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2018 MIPS Performance Results

CMS has released MIPS performance results for 2018. The specific information released includes you or your group’s performance category scores, final MIPS score and payment adjustment information. Any upward, downward or neutral payment adjustment will apply to you or your group’s 2020 Medicare Part B payments for covered professional services. CMS is allowing a Targeted Review to be requested until September 30, 2019.

Accessing Your 2018 MIPS Performance Feedback

The 2018 MIPS performance feedback is available via the Quality Payment Program (QPP) website. If you would like assistance in accessing your feedback reports or interpreting the results, ACEP can help. Please contact Jeffrey Davis, ACEP’s Director of Regulatory Affairs, with questions.

Making Sense of Your MIPS Score 

Performance Categories

Your 2018 MIPS final score will be between 0 and 100 points. The score is based on your performance in 4 MIPS categories, with each performance category having a different weight:

  • Quality (50%)
  • Promoting Interoperability (25%)
  • Improvement Activities (15%)
  • Cost (10%)

Remember, the weights can vary in some circumstances if you met the criteria to qualify for reweighting (e.g., hospital-based MIPS clinicians, non-patient facing MIPS clinicians, approval of a hardship application, extreme and uncontrollable circumstances, etc.).

More information on the performance categories

Bonuses

Your MIPS final score may also include additional awarded bonus points, such as a small practice status or complex patient bonus. If you were also eligible for MIPS in 2017 and submitted Quality data, you could be eligible for an additional Quality Improvement Bonus.

How Your MIPS Payment Adjustment is Calculated

If you were eligible for MIPS in 2018, you had to earn at least 15 MIPS points to avoid a penalty in 2020. If you earned over 15 MIPS points, you are eligible for a positive adjustment (the more points you earn, the higher possible adjustment you will receive). Earning 70 or more points would result in an exceptional performance bonus.

The 2020 MIPS payment adjustments vary between -5% and 1.68%. Since federal law requires CMS to implement MIPS payment adjustments in a budget-neutral manner, the highest upward adjustment is below the +5% that is included in the law.

Below are some examples of MIPS scores and matching payment adjustments:

2018 MIPS Final Score

2020 Payment Adjustment

27.53

0.05%

35.00

0.07%

39.11

0.09%

63.25

0.18%

83.20

0.89%

100

1.68%

Requesting a Targeted Review

If you believe an error was made in the calculation of your 2020 MIPS payment adjustment, you can request a targeted review from CMS via a QPP account through September 30, 2019, at 8:00 pm EST. A targeted review should be requested at the same level as you reported MIPS (individual or group).

CMS is encouraging you or your groups to submit a request as soon as possible if you can provide supporting documentation that a targeted review is warranted. 

More information on how to request a Targeted Review.

Preparing for your 2019 MIPS Reporting

You should review their 2018 MIPS performance feedback which includes final MIPS scores and payment adjustment information. Understanding your 2018 performance can offer valuable information on how you can make improvements for the new reporting year.

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