We are dealing with a public health emergency, and CMS has proactively come forward to facilitate clinicians in Quality Payment Program (QPP). This year, the final rule for QPP MIPS data submission required some flexibility to accommodate the pressure.
CMS recently released the final 2021 Medicare Physician Fee Schedule. P3Care, being a MIPS Qualified Registry, keeps an eye on updates. In this blog post, we have mentioned all the necessary information that MIPS eligible clinicians need to know for QPP MIPS 2021 data submission.
QPP MIPS 2021 Reporting Highlights
The Final Rule for the Medicare Physician Fee Schedule
includes several changes as follows. These changes were finalized, keeping in check
the corona situation.
Implementation of MIPS Value Pathways
In normal conditions, MIPS Value Pathways (MVPs) were
expected to come into effect from 2021. However, post-pandemic, its
implementation has been delayed until 2022. Moreover, CMS is also encouraging
all stakeholders in the development phase of MVPs.
Implementation of APM-APP
Besides the QPP MIPS data reporting, CMS also plans to
initiate an alternative payment reporting method. It refers to the Alternative
Payment Model (APM) Performance Pathways (APP) and will be in effect from this
year. This framework will align with the MVP framework.
This advancement promotes the easy transition to an
alternative collection type method. For this, CMS sunsets the CMS Web
Interface; however, will remain available for collection and submission type
for the 2021 performance year.
MIPS Performance Categories Weights
For MIPS data submission in 2021, the weight for performance
category Quality has reduced to 40 points with a decrease of 5%. Moreover, The cost performance category for QPP MIPS reporting has increased up to 5%, making
20% of the total MIPS score.
By 2022, both performance categories, Quality, and Cost must
be equal at 30% of the total QPP MIPS score 2022.
The Promoting Interoperability (PI) will remain at 25%,
whereas Improvement Activities (IA) at 15% for MIPS data submission 2021 score.
Moreover, the performance threshold will be the same as the previous year, that
is 60 points.
Another rule for QPP MIPS data submission 2022 is about the
performance threshold that will be calculated as per the median or mean of the final score of all MIPS eligible clinicians for the prior year.
Bonus for COVID-19 Complexities
For the Medicare Physician Fee Schedule, CMS also increased
the bonus points for patients’ outcomes. Due to the surge of COVID-infected
patients, MIPS eligible clinicians, groups, virtual groups, & APM entities
can earn up to 10 points instead of 5.
ACO (Accountable Care Organization) Reporting Requirements
For the QPP MIPS 2020 performance period, ACOs reporting is
considered to be affected by extreme conditions. Therefore, CMS waived off its
reporting requirements to field a CAHPS for ACOs survey. In return, ACOs will
receive recognition for patient outcomes without any effort.
Final Medicare Physician Fee Schedule 2022
Now, as we are about to move into MIPS 2022 performance
year, CMS has released the final Medicare physician fee schedule. It suggests
the standard technical proposals while setting rates for CY 2022.
In light of the CMS statement, we conceive:
The conversion factor will be $33.59 for CY 2022, which is
$1.30 lesser than CY 2021. The rate factor resonates with the legal changes
subject to RVUs (Relative Value Units). It also ended the 3.75% of payment
increase, which was a result of the pandemic.
In the larger scheme of things, the 2022 Physician Fee Schedule promotes telehealth and high reimbursement rates to administer the vaccine. Moreover, the geographical barriers have been eliminated, especially for mental illnesses.
Conclusion
This article comprises
the birds-eye view for the Medicare Physician Fee Schedule for 2021. This
overview will give you an idea for designing an effective QPP MIPS reporting
strategy. Quality data submission is not as hectic as it seems. However, you
just need a MIPS Qualified Registry to handle the administrative load and to
submit data timely to CMS.
Read our blog: 9 Reasons Why Your Practice Needs Medical Record Audit