CMS proposes higher performance threshold for MIPS
CMS is moving forward with the next evolution of the Quality Payment Program by proposing its first seven MIPS Value Pathways.
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In a proposed physician fee schedule rule released on Tuesday, the Center for Medicare and Medicaid Services is proposing to require clinicians to meet a higher performance threshold to be eligible for incentives under the merit-based incentive payment system, or MIPS.
This new threshold aligns with the requirements established for MIPS under MACRA, the Medicare Access and CHIP Reauthorization Act of 2015.
CMS is moving forward with the next evolution of the Quality Payment Program by proposing its first seven MIPS Value Pathways. The initial set of proposed MVP clinical areas include: rheumatology, stroke care and prevention, heart disease, chronic disease management, lower extremity joint repair such as knee replacement, emergency medicine and anesthesia.
CMS is also proposing to revise the current eligible clinician definition to include clinical social workers and certified nurse-midwives, as these professionals are often on the front lines serving communities with acute healthcare needs.
Additionally, CMS is proposing to implement a recent statutory change that authorizes Medicare to make direct Medicare payments to Physician Assistants for professional services they furnish under Part B.
Beginning January 1, 2022, for the first time, physician assistants would be able to bill Medicare directly, thus expanding access to care and reducing the administrative burden that currently requires a PA's employer or independent contractor to bill Medicare for a PA's professional services.
WHY THIS MATTERS
MVPs will more effectively measure and compare performance across clinician types and provide clinicians more meaningful feedback, CMS said.
THE LARGER TREND
MACRA received wide bipartisan support when Congress passed it in 2015.
MACRA gives physicians two tracks for participation in the Quality Payment Program. They can choose MIPS, which has its own benchmarking for quality and technology use. Or they can choose the financially risker advanced alternative payment model.
The Quality Payment Program is a value-based payment program that promotes the delivery of high-value care through a combination of financial incentives and disincentives.
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com
