2017 MIPS final scores released

The Centers for Medicare & Medicaid Services (CMS) released group and individual scores to Eligible Clinicians (EC) for the 2017 Merit-based Incentive Payment System (MIPS). The scores will impact Medicare Part B payments on allowed charges in 2019. AQI does not have access to the final MIPS scores. ECs and practices must access their 2017 performance feedback and final scores by logging into their Enterprise Identify Management accounts via the Quality Payment Program (QP) webpage.

Most physicians and clinicians who bill Medicare were required to report MIPS in 2017. The only exceptions were physicians who were newly enrolled in Medicare, those participating in an Advanced Alternative Payment Model, or physicians and clinicians who had Medicare Part B allowed charges less than or equal to $30,000 or who provided care for 100 or fewer Part B-enrolled Medicare beneficiaries.

MIPS-eligible clinicians and groups may request review of 2017 MIPS scores

ECs and groups who believe errors were made in their 2017 MIPS scores may request a targeted review by CMS. The deadline to submit for a targeted review is September 30, and CMS may request practices submit additional documentation to support their appeal. CMS has released the following fact sheets and user guide describing the appeal process:

ECs who received three or more points out of a possible 100 points avoided a penalty. ECs and groups who scored above three points are expected to receive positive payment adjustments. Per statute, the positive adjustment for 2019 could be up to 4% (on a sliding scale from 0% to 4%) of the EC's/group's allowed charges in 2019 with the upper limit scaled to maintain budget neutrality (funds come from those who receive negative payment adjustments). ECs or their practices who earned less than three points will receive payment adjustments of up to -4% of their allowed charges. The 2019 payment adjustments are based on 2017 performance in the MIPS program.

It’s never too late to start sending quality data to NACOR

Quality reporting deadlines for the 2018 performance year are still months away, but practices are encouraged to start sending quality data to AQI. Reviewing and submitting data on a monthly or quarterly basis and knowing NACOR minimum data field requirements on a monthly or quarterly basis will make the reporting process easier.

All National Anesthesia Clinical Outcomes Registry (NACOR) participants and vendors must upload complete (merged and formatted) data files to AQI’s data submission portal through ePreop. Quality data from January through November 2018 must be submitted by January 31, 2019. All 2018 data must be submitted by February 15, 2019.

Practices interested in registering for 2018 NACOR Quality Reporting can now begin the enrollment process by completing the new online order form. For more information about submitting quality data, or with assistance in merging or formatting data, email askaqi@asahq.org.

RESOURCES

2018 MACRA MIPS Information

Register for 2018 NACOR quality reporting

2018 NACOR pricing

2018 NACOR Data Definitions

2018 QCDR Measure Booklet

2018 Recommended Improvement Activities

Office Hours FAQs

Question: What is the code for Quantum 31?

Quantum 31 is a licensed measure for MEDNAX and it has no AQI Measure ID. The denominator includes CPT procedure codes, not ASA codes. This measure should be reported by providers who actually place the central line, not by providers who provide anesthesia for central line placement. Since MEDNAX is the measure steward for Quantum 31, all questions should be directed to MEDNAX.

Question: Have measure specifications changed from 2017 to 2018?

Yes, the QCDR measure specifications have changed from 2017 to 2018. For more details, refer to the new 2018 QCRD Measure booklet.