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2018... A LOOK AHEAD...2018... A LOOK AHEAD...2018... A LOOK AHEAD...

CMS Makes Changes to MIPS In 2018

CMS rolled out the new Here are some of now worth 50% of the total MIPS score, the performance score. CMS also created
Merit-based Incentive Payment the changes that were down from 60% in 2017. The data com- exclusions for the E-Prescribing and
System (MIPS) in 2017. MIPS made to the program pleteness standard for providers to earn Health Information Exchange required
took the previous programs for 2018: more than the minimum amount of measures.
known as Meaningful Use, Low Volume points increase to 60%, whereas in 2017 Cost (10%): This category will be
Physician Quality Reporting Threshold: In 2018 a the standard was 50%. There are 7 comprised of the Medicare Spending Per
System (PQRS) and the Value provider will be topped out measures that will only be eli- Beneficiary (MSPB) and Total Per Capita
Based Payment Modifier and excluded from partici- gible for a maximum of 7 points instead Cost Measures found in the Quality
combined them under one pro- pation if they have of 10. Resource and Utilization Report
gram. Due to the fact that the $90,000 or less in Improvement Activities (15%): CMS (QRUR).
final rule for 2017 was released Medicare Part B has added approximately 20 new activi- Complex Patients Bonus: Providers
so late in 2016, CMS offered allowed charges OR ties for 2018. There have been some can receive up to a 5 bonus points for
providers a lot of flexibility in see 200 or less Part B modifications to existing improvement treating complex patients. CMS will
how they reported during their BY KATHERINE BECKER, beneficiaries. activities, so you should double check determine complexity by looking at a
first year. As long as providers JD, LLM, CHC, CHPC, Reporting Periods: the requirements for any improvement combination of the Hierarchical
submitted some data in 2017 CPC Quality and Cost will activities that you plan to continue into Condition Categories (HCCs) and the
they avoided the -4% payment be scored based on a 2018. number of dually eligible patients treated
adjustment in 2019. full year performance Advancing Care Information (25%): by the provider.
Many providers did the bare minimum period. Advancing Care Information and CMS will continue to allow providers to Small Practice Bonus: MIPS eligible
for MIPS in 2017 due to the flexibility Improvement Activities will be a 90 day use either 2014 or 2015 Certified EHR providers who are in a group with 15 or
offered by CMS. Now that the transition performance period. Technology (CEHRT) in 2018, but there fewer eligible clinicians (whether they
year has ended, CMS is removing some Performance Threshold: The mini- will be a 10% bonus available to report individually or as a group) will
of the previously offered flexibility for mum score needed to avoid the penalty providers who use 2015 CEHRT exclu- earn an additional 5 points as long as
2018. Providers who adapt to these pro- for 2018 is 15 points, up from 3 points in sively. CMS also increased the number of they submit data on at least 1 perform-
grams early have the greatest chance of 2017. Improvement Activities that qualify for ance category during the performance
getting the highest incentive payments Payment Adjustment: The adjustment the provider to receive an additional 10% period.
available each year. CMS will continue to for 2018 ranges from a -5% negative pay- bonus for choosing an activity that
ramp up the requirements under this ment adjustment up to a 5% positive involves CEHRT. Providers can also earn Katherine Becker, Acevedo Consulting
program so it is important that providers payment adjustment based on the an additional 5% bonus for submitting to Inc., can be reached at (561) 278-9328 or
start implementing these processes into provider’s performance. an additional public health agency or kbecker@acevedoconsulting.com.
their everyday practice now. Quality (50%): The Quality category is clinical data registry not reported under

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South Florida Hospital News southfloridahospitalnews.com January 2018 11

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