CMS Releases 2018 Quality Payment Program Performance Data

Today, the Centers for Medicare and Medicaid Services (CMS) released the final 2018 performance data for the Quality Payment Program. We announced the preliminary data earlier this year, and now we have released additional data elements that show significant success and participation in both the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) paths

We heard from you that this program was a big change for many clinicians and we worked with you to improve the program. Therefore, we are pleased to announce that clinician participation rates and success in QPP increased from 2017 to 2018.

2018 Performance Highlights

The final 2018 performance feedback data revealed:

98% of eligible clinicians participated in MIPS in 2018— up from 95% in 2017
98% of eligible clinicians exceeded the performance threshold score of 15 points to receive a positive payment adjustment— up from 93% in 2017
356,353 clinicians participated in MIPS through APMs— up from 341,220 in 2017

Moving Forward

We continue with our commitment to build a program that is fully transparent and provides accurate information. We are also committed to continuing to provide the MIPS performance data points that, based on your feedback, will be most useful to you right now. Additionally, we plan to provide a comprehensive 2018 MIPS Experience Report in the coming months that documents national trends for MIPS eligibility, participation, and reporting.

For a complete breakdown of the 2018 performance data, please see our blog post and 2018 Quality Payment Program Performance Year Data Infographic.

For More Information

To learn more about participating in the Quality Payment Program:

Visit the Quality Payment Program website, CMS.GOV
Find no-cost technical assistance for Small, Underserved, and Rural Practices
Contact the Quality Payment Program at qpp@cms.hhs.gov or 1-866-288-8292. Customers who are hearing impaired can dial 711 to be connected to a TRS communications assistant.

CMS is Soliciting Stakeholder Recommendations for Potential Consideration of New Specialty Measure Sets and/or Revisions to the Existing Specialty Measure Sets for the 2021 Program Year of Merit-based Incentive Payment System (MIPS)

CMS is accepting recommendations from stakeholders for potential consideration of new specialty measure sets and/or revisions to existing specialty measure sets for program year 2021 of the Merit-based Incentive Payment System (MIPS) program. Recommendations for new specialty sets or revisions to the 2020 specialty sets should be made based on the established 2020 MIPS quality measures. The CY 2020 quality measure specifications can be found here: https://qpp.cms.gov/about/resource-library.

In addition, recommendations will be accepted based on potential new MIPS measures that are being considered for implementation in the 2021 program year. These measures can be found on the NQF website under the MAP Quick Links. Here is the link to the 2019 Measures Under Consideration List where the measures under consideration for MIPS can be found.

The current 2020 specialty measure sets are located in the Appendix measure tables of the CY 2020 Quality Payment Program final rule with comment period located at: https://www.federalregister.gov/documents/2019/11/15/2019-24086/medicare-program-cy-2020-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other.

As established in the CY2020 Quality Payment Program final rule, specialty measure sets currently exist for the following specialties:

Allergy/Immunology
Anesthesiology
Audiology
Cardiology
Chiropractic Medicine
Clinical Social Work
Dentistry
Dermatology
Diagnostic Radiology
Electrophysiology Cardiac Specialist (a subspecialty of Cardiology)
Emergency Medicine
Endocrinology
Family Medicine
Gastroenterology
General Surgery
Geriatrics
Hospitalists
Infectious Disease
Internal Medicine
Interventional Radiology
Mental/Behavioral Health
Nephrology
Neurology
Neurosurgical
Nutrition/Dietician
Obstetrics/Gynecology
Oncology/Hematology
Ophthalmology
Orthopedic Surgery
Otolaryngology
Pathology
Pediatrics
Physical Medicine
Physical Therapy/Occupational Therapy
Plastic Surgery
Podiatry
Preventive Medicine
Pulmonology
Radiation Oncology
Rheumatology
Skilled Nursing Facility
Speech Language Pathology
Thoracic Surgery
Urgent Care
Urology
Vascular Surgery

Each recommendation must include the following in order to be considered:

The quality measure ID
Measure title
Supporting rationale and/or documentation that would support inclusion or exclusion of the current quality measure(s) from existing specialty measure sets or inclusion in new specialty measure sets.

Submissions of recommendations for a new specialty measure set and/or revisions to the current 2020 specialty measure sets should be sent to the PIMMS Quality Measures Support mailbox at PIMMSQualityMeasuresSupport@gdit.com. CMS specifically requests stakeholder feedback on applicable quality measures for the following specialties: .Addiction Medicine, Critical Care (Intensivists), Hospice and Palliative Care Medicine, Medical Genetics and Genomics, Pain Management/Interventional Pain Management and Sleep Medicine.

Submissions of recommendations will be accepted from stakeholders up until Close of Business on Friday, February 7th, 2020.

All recommendations submitted by the aforementioned deadline will be considered and assessed for possible inclusion in rule making for the 2021 calendar year of the Quality Payment Program.

Note: Submissions of recommendations for new specialty measure sets and/or revisions to the current 2020 specialty measure sets, does not guarantee that the recommendation will be accepted, proposed, or finalized during rule making for the 2021 calendar year of the Quality Payment Program. Determinations as to whether recommendations are accepted will not be communicated with stakeholders directly since they are being considered for the 2021 program year, but will be made evident through publications of the CY 2021 Quality Payment Program proposed and final rule.

REMINDER: Attend Wave 3 Measure-Specific Workgroup Service Assignment and Refinement Webinars

CMS has contracted with Acumen, LLC to develop episode-based cost measures for their potential use in the cost performance category of the Merit-based Incentive Payment System (MIPS). As part of Wave 3 of measure development, Acumen, LLC is hosting workgroup webinars in January 2020 that will be open to the public with a listen-only option. Stakeholders and members of the public are invited to listen in on the considerations and discussions that inform cost measure development. Please feel free to share this message with anyone you believe may be interested.

Acumen, LLC will convene the expert workgroups via webinar to review specifications based on input from the in-person workgroup meetings, discuss service assignment in further detail, and address targeted questions to determine other refinements to the current measure specifications prior to national field testing in April 2020.

The times and dates for the workgroup webinars are listed below. To register, please click on the webinar(s) you are interested in attending:

For information about the measure development process and development activities undertaken in previous years, please see this summary on the MACRA Feedback Page. Summaries of the previous Wave 3 Clinical Subcommittee and Workgroup meetings are also available for download on the page.

Upcoming Measure Development Activities

The wave 3 measures will undergo field testing in April 2020. During that time, field test reports for eligible clinicians will be available on the Quality Payment Program portal, where MIPS clinicians access their MIPS feedback reports. More information regarding field testing will be released in the coming months. If you would like to be notified of the measure development activities, including field testing, please join our mailing list.

If you have any questions about measure development, the Wave 3 Clinical Subcommittees, or the workgroup meetings, please contact Acumen at macra-clinical-committee-support@acumenllc.com. If you have questions about MIPS, the cost performance category or cost measures currently in use in MIPS, please contact the Quality Payment Program Service Center via telephone at 1-866-288-8292 or via email at qpp@cms.hhs.gov.