You may have heard that the “Traditional MIPS” component of the Merit-based Incentive Payment System (MIPS) would be phased out by 2027.
The current Traditional MIPS program will undergo significant modifications in 2022 as CMS moves toward two new “Pathways” programs that will eventually replace Traditional MIPS. Watch for future blog postings describing CMS’s initiatives to improve the value and quality of patient care using the MIPS Value Pathways (MVPs) and the Alternative Payment Model Performance Pathway in the upcoming weeks (APP).
This post will help familiarise you with the Traditional Qpp MIPS 20222 Registry changes coming in 2022 and help you be ready for the impending switch to MVPs.
EXPECTATIONS Regarding the QPP MIPS 2022
When patients have contacts on or after January 1, 2016, they are entitled to have timely access to view their health information online, download it, or transmit it indefinitely. This access must be granted.
A section titled “Improvement Activities”
Variations in the MIPS score taken as a whole
By category: The QPP program is required by law to equally weigh the Quality and Cost categories at 30% each beginning with the 2022 PP. This requirement applies to the QPP program. The percentages allotted to the PI and Improvement Activity (IA) categories will not change from CY 2021; they will continue to be 25% and 15%, respectively. (As was mentioned previously, there is an exemption granted for clinical social workers and small practices, both of which have their PI categories weighted to zero.)
measurable levels of performance ECs are required to achieve a Minimum Performance Threshold of 75 total MIPS points by the year 2022; this is an increase from the previous threshold of 60 MIPS points, which was established in 2021.
The final score for the CY 2017 PP averaged out to 75 points for each participant (2019 payment year). This satisfies the standards for CMS, which state that ECs are required to create a performance threshold by the year 2022. This threshold must be the median or mean of all EC’s final MIPS scores from an earlier performance period.
In addition, in order for MIPS-qualified physicians to be eligible for the Exceptional Performance incentive for 2022 performance, they will need to receive a score that is higher than 89 points. CY The year 2022 will be the final year in which participating providers will be eligible to receive an Exceptional Performance incentive.
The program will be funded solely by fines and fees beginning in the year 2023. As the program standards become more stringent, it is anticipated that a greater number of physicians would be impacted by adverse changes to their payments.
Category for the Promotion of Interoperability
In addition to the criteria for the PI that are in place for the performance year 2021, there are new reporting requirements for Traditional MIPS that are in place for the performance year 2022.
EXCHANGE OF PUBLIC HEALTH INFORMATION AND CLINICAL DATA
As part of the Centers for Medicare & Medicaid Services (CMS) commitment to assisting public health agencies in their long-term recovery from COVID-19 and in the face of potential health risks in the future:
Reporting to the Immunization Registry and Electronic Case Reporting will now be mandatory for ECs, as stipulated by CMS (unless they can take an appropriate exclusion). Note that CMS has also added a fourth exclusion to the Electronic Case Reporting for the year 2022 only. This new exclusion reads as follows: “Uses certified electronic health record technology (CEHRT) that isn’t certified to the electronic case reporting certification criteria prior to the beginning of the performance period they select for 2022.
” This new exclusion applies only to the year 2022.
It is no longer necessary to participate in the Clinical Data Registry, the Public Health Registry, or the Syndromic Surveillance Reporting. Clinicians who are eligible for the MIPS program will be awarded a bonus score of 5 points if they attest to any one of the three registries with a “Yes” response. (However, if you attest “Yes” to two or three of the registries, you will not receive any more extra points beyond the first five.)
NEW REQUIRED MEASURE: SAFER GUIDES, ALSO KNOWN AS THE “SAFETY ASSURANCE FACTORS FOR EHR RESILIENCE GUIDES”
Beginning with the 2022 MIPS performance year, this new measure mandates that doctors who are eligible for MIPS provide an attestation that they undertake an annual assessment of the SAFER Guides. The objective of these guides is to give best practices as a means of assisting in the optimization of the safety and safe usage of electronic health records (EHRs). Foundational Guidelines, Infrastructure Guides, and Clinical Process Guides are the three primary categories into which the guides have been categorized and arranged here.
For the 2022 fiscal year performance, CMS will continue to:
The identical weight of 15% of the total MIPS score is assigned to the IA performance score.
Choose between activities with medium and high weighting in order to complete the requirements for the IA score.
The required minimum performance time of ninety days.
NEW POLICY TO STOP IMPROVEMENT ACTIVITIES WHEN IT IS APPROPRIATE TO DO SO
In the year 2022, the CMS will also put into effect a policy that requires rapid termination of IAs whenever there is cause to think that the activity may pose a threat to patient safety or is no longer relevant. The IA will be immediately halted, and CMS will notify both the public and the providers of its decision through web postings and listservs. During the subsequent round of regulation, they will also suggest either deleting or changing the IA, depending on what is required.
In the year 2022, the cost category
The Centers for Medicare & Medicaid Services (CMS) made use of cost measures for the year 2021 that analysed the following:
Total per-capita costs (TPCC) incurred by Medicare patients, with a particular emphasis on Primary Care Medicare expenditure per beneficiary (MSPB) physician.
The total amount spent on Medicare patients for the provision of goods and services throughout 18 distinct episodes of care
The Centers for Medicare and Medicaid Services (CMS) did not introduce any new episode-based cost measures in 2021; however, it did include telehealth visits in the calculations of cost measures where applicable. The 18 episode-based cost metrics were grouped together by CMS into several episode categories, such as acute inpatient episodes or procedural episodes.
In addition, CMS included five new episode-based metrics for 2022, two of which fall under a newly created category for chronic diseases.
The year for the quality category:2022
To align and gain consistency with CMS ideas for scoring the new MIPS Value Pathways, the Centers for Medicare & Medicaid Services (CMS) is proposing various adjustments to the Traditional MIPS Quality metric scoring beginning in 2022. (MVPs). To ensure that physicians, EHR vendors, payers, and other third parties have the time to get ready for the MVPs’ phased rollout beginning in the 2023 performance year, CMS will begin this process in 2023.
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