- Data CMS released Wednesday shows 95% of eligible clinicians participated in the first year of the Merit-based Incentive Payment System. Of those, 54% did so as groups, 12% as individuals and 34% through MIPS Advanced Alternative Payment Models.
- Of those who participated, 93% earned a positive payment adjustment and 2% got a neutral adjustment, the 2017 Quality Payment Program Experience Report shows.
- The majority of clinicians across all payment categories chose to report data for 90 days or longer, with fewer than 1% reporting the minimum required and for less than 90 days, as was allowed for the initial year of reporting under the CMS "pick your pace" option.
CMS Administrator Seema Verma tweeted her satisfaction in the data showing "significant participation & performance" in both the MIPS and Advanced APM tracks.
MIPS has been under scrutiny, with the Medicare Payment Advisory Commission pushing for its repeal, proposing instead a program that withholds a portion of payments to create a rewards pool.
MACRA programs have gotten mixed reviews from provider groups, much of it centered around the added burden reporting measures place on clinicians, who are already stressed due to demands of EHRs. In an American College of Physicians survey, a majority of respondents said current MIPS measures fail to reflect the quality of care they provide patients.
CMS acknowledged in the report that more needs to be done to reduce administrative burden and said the agency will work with clinicians toward that goal. "Our obligation is to make this a practical program for every clinician, in both small and large practices," according to the report says. "We take this responsibility very seriously."
To qualify for MIPS in 2017, clinicians had to bill more than $30,000 in Medicare Part B allowable charges and see more than 100 Part B beneficiaries.
Slightly more non-physician clinicians participated in 2017 than did physicians, at 97% versus 94%. Participation rates in small and rural practices were 81% and 94%, respectively. Of 1,057,824 clinicians eligible for MIPS, 99,076 were Advanced APM Qualifying Participants and 52 were Partial QPs, the report notes.
During 2017, about 40% of eligible clinicians submitted data for the Advancing Care Information performance category. Of those, more than half reported via the Quality Payment Program website.
Of the remainder, roughly 25% submitted through an EHR — 87% as a group, 11% as individuals and 2% through an APM. Moreover, 22% chose EHRs to submit data on quality measures and 16% to report on improvement activities.
In terms of quality measures selected and reported, the most prevalent was controlling high blood pressure, an intermediate outcome measure, according to the report. The rest of those in the top 10 were process measures. Among them were tobacco screening and intervention, breast cancer screening and pneumococcal vaccine status in the elderly.
The most reported improvement activity was providing 24/7 access to a patient's medical record, a key ingredient in ensuring timely and coordinated care. Rounding out the top five were use of decision support and standardized treatment protocols, patient-centered medical home attestation, engagement of patients through implementation of improvements in a patient portal, and collection and follow-up on patient experience and satisfaction data on beneficiary engagement.