Expert Perspectives on 2019 MIPS

December 12th, 2018 by

In its third performance year MIPS is beginning to come of age with CMS actively expanding the boundaries and strengthening the requirements to usher the program to maturity. CMS issued the 2019 QPP final rule on November 1, 2018 which illustrates the progression of MIPS towards a mature program including a steady increase in the Cost category, tougher measures for the Promoting Interoperability category, and broader inclusion of clinician types. In addition, and most interesting for high performing providers is the 150% increase in maximum incentives for 2019 performance.

Listen to this 27-minute Voices in Value-Based Care podcast to get perspectives on the impact of the 2019 QPP final rule and how the changes are in alignment with a forward progression of the MIPS program. Through their experience with thousands of providers, MIPS experts Beth Houck and Matt Fusan from SA Ignite discuss reactions from the field and what providers should prepare for with regard the changes to 2019 and future performance years.

At a glance, the biggest changes from the rule include:

  • Performance threshold for penalty avoidance increases from 15 to 30 in 2019, and is expected to reach the national mean by 2022.
  • The exceptional performance bonus threshold increases from 70 to 75, with a predicted maximum financial incentive = 4.7%. As less clinicians share the bonus, the incentive increases for top performers.
  • MIPS Cost increases from 10% – 15% and will continue to increase 5% a year over the next three years as MIPS Quality decreases by the same factor.
  • Promoting Interoperablity has significantly increased in difficulty, going from lots of easy measures and points to less measures which are more difficult to achieve.
  • For the first time possible by law, CMS elected to increase MIPS eligibility to six new clinician types and added an opt-in for clinicians who proactively want to participate in MIPS.

There are other changes pertaining to hospital-based clinicians and expansion of Advanced APMs to include commercial value-based care programs as well. In the Voices in Value-Based Care podcast Beth Houck and Matt Fusan share more details and the mixed reviews from SA Ignite customers and the market – One perspective is that CMS will finally start rewarding providers for the hard work and resources which have been invested in MIPS. Where do you stand?

Access the final 2019 QPP rule here.

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