The hospital VBP program will not be calculating clinicians’ performance in the fiscal year 2022. The reason is the impact that COVID-19 PHE (Public Health Emergency) has lent to the healthcare industry.
Recently, CMS (Centers for Medicare and Medicaid Services) suppressed a list of measures in the FY 2022 Inpatient Prospective Payment System (IPPS)/Long-Term Care Hospital (LTCH) PPS final rule for several hospitals reporting programs, including the Hospital Value-Based Purchasing (VBP) Program.
What Is the Outcome Expectation from the Measure Suppression Policy?
Healthcare leaders suggest that CMS would not be able to calculate measures that are affected by the COVID emergency in any way. Significantly, we are looking into the quality of score determined from such affected MIPS Quality Measures.
However, CMS thinks that measuring value-based healthcare performance from the remaining measures would not be fair. All measures come under the Clinical Outcomes Domain, and such classification would not justify a nationwide comparison. As a result, we have a new scoring policy for the fiscal year 2022, which would restrict measuring scores for all hospitals in the upcoming year.
Let’s see its repercussions on the MIPS-based facilities.
The Influence on MIPS-Based Facilities in 2021
We know that CMS uses the performance score from hospital VBP programs to measure the performance of MIPS-based facilities, eligible clinicians, and groups. The eligibility case is referred to when an entity meets the minimum MIPS reporting requirements threshold. Then, they receive a score that is calculated from their submitted data from any of the MIPS data submission methods in the quality and cost categories.
So, now, the performance score for FY 2022 would be used to calculate the score for FY MIPS 2021.
How Cost Category will be Calculated?
CMS states that if eligible MIPS-based facilities, clinicians, and groups would qualify for even one measure of the Cost category, they will automatically measure the Cost category performance as a whole.
Interested entities need not entertain the MIPS Cost performance category in any sort, be it for data collection or submission.
On the other hand, if clinicians do not meet any case performance threshold for any of the Cost measures, they will be receiving a Zero score. Moreover, their performance will be reweighted to another performance category.