MIPS 2020 Performance - Good News for CEDR Participants

CMS recently released its analysis of the Merit-based Incentive Payment System (MIPS) performance for 2020. I am excited to share the outstanding news that ACEPs Quality Clinical Data Registry (QCDR) - CEDR - provided 20,581 ED clinicians (70% of which are emergency physicians (EPs) with the means to report on their quality performance successfully.

All EP CEDR participants achieved a bonus payment in MIPS. Of these, 92% met the exceptional performance threshold, resulting in a significant increase in their merit bonus. There were no penalties applied to EPs.  Despite the lean bonus potential COVID-19 created in the MIPS program, 84% of ED clinicians will receive enough bonuses to cover their CEDR program costs. Forty-five percent did so well that the bonus will cover their CEDR program costs and their membership in ACEP.  Moreover, 22% scored a perfect MIPS score of 100 points, resulting in an estimated $1,980 bonus for each physician. CMS will apply these bonus payments to 2022 Medicare reimbursements.

CEDR achieves this advantage for EPs by providing EM-specific measures which are not accessible via non-EM registries. These CEDR custom measures scored an average of 19% better than the public domain measures offered by CMS.  Unlike CMS measures, CEDR measures also provide EPs with tools to practice EM in a more meaningful way that impacts relevant outcomes. For example, CMS offers sinusitis, URIs, and bronchitis measures, while CEDR measures focus on key, EM-specific conditions such as sepsis, PE, and chest pain.  Focusing on quality in these areas has a far greater impact on the outcomes of the patients we see every day.

In 2020, CMS only offered a maximum bonus of 2.2%. However, the current proposed final rule indicates that the maximum bonus for 2022 may be as high as 12%.  Thus, next year, CEDR will provide emergency physicians with a golden opportunity to not just avoid penalties but to enjoy the highest level of bonus for the excellent quality care provided by our EDs every day. CMS has already announced that they anticipate applying penalties to half the physicians in the United States next year. Thus, CEDR is an essential ACEP member benefit because it positions our members and groups well to continue to thrive in quality reporting while remaining on the bonus side of the MIPS program rather than on the penalty side. This is especially important given how we continue to fight cuts in reimbursement in other domains, such as E/M codes and surprise billing.

Many thanks and congratulations to the CEDR/Quality staff and numerous ACEP member physician experts and volunteers who spend countless hours working to ensure the success of this exemplary tool.