MACRA / MIPS

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Navigating MIPS/MACRA 2019

Based on the proposed rule, there are likely extensive changes to MIPS coming in 2019–more than perhaps most may have anticipated. From changes to eligibility and new provider types, to multiple changes in many of the MIPS component specifications–there’s quite a lot embedded in the proposed rule’s 1,400+ pages.

Promoting Interoperability

In keeping with the change of Meaningful Use to “Promoting Interoperability” (PI), CMS has changed the Advancing Care Information (ACI) MIPS component to “Promoting Interoperability” (also PI) in order to align MIPS with the PI requirements for hospitals.

Additionally, there are now three components for the low-volume threshold: Part B charges ($90,000); number of beneficiaries (200); and the (new for 2019) number of covered professional services (200).

Instead of requiring this performance category to have a weight of 30% in Year 3 of the program (performance period 2019), CMS has chosen a weight of 15% for 2019 (an increase from 10% in 2018).


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Changes for 2019


For 2019, the MIPS performance threshold is proposed to be 30 points, up from 15 points in 2018 and 3 points in 2017.

Quality Component

  Category weight decreased from 50% weight in 2018 to 45% weight in 2019

Cost Component

  8 episode-based measures will be added to the list of Cost measures

Improvement Activities

  6 new Improvement Activities added

Promoting Interoperability

  Was previously named Advancing Care Information (ACI) in 2017 and 2018   ECs must use 2015 CEHRT in 2019

To recap, unlike Meaningful Use, MIPS is required by legislation to be budget neutral–which essentially means any incentives paid out to high performance must be funded by penalties that were assessed for poor performance.

  Eligibility changes that make it easier for providers to be excluded from MIPS

  Maximum penalty of 5% for 2018 performance period, and 7% for 2019

Once again, a reminder that this is a proposed rule. Providers and health systems should review the legislation, and are encouraged to submit comments to CMS for consideration when determining the final rule.


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VERY IMPORTANT DATES FOR MACRA 2018 - 2019

VERY IMPORTANT DATES FOR MACRA 2018 - 2019

 


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Visit NANI’s website to learn more.




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