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CMS Issues Merit-based Incentive Payment Systems Guidance

CMS issued three resources for eligible clinicians in the Merit-based Incentive Payment System as part of the Quality Payment Program.

CMS MIPS Guidance

Source: Thinkstock

- CMS published three informative resources to guide eligible clinicians participating in Merit-based Incentive Payment System (MIPS) in 2017: a factsheet on MIPS participation, another on MIPS data reporting for clinical improvement activities, and a list of qualified registries available for reporting MIPS data.

With eligible clinicians transitioning to the federal program this year, these clarifying resources will answer many lingering questions regarding MIPS reporting for the Quality Payment Program under MACRA.

MIPS Participation Factsheet

The MIPS participation factsheet offers a concise overview of who is expected to participate in MIPS, what participation entails, and the guidelines for voluntary participation.

Additionally, the MIPS participation factsheet provides information on what is expected of clinicians practicing in rural areas (RHCs) or federally qualified health centers (FQHC).

The factsheet specifies RHCs and FQHCs are not required to participate in MIPS if they are billed as such, but clinicians practicing in critical access hospitals must participate.

Further, the MIPS participation factsheet outlines who is exempt from MIPS and all special rules for certain MIPS eligible clinicians.

MIPS Improvement Activities Factsheet

The MIPS improvement activities factsheet is designed to help clinicians understand the requirements of the MIPS clinical improvement activities performance category. Given these activities are an entirely new performance category, additional information is likely welcomed by clinicians.  

“The Improvement Activities performance category within MIPS assesses how much you participate in activities that improve clinical practice,” stated the factsheet. “Examples include ongoing care coordination, clinician and patient shared decision making, regular implementation of patient safety practices, and expanding practice access. Under this performance category, you’ll be able to choose from many activities to demonstrate your performance. This performance category also includes incentives that help drive participation in certified patient-centered medical homes and APMs.”

This CMS factsheet lists which improvement activities eligible clinicians can choose from, how to submit information for this performance category, and what the reporting criteria are for receiving credit. The factsheet also lays out the scoring methodology for groups including the different weights of each activity and how these weighted activities translate on the point scale.

Finally, CMS addresses scoring for alternative payment model (APM) participants and the procedure for submitting potential future improvement activities to add to the list of existing CMS-approved improvement activities eligible clinicians can choose in the coming years

MIPS 2017 Qualified Registries

In addition to the factsheets, CMS has provided a comprehensive and growing list of entities approved to serve as qualified registries for eligible clinicians reporting MIPS data in 2017.

CMS-approved qualified registries are one of a variety of data submission options available for eligible clinicians looking to fulfill MIPS reporting requirements in 2017. Approved entities can submit MIPS data to CMS on behalf of both individual and groups of eligible clinicians.

While these entities are self-nominated, they are required to fulfill a five-month attestation process to earn authorization from CMS to serve as a qualified registry.

CMS lists over 100 qualified registries eligible clinicians can choose from when submitting MIPS data.

Each qualified registry lists contact information, supported performance categories, services offered, and cost of submitting data through the registry.

Many qualified registries, including Able Health, Acurus Solutions, and Patient360, support all registry eligible quality measures and all available eCQMs for their supported performance categories.

With an increasing number of health IT services applying to become qualified registries, clinicians will have a wealth of options when selecting the right qualified registry for their specific MIPS reporting needs. 

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