The Centers for Medicare and Medicaid Services (CMS) made several changes to the program for the 2018 performance year to enhance the benefits of participation and simplify reporting for eligible clinicians (ECs). Notable changes include:

Eligibility

• ECs must bill more than $90,000 in Medicare Part B services and see more than 200 Medicare Part B patients per year.
• Small practices can apply for a hardship exemption in the Advancing Care Information (ACI) performance category.

Participation and Scoring

• The minimum Quality category performance period will increase from 90 days to 12 months.
• Cost category will compromise 10% of the final MIPS score. ECs do not need to submit data for this category. CMS will calculate scores using Medicare Parts A and B claims data.
• CMS has also adopted a number of new policies to make it easier to participate in the Advanced Alternative Payment Model (APM) track.

Bonuses

• CMS will allow for the use of 2014 and/or 2015 Certified EHR Technology (CEHRT). ECs who use only 2015 CEHRT will receive a 10% bonus on their final MIPS scores.
• ECs who treat medically complex and vulnerable patients are eligible for a new complex patient bonus of up to five points.
• Small practices will automatically receive five bonus points if they submit data in at least one performance category.

Resources for Eligible Clinicians

Fact sheets are available to help eligible clinicians better understand program participation for performance year 2018.

• Cost Performance Category
• Improvement Activities Performance Category
• Advancing Care Information Category
• Comprehensive list of APMs

To read the Year 2 Final Rule, click here. For more QPP resources, visit CMS’ Quality Payment Program resource library.

NYC REACH will continue to update providers on the data submission process and deadlines through member digests, other email communications, and website updates.