Top Ten MIPS Changes from 2017 to 2018: Part 2, Numbers 6 – 10
In 2017, eligible clinicians could report for a period of 90 days to earn a neutral or positive payment adjustment. Data completeness had to only reach 50 percent.
6. Changes in the Quality Category
In 2018, eligible professionals must report a full calendar year with data completeness at 60 percent. Some topped-out measures are being removed in this category and scored on a four-year phasing out timeline, although some may be considered to remain as they contribute important aspects of patient safety and reliability. CMS will also cap the possible points at seven for six measures.
7. Changes in the Advancing Care Information/Promoting Interoperability CategoryIn 2017, there was no bonus for using the 2015 Edition of CEHRT (Certified Electronic Health Record Technology) for the transition year. In addition, the ACI category could be reweighted to zero percent if there were not sufficient measures applicable and available for clinicians.
In 2018, there is a 10 percent bonus for exclusively using the 2015 Edition of CEHRT. In addition, reweighting can occur for the following reasons: significant hardship exception; new significant hardship for small practices and hospital-based ECs; new exceptions for Ambulatory Surgery Center based ECs; exceptions of your EHR was decertified; and there is a deadline of December 31 of the performance year to apply for hardship.
8. Changes in Improvement ActivitiesIn 2017, there were 92 activities to choose from. In 2018, CMS finalized more activities and changed existing activities for a total of 112. There were some additional changes around the Patient-Centered Medical Home (PCMH). In 2017, only one practice within a TIN had to be a PCMH to get full credit and that PCMH was accredited from one of four nationally recognized organizations. In 2018, CMS finalized a 50 percent threshold for the number of practice sites within a TIN to receive credit, and they finalized the term “recognized” to mean the same as “certified.”
9. Bonus OpportunitiesIn 2017, there were few bonus options available. In 2018, there are several options: Complex Patients Bonus; Small Practice Bonus; 2015 EHR Certified Edition Bonus; and Performance Improvement Bonus Points in the Quality category only.
10. Small Practice Scoring Considerations
In 2017, there was a reweighting of Improvement Activities to include either two medium-weight or one high-weight activity to earn a full score. In 2018:
• CMS will continue to reweight the Improvement Activities
• Practices or ECs will receive three points if data completeness falls below 60 percent in the Quality measure, as long as they have a benchmark and meet the case minimum requirement
• Practices or ECs can apply for a Hardship Exception for the ACI category if facing overwhelming barriers to adopting a certified EHR
• CMS has included a Small Practice Bonus of five points
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