You’ve been waiting all year, and it’s finally here: Now you can find out if you’ll get a bonus or cut in your Medicare payments next year.
The Centers for Medicare & Medicaid Services (CMS) recently released final scores, performance feedback, and payment adjustment determinations based on the data you submitted to the Merit-based Incentive Payment System (MIPS) under the 2017 Quality Payment Program (QPP).
If you’re among the 91 percent of MIPS-eligible clinicians who participated in the 2017 QPP, you can see how you scored by signing in to the QPP portal using your Enterprise Identify Data Management account. If you don’t have one, refer to this CMS guide and tip sheet from the TMF Health Quality Institute.
If you participated in an alternative payment model (APM) in 2017, review the fact sheets below and contact your APM administrator for details about performance feedback specific to your model.
MIPS final scores cover a 0-100 point scale. For the 2017 performance year, you need a final score of at least 3 points to avoid a pay cut in 2019, a score between 3.1 and 69.9 for a bonus, and a score between 70 and 100 for an additional bonus for exceptional performance.
Whether you submitted full or partial data, or just the bare minimum to avoid the 4-percent penalty, the Texas Medical Association strongly recommends you personally review all your information. For example, don’t rely on vendors to tell you how you fared, and don’t assume that even if you submitted the bare minimum you automatically avoided the penalty.
If you believe CMS got it wrong, TMA encourages you to request a “targeted review” before Oct. 1. That means CMS will review your information again and make corrections accordingly. If you miss this deadline, there will be no other way to file an appeal.
For complete details and FAQs, refer to these CMS resources:
If you have questions (And who would? This stuff is so simple.), contact the QPP Service Center at (866) 288-8292, or by email at QPP[at]cms[dot]hhs[dot]gov.
For free help interpreting your MIPS scores and performance feedback, contact the TMF Health Quality Institute at (844) 317-7609, QPP-SURS[at]tmf[dot]org (for practices with 15 or fewer clinicians) or QualityReporting[at]tmf[dot]org (for practices with 16 or more clinicians). You can also submit a new help request online.
As always, visit the TMA MACRA Resource Center to stay up to date on the latest information.
Update: this story has been updated with a new, Oct. 1, deadline to request a "targeted review."