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QPP, MIPS & Alternative Payment Models

Home » Public Policy » QPP, MIPS & Alternative Payment Models

QPP, MIPS & Alternative Payment Models

CHIME recognizes that for payment and delivery reform to succeed, we need a high-performing, interoperable and secure technical infrastructure. CHIME strongly supports steps CMS has taken to improve the flexibility by which clinicians use health IT to drive better outcomes. The first performance year for the programs established under the Medicare Access and CHIP Reauthorization Act (MACRA) is 2017, so Medicare physicians will now be reimbursed based on their participation in the Quality Payment Program (QPP), either in the Merit-based Incentive Payment System (MIPS) or an Alternative Payment Model (APM). MACRA applies to Medicare physicians and clinicians, but not to other providers like Medicaid clinicians and hospitals creating different rules for different providers. In reviewing the MACRA rules, we see a few significant challenges that may impede provider success: 1) the lack of interoperability among and across our disparate health system; 2) the need for better synchronization across all CMS reporting programs; 3) vendor readiness; and 4) the need to simplify program requirements.

 

CHIME Top Recommendations to Policymakers

  • Make 2018, in addition to 2017, a transition year, given that MACRA establishes an entirely new and complicated regulatory structure
  • Stage-3 Meaningful Use-like measures and use of Version 2015 CEHRT should not be required any sooner than 2019
  • Align program requirements as closely as possible with the hospital setting and with other CMS reporting programs

CIO Cheat Sheets 

  • Comprehensive Summary of Promoting Interoperability Provisions for MIPS Clinicians (Dec 2018)
  • Comparison of Final Promoting Interop Requirements for Hospitals in 2019 and Proposed Ones for MIPS Clinicians in 2019 (Aug 2018)
  • Summary of Energy and Commerce, Health Subcommittee – MACRA Hearing (Jul 2018)
  • QPP Proposed Rule Summary for 2019
  • Meaningful Use Requirements for Medicare Hospitals, Medicaid Providers, and MIPS Eligible Clinicians – a Comparison Table (Aug 2017)*UPDATED Aug 21
  • MACRA Final Rule (Oct 2016)
  • Comparison Table on MU3, Modified Stage 2, and ACI Component of MACRA (May 2016)*Updated May 19 

Letters to the Administration

  • CHIME letter to CMS on MIPS in the Physician Fee Schedule (Sept 2019)
  • CHIME submits comments on proposed Quality Payment Program / Physician Fee Schedule rule (Sep 2018)
  • CHIME Submits MIPS Improvement Activity Ideas (Mar 2018)
  • CHIME Comment Letter on final rule with comment on QPP Year 2 (Dec 2017)
  • CHIME Comment Letter on Proposed Year 2 of the QPP Program (Aug 2017)
  • CHIME Responds to MACRA Final Rule with Comment (Dec 2016)
  • CHIME Responds to Proposed Rule on MIPS and APMs (Jun 2016)
  • CHIME Responds to Meaningful Use Stage 3 Final Rule with Comment (Dec 2015)
  • CHIME Responds to MIPS RFI (Nov 2015)
  • CHIME Responds to Proposed MU Modifications 2015 -2017 (May 2015)
  • CHIME Response to CMS MU Stage 3 NPRM (May 2015)

Congressional Letters & Testimony

  • Testimony before the US House of Representatives Energy and Commerce Committee Health Subcommittee on, ‘Examining Bipartisan Legislation to Improve the Medicare Program’ (Jul 2017)
  • CHIME Statement for the Record – Energy & Commerce Health Subcommittee – MACRA Hearing (Mar 2016)

CMS Resources

Year 1 Resources (2017)
  • MIPS Participation Fact Sheet
  • MIPS Improvement Activities Fact Sheet
  • Web Interface Fact Sheet
  • CMS Final Rule for 2017
Proposed Changes to Year 1 (2017) & Year 2 (2018)
  • CMS QPP website
  • CMS Fact Sheet on Year 2 Proposed Rule
  • CMS Proposed regulation on Year 2 (2018)

 

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  • We Need Your Help: Tell Congress We Need a National Patient Identification Strategy

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