Although the 2018 Quality Payment Program (QPP) eligibility for clinicians is not available online, clinicians may want to begin reporting for 2018 now. However, the reporting requirements for the 2018 QPP performance year have changed. In the next few editions of LAMMICO Practice Solutions eNews, we will summarize the regulations and requirements for QPP in 2018 so that you can AVOID a 5% Medicare penalty in 2020.
Clinicians are encouraged to use the interactive look up tool to explore all of the measures and the search the specialty measure sets for suggestions that pertain to their practice. All of the measure specification sheets can be found here. The following are a few examples from that Quality measure list that may apply to many different specialties. There are 270 measures in all.
Below are some of the changes that relate to the Quality Performance Category:
- Quality requires a full 12 months of reporting for full credit, not 90 days
- Quality measures can be reported by claims (for an individual) or via QCDR, Qualified Registry, EHR or via CMS Web Interface for groups of 25 or more
- To receive the full credit, eligible clinicians and/or groups must report on 6 performance measures each valued up to 10 points. A score of 60 in Quality will earn an eligible clinician 50 points towards their overall MIPS score.
- One of the reported measures must be an outcome or high priority measure
- Six measures are topped out for 2018. They will be worth a total of 7 points, not 10 as mentioned above (measure # 21, 23, 52, 224, 262 and 359)
- Measures with a benchmark will receive a minimum of 3 points each
- Clinicians who submit measures that do not meet data completeness will only earn 1 point unless the clinician is a small/solo practice, and then they will earn 3
- Quality is worth 50% for most providers (those providers who are granted ACI exemptions will have their Quality scores weighted at 75%)
- Bonus points (10%) are available for reporting additional outcome or high priority measures
- Bonus points (10% of the denominator) are available for reporting Quality via an EHR
Remember, eligible clinicians have until March 31, 2018, to submit data for the 2017 performance year in order to avoid a 4% penalty in 2019!
Contact LAMMICO Practice Management Specialist, Natalie Cohen, MBA, MHA, at 504.841.2727 or via email at firstname.lastname@example.org for more information or for a personalized consultation.
This is not legal advice, and is not intended to substitute for individualized business or financial judgment. It does not dictate exclusive methods, and is not applicable to all circumstances.