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CMS Quality Reporting- Legacy Programs

CMS Quality Reporting- Legacy Programs

EHR Meaningful Use Incentive Payment in 2018

  • Returning EP participants who attested in 2016 may receive incentives in 2018. Learn more about the payment adjustments here.
  • Medicare providers will continue to attest on EHR measures through the MIPS Advancing Care Information category. MIPS reporting begins January 1, 2017, click here to learn how to report in 2017 to avoid a negative payment adjustment in 2019.

PQRS Payment Adjustment in 2018

  • Members who reported 2016 PQRS data through qualified registries or reported using GPRO EHR from January 1, 2016 through February 28, 2017 may receive for payment adjustments. These adjustments for the 2016 reporting period will begin  January 1, 2018. Learn more about avoiding the 2018 PQRS payment adjustment here.
  • Medicare providers will continue to report measures similar to those found in PQRS through the MIPS Quality category. MIPS reporting began January 1, 2017. Click here to learn how to report in 2018 to avoid a negative payment adjustment in 2020.
  • For MIPS 2018 reporting, make sure to sign up with Regent.

The Value-based Modifier 2018

  • In 2018, Medicare will apply the Value Modifier to payments under the Medicare PFS for physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists who are solo practitioners and physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists in groups with 2 or more EPs.
  • 2016 is the performance period for the Value Modifier that will be applied in 2018.
  • Avoiding the 2018 PQRS payment adjustment by satisfactorily reporting via a PQRS GPRO is one of the ways groups can avoid the automatic downward payment adjustment and qualify for adjustments based on performance under the Value Modifier in 2018.
  • Alternatively, groups can also avoid the automatic downward payment adjustment and qualify for adjustments based on performance in 2018, if the EPs in the group participate in the PQRS as individuals in 2016 and at least 50% of the EPs meet the criteria to avoid the 2018 PQRS payment adjustment.
  • Solo practitioners can avoid the automatic downward payment adjustment and qualify for adjustments based on performance in 2018 by meeting the criteria to avoid the 2018 PQRS payment adjustment as individuals. Visit the PQRS GPRO Registration webpage for detailed information about participating in the PQRS in 2016.
  • 2018 will be the final payment adjustment period under the Value Modifier.
  • Visit the 2016 QRUR and 2018 Value Modifier webpage for detailed information about the 2018 Value Modifier.
  • Starting January 1, 2018, under MIPS, Medicare providers will receive feedback on the cost of care based on measures similar to the VM program. Cost will be 10 percent of the final MIPS score in 2018. The cost component will be calculated by CMS via claims.