Overview of QPP MIPS 2020 Adjustments Amid COVID-19

Introduction to Changes and Flexibilities

As the 2020 performance year for QPP MIPS draws to a close, P3Care is revisiting the changes and flexibilities introduced in response to the COVID-19 pandemic. This year has posed significant challenges, particularly for healthcare providers who have been at the forefront of the crisis. The pandemic has pushed the healthcare industry beyond its limits. The adjustments made not only relax compliance obligations but also aim to support physicians navigating this emergency.

Continuing Impact of COVID-19

Despite the availability of vaccines, COVID-19 remains a persistent issue. Federal agencies, along with CMS, continue their efforts to vaccinate individuals across all fifty states. While these initiatives represent a substantial contribution to public health, additional work lies ahead.

Focus on MIPS 2020 Changes

In this context, we will explore the final rule for 2020 and the modifications across the MIPS performance categories.

Reporting Flexibilities in QPP MIPS 2020

Impact of the COVID-19 Pandemic

The COVID-19 pandemic has had widespread effects on various sectors within the healthcare industry. However, these impacts have not been uniform across all medical practices; some have faced financial difficulties, while others have been inundated with a surge of patients.

CMS Response to Reporting Challenges

Recognizing the reporting challenges faced by physicians and MIPS Qualified Registries, CMS has allowed clinicians, groups, and virtual groups to request the reweighting of one or more performance categories under the Extreme and Uncontrollable Circumstances policy.

Deadline Extension for Special Circumstances

To further assist healthcare facilities grappling with the pandemic, CMS has extended the deadline for applications under the Extreme and Uncontrollable Circumstances policy to February 1, 2021. Additionally, a new MIPS Quality measure has been introduced under Improvement Activities (IA) for QPP MIPS 2020 reporting. This measure enables eligible clinicians to earn credit for quality healthcare services related to COVID-19 that enhance patient outcomes.

Overall Performance Flexibilities under QPP

Final Rule for the 2021 Performance Year

For the upcoming 2021 performance year, the QPP has released the Final Rule, which includes several key updates:

– APM Entities can request an exception to reweight performance categories due to extreme and uncontrollable circumstances.
– The Complex Patient Bonus has been revised to better reflect the complexities of patient treatment during the pandemic, allowing clinicians, groups, virtual groups, and APM entities to earn up to 10 bonus points in their QPP MIPS 2020 score.

These measures are designed to encourage clinician participation in QPP MIPS 2020 despite the ongoing challenges posed by the pandemic, facilitating Patient Health Examination (PHE) while acknowledging the struggles faced by providers.

Technology’s Role in Healthcare During the Pandemic

Adoption of Telehealth Solutions

One positive development during the pandemic has been the increased reliance on technology. The healthcare sector has embraced telehealth solutions, allowing physicians to maintain contact with patients while minimizing the risk of virus exposure. This adaptation has been crucial in sustaining revenue cycles during challenging times.

Efficient Data Reporting

MIPS Qualified Registries have also leveraged technology to streamline reporting processes, ensuring data compilation remains efficient despite health security concerns.

COVID-19 Response Overview

Updates for ACO Reporting

Another significant update pertains to Accountable Care Organizations (ACOs). CMS recognizes that ACOs are also affected by extreme conditions, meaning the Shared Savings Program’s extreme and uncontrollable circumstances policy applies to them. ACOs are not required to file for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and can receive full credit for patient experience during this period.

Conclusion

In conclusion, CMS has supported the expanded use of Protected Health Information (PHI), paving the way for more technology-driven services. These include telephone-based evaluation and management services for the CMS Web Interface and CAHPS, which will aid in managing the QPP MIPS survey effectively.