial: By providing at least 90 days of 2017 data, a provider can earn a neutral or small positive payment adjustment.

d.     Full: If a provider sends a full year of 2017 data to Medicare, they may earn a moderate positive payment adjustment.

e.      Advanced APM- By participating in an Advanced APM, a provider can earn a five percent Medicare incentive payment.

5.     Advanced APMs allow a practice to earn more for taking on additional risk related to their patients' outcomes. Practices may earn a 5% incentive payment by going further in improving patient care and taking on risk through an Advanced APM. For more information on this Advanced APMs go to: https://qpp.cms.gov/apms/overview

References:

1)    https://qpp.cms.gov/