MIPS Highlights

Quality Payment Program Year 3: MIPS Highlights

  • Raising the performance threshold to 30 points in Year 3 (from 15 points in the previous year).
  • Exceptional performer threshold raised to 75+ points.
  • Positive and/or negative payment adjustment = 7% (of course positive adjustment needs to be budget neutral). Payment adjustment will be in 2021.
  • Requirement of 2015 Certified Electronic Health Record
  • Expansion of defining MIPS eligible clinicians to include new clinician types (physical therapists, occupational therapists, speech-language pathologists, audiologists, clinical psychologists, and registered dietitians or nutrition professionals)
  • Added a 3rd element to the low-volume threshold determination, and giving eligible clinicians who meet one or two elements of the low-volume threshold the choice to participate in MIPS (opt-in policy)
  • Adding new episode-based measures to the Cost category
  • Restructuring the Promoting Interoperability category (formerly Advancing Care Information) to support greater electronic health record interoperability and patient access. Moving clinicians to a single, smaller set of objectives and measures with scoring based on measure performance for the PI performance category.
  • Allowing the use of a combination of collection types for the Quality performance category
  • Retaining and increasing some bonus points.
  • Option to use facility-based Quality and Cost performance measures for certain facility-based clinicians.
  • Increasing the small practice bonus to 6 points, but including it in the Quality performance category score instead of as a standalone bonus.
  • Continuing to award small practices 3 points for submitted quality measures that don’t meet the data completeness requirements.
  • Continue to allow small practices to submit Quality through the Medicare Part B claims submission type
  • Providing an application-based reweighting option for the PI performance category for clinicians in small practices
  • Continuing to provide small practices with the option to participate in MIPS as a virtual group

For more information on the Quality Payment Program Year 3 Final Rule click here.