On November 2, the Centers for Medicare & Medicaid Services (CMS) released its final rule governing its Medicare Quality Payment Program in 2018.
The program, enacted under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), will affect participating physicians’ payment in 2020. This means physicians have about two months to prepare for what they need to report when the calendar turns to 2018, especially in performance categories that require full calendar year data reporting.
The final rule did not deviate much from a proposed rule released in June. In a statement, CMS Administrator Seema Verma said during visits with U.S. clinicians, she and colleagues heard numerous concerns about the agency’s “burdensome regulations” and the effect on patient care.
“These rules move the agency in a new direction and begin to ease that burden by strengthening the patient-doctor relationship, empowering patients to realize the value of their care over volume of tests and encouraging innovation and competition within the American healthcare system,” Verma said.
Here are the top things physicians need to know about the 2018 rule for the Quality Payment Program:
CMS notes as a way to extend flexibility, physicians or groups eligible for participation in the Merit-based Incentive Payment System (MIPS) with $90,000 or less in Medicare Part B allowed charges or 200 or fewer Part B beneficiaries will not be required to participate in quality metric reporting. This is the same as the proposed rule released in June.
RELATED READING: The growing financial impact of patient satisfaction
This expands the current $30,000/100-patient threshold and is projected to exclude an additional 134,000 physicians participating in Medicare, raising the total to 926,000 clinicians nationwide who do not have to report data under the Quality Payment Program as of January 1, 2018. That's 40% of all eligable physicians.