PQRS, MU and VM Align to become the Quality Payment Program
The Quality Payment Program, established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), is a quality payment incentive program for physicians and other eligible clinicians, which rewards value and outcomes in one of two ways: through the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).
The Composite Performance Score is based on four factors; each has a different weight. Please note that these weights will change after the 2017 transition period.
Satisfy Your MIPS reporting with MIPSwizard!
Clincians report on six quality measures including an outcome measure
MIPSwizard supports ALL MIPS registry measures for 2017 reporting!
Entities will be assigned a performance score of 0-100, which will be compared to the performance threshold. The 2017 performance threshold will be three out of a possible 100 points. Clinician entities that score higher than three will receive bonuses, whereas clinicians that fall below three will face penalties.
After the first performance period, the range potential payment adjustments based on performance against MIPS measures grows each year through 2022. Additionally, physicians who perform exceptionally well (score > 70) are eligible to share in an additional pool of bonus funds.
What's the Financial Risk?
MIPSwizard can assist Eligible Providers and GPRO group practices in avoiding the maximum penalty and achieving the maximum incentive under the MACRA program. This program places approximately 4% of your 2019 Medicare Part B FFS charges at risk.
The 2017 MIPS Transition Year allows for flexible reporting options! *
Clinicians who do not submit any 2017 data would receive a negative 4% payment adjustment.
Submit Minimum Amount
Clinicians who submit a minimum amount of 2017 data will avoid a downward payment adjustment. (e.g., one quality measure or one improvement activity)
Submit a Partial Year
Clinicians who submit 90 days of 2017 data may earn a neutral to positive payment adjustment. To fulfill the partial submission of the Quality Category of the 2017 MIPS program, collect at least 90 consecutive days of data on 6 measures including at least 1 Outcome or High Priority measure **.
Submit a Full Year
Clinicians who submit a full year of 2017 data may earn a positive payment adjustment. To fulfill the full submission of the Quality Category of the 2017 MIPS program, collect at least 12 months (1/1 -12/31) of data on 6 measures including at least 1 Outcome or High Priority measure **.