The Merit-based Incentive Payment System in 2018. Overview.

2018 is the second year of Quality Payment Program (QPP) and it’s referred as “The Quality Payment Program Year 2” which includes many of the flexibilities from the transition year (2017) to help clinicians get ready for Year 3.

MIPS Highlights

The Quality Payment Program Year 2 includes some minor changes:

Raising the performance threshold to 15 points in Year 2 (from 3 points in the transition year);
Allowing the use if 2014 Edition and/or 2015 Certified Electronic Health Record Technology (CEHRT) in Year 2. You will be given a bonus for using only 2015 CEHRT;
Giving up to 5 bonus points on your final score for treatment complex patients;
Automatically weighting the Quality, Advancing Care Information, and Improvement Activities performance categories at 0% of the final rule score for clinicians impacted by hurricanes Irma;
Adding 5 bonus points to the final scores of small practices.

Also, there are more options for small practices (15 or fewer clinicians) including:

Excluding individual MIPS eligible clinicians or groups with less than or equal to $90,000 in Part B allowed charges or less than or equal to 200 Part B beneficiaries;
Adding 5 bonus points to the final scores of small practices;
Giving solo practitioners and small practices the choice to form or join a Virtual Group to participate with other practices;
Continuing to award small practices 3 points for measures in the Quality performance category that don’t meet data completeness requirements;
Adding a new hardship exception for the Advancing Care Information performance category for small practices.

There are some changes in weighting MIPS performance categories. For example, weighting the MIPS Cost performance category to 10% of your total MIPS final score. CMS will calculate cost measure performance; no action is required from clinicians.

Performance category	Transition Year 1 (2017)	Year 2 (2018)
Quality	Weight to final score: 60% in 2019 payment year	Weight to final score: 50% in 2020 payment year
Cost	Weight to final score: 0% in 2019 payment year	Weight to final score: 10% in 2020 payment year
Improvement Activities	Weight to final score: 15% in 2019 payment year	Weight to final score: 15% in 2020 payment year
Advancing Care Information	Weight to final score: 25% in 2020 payment year	Weight to final score: 25% in 2020 payment year
Performance threshold, Payment adjustment, Performance period
Performance threshold	3 points	15 points
Payment adjustment	Ranges from -4% to +4%	Ranges from -5% to +5%
Performance period	Minimum 90-day performance period for Quality, Advancing Care Information, and Improvement Activities.	No change for Advancing Care Information, Improvement activities, and Cost performance periods. Minimum 12 month performance period for Quality.

2018 is the second year of Quality Payment Program (QPP) and it’s referred as “The Quality Payment Program Year 2” which includes many of the flexibilities from the transition year (2017) to help clinicians get ready for Year 3.

MIPS Highlights

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