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Need help with your MIPS Feedback Report? HQI is Here For You

Merit-based Incentive Payment System (MIPS) Feedback Reports are available! If you have accessed your report, you might have some questions we can answer. Here is the latest guidance from the Centers for Medicare & Medicaid Services (CMS):

Q: We have been unable to access our MIPS Feedback Report. Is CMS aware of this issue?
A: CMS indicated that they were aware of this issue and they are working to rectify it.

Q: Why am I receiving a low payment adjustment when I earned a high 2017 MIPS final performance score?
A: CMS gradually implemented the 2017 performance period, understanding that the Quality Payment Program was a big change for clinicians. CMS designed a scoring system that would reduce burden and increase flexibility during this transition year. As a result, more clinicians successfully participated. In fact, 91% of MIPS-eligible clinicians submitted data for the 2017 performance period. With more clinicians participating, the distribution of incentive payments was widely spread. Because the MIPS payment adjustment is required to be budget neutral, a scaling factor is applied to positive 2019 MIPS payment adjustment factors, which may result in a lower adjustment than you anticipated. Clinicians that were required to participate and did not, received a 4% payment reduction. The program and incentives will continue to evolve. If you still believe there is an error with your 2017 MIPS final performance score, submit a targeted review request as soon as possible. Targeted reviews can be requested until September 30, 2018, but targeted review requests should be submitted soon to ensure that payment adjustments are applied correctly as of January 1, 2019. More information about targeted review, is available on the qpp.cms.gov website.

Q: We participate in HQI’s Practice Transformation Network (PTN). When I log into the EIDM account, I see “Participant in Health Quality Innovators” listed. Is the Transforming Clinical Practice Initiative (TCPI) considered an alternative payment model (APM) under the Quality Payment Program?

A: Yes, TCPI is designated as an APM under the Quality Payment Program. This designation provides partial scoring credit toward the MIPS Improvement Activities performance category for those MIPS-eligible clinicians participating in TCPI. This assignment rewards MIPS eligible clinicians for improving clinical practice by participating in the model. Participation in TCPI does not exempt participants from MIPS, nor does it modify reporting requirements under MIPS. Rather, participating MIPS-eligible clinicians automatically receive at least partial credit in the Improvement Activities performance category. Participation in TCPI can only result in a higher overall MIPS score; it will never result in a lower score.

Q: Is the Accountable Health Communities Model (AHC) considered an APM?

A: The Accountable Health Communities Model is tested under 1115A of the Social Security Act and is therefore an APM.
AHC is designated an APM under the Quality Payment Program. It is not considered an Advanced APM, nor a MIPS APM. This APM designation provides partial scoring credit toward the MIPS Improvement Activities performance category for those MIPS eligible clinicians participating in AHC. This assignment rewards MIPS eligible clinicians for implementing clinical practice improvement by participating in the model. Participation in AHC does not exempt participants from MIPS, nor does it modify reporting requirements under MIPS. It also does not change the scoring requirements, as participants are scored in the same manner as other MIPS eligible clinicians. Rather, the only impact is that participating MIPS eligible clinicians automatically receive at least partial credit in the Improvement Activities performance category. Participation in AHC can only result in a higher overall MIPS score; it will never result in a lower score.

Q: Is the Transforming Clinical Practice Initiative (TCPI) considered an Alternative Payment Model under the Quality Payment Program?

A: TCPI is designated an APM under the Quality Payment Program. It is not considered an Advanced APM, nor a MIPS APM. This APM designation provides partial scoring credit toward the MIPS Improvement Activities performance category for those MIPS eligible clinicians participating in TCPI. This assignment rewards MIPS eligible clinicians for implementing clinical practice improvement by participating in the model. Participation in TCPI does not exempt participants from MIPS, nor does it modify reporting requirements under MIPS. It also does not change the scoring requirements, as participants are scored in the same manner as other MIPS eligible clinicians. Rather, the only impact is that participating MIPS eligible clinicians automatically receive at least partial credit in the Improvement Activities performance category. Participation in TCPI can only result in a higher overall MIPS score; it will never result in a lower score.

If you have other questions about MIPS or the Feedback Report, please reach out to us at 844-357-0589 or qpp@hqi.solutions. If your practice participates in the PTN, please contact your Quality Improvement Advisor directly.
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