The Centers for Medicare & Medicaid Services (CMS) recently announced a proposed rule that would make changes in the second year of the Quality Payment Program as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The main goal is to ease provider burdens, making it easier for rural and small providers to participate.
As the Quality Payment Program moves into the second year,
CMS wants to ensure that there is meaningful measurement and the opportunity for improved patient outcomes while minimizing burden and improving coordination of care for patients. CMS wants to continue with what’s running well and improve the policies finalized in the transition year.
“We’ve heard the concerns that too many quality programs, technology requirements, and measures get between the doctor and the patient,” said CMS Administrator Seema Verma. “That’s why we’re taking a hard look at reducing burdens. By proposing this rule, we aim to improve Medicare by helping doctors and clinicians concentrate on caring for their patients rather than filling out paperwork.”
The Quality Payment Program is updated annually as part of MACRA. Providers can choose how they want to participate based on their practice size, specialty, location, or patient population.
The proposed rule contains new policies for doctors and clinicians participating in the Quality Payment Program that would encourage participation in either Advanced Alternative Payment Models (APMs) or the Merit-Based Incentive Payment System (MIPS).
Because the Quality Payment Program brings significant changes to how clinicians are paid within Medicare, CMS is continuing to use clinician feedback to shape and streamline the second year of the program and to reduce clinician burden.
For MIPS, CMS proposed to continue the 2017 transition year into the second performance year by postponing the cost performance category for another year.
For Advanced APM track, CMS proposed to extend the revenue-based nominal risk amount standard for another two years.
Another step to ease Quality Payment Program burdens is implementing “virtual groups” as another way providers can elect to participate in MIPS. The virtual groups, which are not currently available in the first performance year, would be composed of solo practitioners and groups of ten or fewer eligible clinicians who agree to come together and partner virtually to participate in the Quality Payment Program’s Merit-Based Incentive Payment System (MIPS) for a performance period of a year.
Because the groups are virtual, eligible clinicians are able to collaborate regardless of location or specialties. Little interest has been shown for this option, however.
To make it easier for rural and small providers to participate, CMS also proposes to increase the low-volume threshold.
Additionally, CMS plans to add “bonus points under the scoring methodology to account for caring for complex patients, and using 2015 Edition Certified Electronic Health Record Technology (CEHRT) exclusively.”
If finalized, the proposed rule would further support the agency’s aim of regulatory relief, program simplification, and state and local flexibility in the implementation of new and effective approaches to healthcare delivery.
To view all potential changes to the Quality Payment Program, you can find the full proposed rule at https://qpp.cms.gov/docs/QPP_Proposed_Rule_for_QPP_Year_2.pdf, including instructions for submitting comments.
CMS will accept comments on the proposed rule until August 21, 2017.