BC Advantage - 2017 Issue 8
Raising the MIPS Low-Volume Threshold: Good News or Bad?
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Article Overview
This commentary discusses a proposed Quality Payment Program change affecting the MIPS low-volume threshold and evaluates its likely impact on clinician participation, small practices, and nephrology. It places the proposal in the context of MACRA, the QPP, and related Medicare participation trends, with attention to how exclusions may affect the remaining MIPS performance pool. The piece is relevant for nephrologists, other specialists, small-practice clinicians, and readers tracking CMS payment policy changes.
Why This Topic Matters
The article helps readers understand how a proposed MIPS threshold change could alter who participates in the program and how remaining participants may be affected. It is useful for clinicians and administrators trying to gauge policy impact on specialty practices and Medicare-based revenue patterns.
Article Sections
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Revisiting the LVT
Introduces the low-volume threshold concept within the Quality Payment Program and summarizes the policy context from prior MACRA rulemaking. It also frames the discussion around specialty-level participation patterns.
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Small practices
Discusses the proposal’s stated goal of reducing burden on smaller practices and considers how that rationale may affect different practice sizes. The section compares broader practice-size trends referenced in the rulemaking context.
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$90,000 or 200 patients
Reviews projected changes in the number of clinicians excluded from MIPS and the broader implications for the remaining participant pool. It also touches on the relationship to Advanced APM participation and overall program dynamics.
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Nephrology numbers
Focuses on projected nephrology participation trends across program years and compares the specialty’s expected outcomes under the cited policy changes. The section draws on the article’s specialty-specific interpretation of the rulemaking data.
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It's bad news
Summarizes the author’s perspective on the proposal’s likely effect on nephrology and on the competitive environment for remaining MIPS participants. It closes with observations about other proposed policy changes that may influence clinician risk.
What You Will Learn
- How the MIPS low-volume threshold fits into the Quality Payment Program and MACRA context
- Why the proposal is framed as a burden-reduction measure for small practices
- How participation exclusions may change the size and composition of the remaining MIPS pool
- Why nephrology is discussed as a specialty that may be affected differently from primary care or other practices
- What broader MIPS policy changes are cited as potentially moderating risk for clinicians
Who Should Read This
- Nephrologists
- Other physicians participating in MIPS
- Small practice clinicians and administrators
- Medical practice managers
- Health policy readers following CMS payment programs
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