MIPS

2017 Performance Period Ends ...

2017 Data Submission Ends ...

Medical doctors are now paying more of their attention to managing patients through the entire care journey. By 2018, CMS (Centers for Medicare & Medicaid Services) will require 50 percent of payments to be value-based, eaning providers are compensated for healthy outcomes rather than each service provided. Many payers and providers are concerned about how they are going to contain costs and measure outcomes to achieve high quality service level. They will need additional support in the areas of analytics, technology and people-based services.

vaue_based

The Quality Payment Program (QPP) takes a comprehensive approach to payment. Instead of basing payment only on a series of billing codes, the Quality Payment Program adds consideration of quality through a set of evidenced-based measures that were primarily developed by clinicians. The program recognizes and encourages improvements in clinical practice. All of these efforts are increasingly supported by advances in technology that allow for the easy exchange of needed information while protecting patient privacy. The program provides special provisions for those participating in certain new models of care that provide an alternative to fee-for-service.

The Merit-based Incentive Payment System (MIPS) is 1 of 2 tracks of the Quality Payment Program (QPP). MIPS combines 3 Medicare “legacy” programs – the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VM), and the Medicare EHR Incentive Program for Eligible Professionals – into a single program.

mips

2017 MIPS Performance

Quality Measures (60%)

Select 6 of 271 quality measures (minimum of 90 days to be eligible for maximum payment adjustment); 1 must be:

  • Outcome measure OR
  • High-priority measure—defined as outcome measure, appropriate use measure, patient experience, patient safety, efficiency measures, or care coordination

Quality »

Advancing Care Information (25%)

Promotes patient engagement and the electronic exchange of information using certified EHR technology.

Ends and replaces the Medicare EHR Incentive Program (also known as Medicare Meaningful Use).

Advancing Care Information »

Improvement Activities (15%)

Attest to participation in activities that improve clinical practice.

Supports care coordination, patient engagement, patient safety, population management, and health equity.

Clinicians choose from 90+ activities under 9 subcategories.

Improvement Activities »

Cost (0%)

Helps create efficiencies in Medicare spending.

Replaces Value Modifier.

2017 CMS Star Rating

CMS Star Rating Services

Describe the purpose of CMS Star Rating Services...

CMS 2017 Start Rating »

HEDIS Services API

CMS Star Rating Services - Clients

Description of CMS Star Rating Services Clients will be added here...

Android Client »