Eyeworld Daily News

EW SHOW DAILY 10 ASCRS News Tuesday, April 17, 2018 by Ellen Stodola EyeWorld Senior Staff Writer measures meeting data complete- ness, but not measure benchmarks. For full participation in MIPS, a physician or group must report Quality and Cost categories (the full 2018 calendar year) and ACI and Improvement Activities (any 90 days up to the full calendar year). Another important topic that Ms. McCann addressed was if you can do MIPS without an EHR. She said that you cannot participate in ACI without an EHR, which is 25% of the final MIPS score. How- ever, she noted that with the small practice hardship exemption, the 25% category score is reweighted to Quality. She said that you submit quality measures through claims or registry, and submit Improvement Activities through a registry or CMS attestation site. Practices with EHR may still use 2014 technology but will receive a bonus for moving to 2015 technology. Ms. McCann went on to discuss specifics on MIPS for small practic- es, individual and group reporting, virtual groups, and specifics on the MIPS category requirements and weights. She also brought up advanced alternative payments models, or APMs, which are the alternative pathway to using MIPS. However, she noted that, for ophthalmology, MIPS "is the pathway for the majori- ty of our members." Before closing, Ms. McCann highlighted some ASCRS key recom- mendations for the future, which included simplifying and streamlin- ing the MIPS program and scoring; reinstating quality measures groups; resolving the attribution, risk adjust- ment, and cost methodology issues in the Cost category; topped-out measures; and having more trans- parency and accountability from CMMI. EW Editors' note: Ms. McCann has no financial interests related to her comments. a penalty up to 5%. The exceptional performance threshold remains 70 points; it's also possible to earn MIPS final score bonus points. She added that the Year 2 QPP final rule includes several options to meet the 15-point threshold by submitting minimal data in 2018 to avoid a penalty in 2020. Examples of minimal reporting that will earn 15 points and avoid the penalty: full participation in the Improvement Activities category, such as submitting one high-weight- ed activity or two medium-weighted activities for small practices, or two high-weighted activities, four medi- um-weighted activities, or a combi- nation of both for large practices; the Advancing Care Information (ACI) category base score and one quality measure meeting the mea- sure threshold, or data complete- ness, but not benchmarks; ACI base score and one medium-weighted improvement activity; or six quality Payment Program (QPP). It contin- ues transition flexibility for year 2. Participants can avoid a penalty by submitting minimal data. The major changes from 2017 include an increase in the Cost category weight to 10%; policies to reduce the burden for small practices of 15 or fewer; increased quality report- ing threshold from 50% to 60%; improvement scores incorporated into the Quality category, and cost improvement delayed by MACRA technical corrections; low volume threshold increased to $90,000 in al- lowed Part B charges or 200 patients; implementing virtual groups; and a small practice definition (15 or fewer Medicare-eligible clinicians). CMS set the 2018 MIPS perfor- mance threshold at 15 points, up from 3 points in 2017, Ms. McCann said, with scores above eligible for a bonus, scores at the threshold (15) receiving no bonus or penalty, and scores below the threshold receiving I n an ASOA course late Sunday afternoon, Nancey McCann, ASCRS director of government relations, Fairfax, Virginia, gave an update on the second year of the Merit-Based Incentive Payment System (MIPS). She first highlighted the MAC- RA 2018 technical corrections: CMS authority to extend the MIPS transi- tion period for an additional 3 years; CMS authority to continue to weigh the Cost category at less than 30% for 3 additional years, with delayed improvement scoring until 2022; and excluding Medicare Part B drugs from MIPS eligibility determinations and payment adjustments. Ms. McCann moved into discussing the MIPS 2018 category weights. The Quality category com- prises 50%, Cost is 10%, Advancing Care Information is 25%, and Im- provement Activities make up 15%. She highlighted what's new in the second year of the Quality What you need to know in the second year of MIPS Ms. McCann discusses the second year of MIPS.

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