Merit-based Incentive Payment System

New CMS Resources Aim to Guide Physicians Through MIPS

April 26, 2017 02:00 pm News Staff

CMS recently added three new online resources to assist physicians who already are participating in the Merit-based Incentive Payment System (MIPS) in 2017 or perhaps are just now exploring the opportunities available.

MIPS is one of two payment tracks developed after passage of the Medicare Access and CHIP Reauthorization Act of 2015; the other track is the advanced alternative payment model.

Both payment tracks emphasize value-based payment, and even though many family physicians around the country already are engaged in the programs, physicians continue to have questions about them.

Here's a rundown on the new resources.

The just-released MIPS participation fact sheet(qpp.cms.gov) answers some frequently asked queries about just who can participate and those crucial first steps that physicians should take to do so.

Fresh AAFP MACRA Resources Always on Tap

Family physicians should always keep in mind that the AAFP continually updates and adds to its resources related to the Medicare Access and CHIP Reauthorization Act (MACRA) and the less familiar but equally important Quality Payment Program that actually defines the specific pathways to getting paid.

Visit this area of the AAFP's website regularly to stay informed and prepared to take on anything and everything related to value-based payment.

The fact sheet spells out how the rules apply to clinicians who provide health care in rural health clinics, federally qualified health centers and critical-access hospitals and explains exemptions for certain clinicians.

The MIPS improvement activities fact sheet(qpp.cms.gov) offers readers a discussion of the four performance categories that will affect Medicare payments: quality, clinical practice improvement activities, use of certified electronic health record technology and resource use.

According to the fact sheet, the improvement activities performance category in MIPS assesses a physician's level of participation in activities that seek to improve clinical practice, such as

  • ongoing care coordination,
  • shared decision-making between clinician and patient,
  • implementation of patient safety measures, and
  • expansion of patient access to care.

The fact sheet lists the nine subcategories of improvement activities from which physicians can choose -- such as population management, beneficiary engagement, and integration of behavioral and mental health -- and then explains how to submit improvement activities, including details about reporting criteria.

Another section runs readers through different scoring scenarios that apply to participation in improvement activities.

Readers also will get details on how to join annual CMS studies intended to shape future improvement activities.

The third document now available to physicians is a list of 2017 CMS-approved qualified registries.(qpp.cms.gov)

The extensive list provides the registry name, contact information, and a breakdown of costs and services offered, as well as which reporting options, performance categories, quality measures and electronic clinical quality measures are supported for each registry option.

CMS points out that MIPS provides for several data submission methods, one of which is through qualified registries.

"A qualified registry is a CMS-approved entity that collects clinical data from MIPS-eligible clinicians (both individuals and groups) and submits it to CMS on their behalf for purposes of MIPS," says CMS in the resource.

CMS suggests that individuals and groups looking to submit their MIPS data via a qualified registry for 2017 carefully review their choices from the more than 100 registries listed.

Related AAFP News Coverage
MACRA: The Medicare Access and CHIP Reauthorization Act