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QUALITY PAYMENT PROGRAM 2021

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MIPS 2021 Final Rule: Overview

Under the country-wide National Public Health Emergency (PHE) as a result of the COVID-19 pandemic, CMS pays attention to policies governing the Quality Payment Program (QPP) 2021. Therefore, the Merit-based Incentive Payment System 2021 keeps posing the least burden upon eligible clinicians (ECs).

MACRA MIPS is one part of the puzzle. Advanced APM is the other. To grow farther from MIPS 2020, the government continues to develop the MIPS Value Pathways (MVPs) framework, giving final touches to the fundamental principles and providing additional knowledge about them. In brief, it is something new, and stakeholders are in for a proper introduction when they collaborate with CMS.

Additionally, the Advanced APM track in 2021 is less burdensome to report. As a third-party intermediary, a Qualified Registry for five times in a row, we are ready to deliver and make it even easier for clinicians to report this year.

Most of the submission processes endure similar to that of 2020. However, the one change that we see this year is that the APM entities are no longer evaluated for their low-volume thresholds. It means a clinician in a MIPS APM has to be eligible individually or group-wise. In case you are booked by time, P3 understands 2021 MIPS requirements completely; we are willing to help you get through it seamlessly.

MIPS 2021 Final Rule: Overview

You must:

  • Bill more than $90,000 annually for covered medical services;
  • Give services to more than 200 Medicare Part B patients;
  • and, provide more than 200 covered services under PFS.

HOW TO REPORT MIPS DATA IN 2021

The process is essentially the same as it was back in 2020. The MIPS data submission methods don’t change a bit in 2021. Like before, you can report MIPS 2021 measures most effectively through the following mediums:

CMS Web Interface

Qualified Registry

Qualified Clinical Data Registry (QCDR)

Medicare Part B Claims

CAHPS for MIPS Reporting

Not to entangle in a web of confusion, it is equally sensible to mention the five collection types to follow the above submission methods. A collection type is how the data is collected from participating clinicians. The available ones are:

Electronic Clinical Quality Measures (eCQMs)

MIPS CQMs (Registry Measures)

Qualified Clinical Data Registry (QCDR) Measures

Medicare Part B Claims

The CAHPS for MIPS Survey

HEALTHCARE COMPLIANCE IN THE NEW YEAR

MIPS 2021

 

  • The performance threshold increases to 60 from 45 points as decided in the CY 2020 Quality Payment Program (QPP) Final Rule
  • The Quality category weighs at 40% (5% decrease)
  • The Cost category weighs at 20% (5% increase)
  • The Promoting Interoperability (PI) category weighs at 25% (no change)
  • The Improvement Activities (IA) category weighs itself at 15% (no change)

Advanced APM 2021

 

Being an integral part of the QPP 2021, the Advanced APM track, takes us further into the program. Let us know what happens with it.

  • The performance threshold increases to 60 points
  • The Quality category accounts for 50% of the total MIPS score
  • The Cost category has a 0% portion in the total score
  • The Promoting Interoperability category accounts for 30% of the total score
  • The Improvement Activities category accounts for 20% of the total score

HOW TO SUBMIT MIPS DATA TO CMS?

STEP 1

A health IT expert spends 30 minutes with you on the phone to understand the clinical workflow and requirements

STEP 2

Shortlisting measures and informing the practice manager of the reporting activity

STEP 3

We take care of the Cost component making sure no workload is on your practice