QPP MIPS is informing all providers about the major changes that CMS has made in MIPS 2023 reporting. Get ready providers, new challenges coming your way.
The Merit-based incentive payment system is providing a passage to connect the extensive provider network in the USA. It binds a group of eligible clinicians to take part in QPP MIPS reporting by picking their participation type. Afterward, they report their activities and measures throughout the performance year. Next in line is the MIPS payment adjustment year when CMS evaluates the provided data and assigns a MIPS score. Thus, providers meet their fate either by getting positive or negative adjustments. So, just like the previous MIPS program, MIPS 2023 has the same functionality. However, CMS has brought some changes in MIPS rules and its framework this year too.
In this blog, we will be seeing how CMS has addressed the providers to improve their performance. And how MIPS 2023 is going to deal with new challenges that CMS has already summoned.
CMS has tried to resolve the upcoming difficulties with a fine strategy. Also, it has asked the providers to do the same. Anyhow, one thing it has never allowed the providers to let down, is their quality of care. CMS has two constitutional pillars for letting down the conventional SGR and empowering the QPP. One of them is the idea of improving the quality of care. And second is making healthcare accessible for all. We all know, CMS has put lots of effort into assuring that the MIPS program meets these two criteria.
However, CMS has run MIPS programs with multiple motives under the two main umbrellas. Thus, it has made several changes in MIPS to accomplish them all. In the past, most of the changes were either concerned with some rules and regulations or with measure reporting. Anyhow, this year, it has been finalized for the sunset of the MIPS program in the coming years. Soon, another reporting path, the MIPS Value Pathways will take the place of MIPS. Thereby, CMS has made several structural and functional changes to divert its participants toward new passage.
Listed below are some major changes in the MIPS program for MIPS 2023 reporting.
There is no such change in every category proportion for MIPS 2023. It is the same as it was in MIPS 2022. This implies the cost and quality categories will still have the same weights, i.e.30% for each. And the weights of promoting interoperability and improvement activities are 25% and 15% respectively.
However, considering the shift to MVPs, CMS has made changes in each measure list of every category. It has added some, excluded some, or retained some for MVPs. Fulfilling the data completeness requirement, the MIPS participants have to hit the performance threshold. This MIPS 2023 performance threshold is 75 points. If any participant is unable to get it, they will consequently bear a penalty of up to 95%.
CMS Web Interface has been a MIPS data collection type for several years. It allows all MIPS participants to log in and submit their MIPS reporting files there. However, for MIPS 2023, CMS has deprived participants of this option as well. Now they have only five data collection options in their list. The two most significant ones are MIPS Qualified Registry and certified Electronic Health Records.
CMS made this announcement early before MIPS 2023. It was in MIPS 2022 Final Rule when QPP declared that PY 2022 is the last year for such a bonus.
The exceptional performance bonus is a plan from the CMS side to encourage participants. If this happens that they scored 89 points at least, they get the benefit of an additional bonus. Thus, providers were willing to take more and more burden to accomplish this bonus.
However, for MIPS 2023, it is quite clear that CMS has canceled this bonus for good. This step is another way to upgrade the difficulty level for MIPS participants in PY 2023. Now, CMS intends to see how providers will deal with the coming problems.
From MIPS 2023, CMS has provided participants with another framework called MVP. It includes several measures, each measure with its specified eligible specialty type. With this approach, CMS has asked clinicians to report only the related measures among the provided list of MVPs. Considering PY 2023 as the first year of MVPs reporting, CMS has tried to be a little lenient. However, CMS has actively proposed several strict structural changes for future years. Anyhow, the final rule will be provided from time to time for every PY.
Yes, we can understand the situation of providers for QPP MIPS 2023. We as MIPS Qualified Registry can feel the pressure created by MIPS 2023 final rule on them. However, we are ready to be your helping hand in PY 2023 for MIPS reporting just like in previous years. We are aware of tactics and have made different strategies to hit the maximum MIPS score with this rigid MIPS framework. We are always open to your MIPS-related queries and we will give you satisfactory answers for sure.