Like always, CMS (The Center for Medicare and Medicaid Services) is up to provide us with insights into quality healthcare. Recently, they released updates about Medicare Physician Fee Schedule (PFS) Proposed Rule that also reflects on the Quality Payment Program (QPP).
The window for the public window was opened until October 5, 2020, and physicians and other stakeholders proposed their suggestions on the latest updates quite graciously.
How CMS Plans to Upgrade QPP?
Due to the coronavirus pandemic, many improvement activities were delayed. CMS, despite the tough conditions, tried its best to simplify solutions regarding MACRA & MIPS and played their role as an effective authority.
In response to the COVID-19, CMS released some new guidelines, For Instance, to roll out the timeline of MIPS Value Pathways. The organization wants to help physicians upgrade and accommodate the changing environment.
Here are three updates about QPP. The proposed rules are regarding the ACO (Accountable Care Organization) reporting substantially, and its quality requirements along with the MIPS APM (Alternative Payment Models) score options, effective from early sessions in 2021.
MIPS Value Pathways Are Delayed Until 2022
Last year, CMS was keen on upgrading QPP MIPS by incorporating MIPS Value Pathways (MVPs). The purpose was to combine quality, cost, and improvement activities based on the medical history of the patient, forming a customized healthcare plan.
Before the pandemic, CMS was hopeful to implement MVPs by 2021. However, the program is delayed by at least 2022 to facilitate physicians in their journey of providing quality care amidst corona. It is also to lower down their administrative burden.
Having said that, we have new principles and requirements to demonstrate the workflow with all stakeholders concerning various MVPs options.
CMS Updates Points for ACO Reporting
Gear up ACOs! The new updates have a lot of stuff for you.
Currently, ACOs use the CMS Web Interface to report data for ACO contracts and QPP MIPS for quality measures.
The new proposal tries to reduce the number of measures reported by ACOs. Moreover, they are to be consistent with MSSP reporting requirements.
Starting from 2021, CMS also plans to replace the MIPS APM scoring standard with the APM Performance Pathway (APP).
APP is similar in context to MVPs as it also allows reporting a fixed set of measures for each performance category. Performance category, the cost will weigh 0% in the APP.
Many Requirements Will Accommodate COVID-19 Response
CMS certainly is going stricter with its policies for a progressive healthcare system. However, coronavirus changed everything. Now, they are trying to simplify solutions to help physicians avoid penalties.
For MIPS 2020, the points for complex treatments are going to be 10 points rather than 5.
APM entities that experienced extreme and uncontrollable circumstances will be able to apply from the beginning of2020 performance year to reweight MIPS performance categories.
For 2021, the performance threshold is proposed to be 50 points for QPP MIPS, a 5-point increase rather than 60 points as expected.
