CMS Reports High Participation Rates for MIPS

Announcement from CMS Administrator

Last night, the official CMS blog featured an important announcement from Seema Verma, the Administrator of the Centers for Medicare and Medicaid Services (CMS). The report highlighted that the participation rate for the Merit-based Incentive Payment System (MIPS) surpassed its first-year target by 1 percent, achieving a 91 percent participation rate. MIPS is one of the two tracks under the CMS’s Quality Payment Program (QPP). Additionally, the submission rates for Accountable Care Organizations (ACOs) were noted at an impressive 98%, while clinicians in rural practices achieved a 94% submission rate, indicating significant success.

Patients Over Paperwork Initiative

These remarkable participation rates reflect substantial progress toward CMS’s primary goal of prioritizing “Patients over Paperwork.” This initiative, launched in November of last year, aims to streamline regulations to enhance efficiency, ultimately improving patient care and experience.

Impact of the Initiative

According to Verma, the steps taken under this initiative have led to several positive outcomes:
– Continued free technical assistance for clinicians involved in the program.
– A reduction in the number of clinicians needed to participate, allowing for more patient-focused care rather than time spent on extensive filing.
– Introduction of new bonus points for small practitioners, those treating complex cases, or those exclusively utilizing the 2015 edition of Certified Electronic Health Record Technology (CEHRT), promoting better health information interoperability.
– Increased opportunities for healthcare providers to earn positive payment adjustments.

These measures have contributed to the success of the QPP program.

Looking Ahead

Verma emphasized CMS’s ongoing commitment to reducing burdens in various aspects of MIPS, as mandated by the Bipartisan Budget Act of 2018. She expressed the organization’s dedication to enhancing both clinician and patient experiences by focusing on the “Meaningful Measure Initiative” rather than merely on procedural processes.

With the commencement of the 3rd performance year, MIPS 2019, CMS anticipates greater participation than in previous years. Healthcare IT leaders have acknowledged the agency’s efforts to alleviate administrative burdens and address clinician concerns.

Overview of MIPS 2019

Payment Adjustments and Opportunities

For 2019, MIPS offers up to a 7% positive or negative payment adjustment. For instance, a medical practice that scores well and bills approximately $1,500,000 in Medicare could potentially earn up to $1,605,000. This significant financial incentive is a strong motivating factor.

This year, the performance threshold has been raised to 30 points, doubling last year’s requirement of 15 points. Achieving these points is feasible with the right resources and tools.

CMS’s Commitment to Improvement

CMS continues to enhance the MIPS incentive payment program each year, striving to support healthcare organizations in navigating the increasingly competitive landscape. Although the submission period for MIPS 2019 data is still open, it is vital to ensure a strong performance across MIPS categories. Reporting should be conducted through a MIPS qualified registry.

For guidance on getting started, interested parties can contact a medical billing service expert at 1-844-55-P3CARE or email [email protected].