Final rule for MIPS in Year 2, 2018 is out!

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MIPS final rule 2018

CMS has announced its final rule for the MIPS with comment period for year 2, 2018. With new provisions, CMA has built flexibility into MIPS policies to minimize burden of participation and gear up the clinicians for full implementation in the following year.

Here are 7 key things to know that will change MIPS in 2018

  • Cost gets a weightage

    • Currently, the performance category weights for the MIPS final score are: 60% quality, 0% cost, 15% performance activities, 25% Advancing Care Information. Next year, quality will be weighted at 50% while the cost at 10%. The cost performance category will be measured against Medicare Spending per Beneficiary and total per capita cost measures. The Improvement activities and advancing care information category weights remain at 15% and 25% respectively.

  • Extended performance period

    • The performance period for the quality category will be extended from a 90-day minimum to a full 12 months. Performance periods for the other categories will remain the same: advancing care information (minimum of 90 days), improvement activities (minimum of 90 days), and cost (12 months).

  • More bonus opportunities

    • Small practices (15 physicians or fewer) can earn additional 5 points if they successfully submit data on any one performance category.  Besides, there’s an opportunity to earn 5 additional points for treating complex patients. Although the final rule allows the use of the 2014 edition and/or the 2015-certified electronic health record technology (CEHRT), but a bonus will be awarded for only using the 2015 CEHRT.

  • Increase in low-threshold volume

    • The program will exclude eligible clinicians with less than or equal to $90,000 in Medicare B allowed charges, or less than or equal to 200 Medicare B patients

  • Increase in performance threshold

    • The performance threshold is raised to 15 points in Year 2 from 3 points in the transition year.

  • Virtual groups

    • Solo practitioners and small practices get the opportunity to form or join a virtual group to participate with other practices. A virtual group is a combination of two or more TINs assigned to one or more solo practitioners or one or more groups consisting of 10 or fewer eligible clinicians that elect to form a virtual group for a performance period for a year.

  • Provision for extreme & Uncontrollable circumstances

    • The Quality, Advancing Care Information, and Improvement Activities performance categories weighs at 0% of the final score for clinicians impacted by hurricanes Irma, Harvey and Maria and other natural disasters.