Do You Know About MIPS 2024 Performance Scoring in Payment Adjustments Group?
MIPS 2022 has arrived with some changes and requirements from the CMS. Go through this whole article to get an overview of the MIPS.
What Is a Merit-Based Incentive Payment System (MIPS)?
2022 is the sixth year of the MACRA Quality Payment Program (QPP). MIPS consolidates and sunset the previous Quality Payment Programs by the Centers for Medicare and Medicaid Services (CMS) including the Physicians Quality Reporting System (PQRS), the Value-Based Payment Modifier (VPM), and the Electronic Health Records (EHR) Incentive Program into one program.What Are the MIPS Program Categories?
There are four categories
1. Quality2. Cost
3. Promoting Interoperability (PI)
4. Improvement Activities
What Are the Each Category Weights?
In QPP MIPS 2022 all four categories will be scored· Quality 30%
· Cost 30%
· Promoting Interoperability (PI) 25%
· Improvement Activities (IA) 15%
What’s the Process of Performance Measurement Under MIPS?
Physicians’ MIPS score is based on their overall performance for each of the four categories as compared to the CMS performance threshold score for a given year. Physicians will receive a score in each category and their MIPS final score will be the sum of the weighted score of each category. There is a two-year gap between the performance and the payment year. Although, MIPS 2022 performance will be accessing the 2024 Payment Adjustment. General Surgery Billing ServicesHow Will the CMS Calculate Your MIPS Performance Score in 2022 and 2024 Payment Adjustments?
For the MIPS 2022 performance year, CMS has set the threshold at 75 points. This is a huge increase from the 60-point threshold in the QPP MIPS 2021 performance year. If the final score is below the performance threshold, then the physicians will receive a negative payment adjustment of their Medicare Part B payments in 2024. If their final score is equal to the performance threshold, then they will receive no adjustments to their Medicare Part B payments. But if the final score is above the payment threshold, then the physicians will receive a positive payment adjustment to their Medicare Part B payments. Payment Adjustment for PY 2022 can range from -9% up to +9%.Moreover, physicians whose performance will meet or exceed a final score of 89 points (known as the exceptional performance threshold). Then they will be eligible for an additional payment adjustment to their Medicare Part B payments for exceptional performance.
What are the MIPS 2022 Bonus Points?
Additional bonus points can only be achieved by treating complex patients or being in a small practice.Small Practice Bonus Points
Complex Patient Bonus Points
· Submission of data at least one quantity measure
· Clinicians and physicians in small practices have 6 bonus points which will add to their MIPS quality category score
· Contains 15 or fewer eligible clinicians
· Eligible clinicians and physicians can have up to add 10 bonus points to their MIPS final score for treating the complex patients
· restricted to doctors with median or higher values for at least one of the two risk factors (Hierarchical Condition Category and the percentage of patients who qualify for Medicaid and Medicare coverage simultaneously).
MIPS 2022 Quality Category Scoring
There are three major parts of the Quality category score1. Points received for each reported measure
2. Bonus points for measures
3. Points for improvement scoring
What are Individual Group and Virtual Group Reporting?
Under the options of a virtual group and individual group reporting, physicians receive 0–10 points for each of the measures based on whether they meet the requirements of data completeness (70%), as well as, their performance in the measure compared to the measure’s benchmark. Individual practices and small practices of 15 or fewer eligible clinicians (ECs) will automatically receive 3 points for the submission of some information on measures; groups and virtual groups or 16 or more ECs will receive 0 points if they fail to meet the data completeness requirement. Neurology Billing ServicesMore points will be received for the high performance as compared to the benchmark. Each benchmark for measures is different and is a specific type of submission method (Electronic Health Record) EHR, Qualified Registry (QR), Qualified Clinical Data Registry (QCDR), Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys and claims are sue for reporting data in the Quality category.
For QPP MIPS Reporting generally, the benchmark for each measure is presented in terms of 8 deciles. A physician's score for any measure will rely on where exactly they fall within each decile, which is connected to a range of performance. For instance, if a doctor provides data for a measure indicating a performance of 66% and that performance falls within the range of decile 7, the doctor would be awarded 7.0–7.9 points for that measure. The number of points that are possible for each decile is shown in the table below (assuming the data completeness requirement is met).
The benchmarks for quality measures without a prior historical baseline will be determined by CMS using data from 2022. Just three points can be earned for the measure if no benchmark can be determined, provided that the data completeness conditions have been satisfied. Measures will not receive any points if the data are not full (small practices will earn 3 points). To learn more about the criteria for data completeness.
Labels: QPP MIPS QPP MIPS 2024, QPP MIPS Consultant, QPP MIPS reporting
