decisionhealth Newsletters, Coder Pink Sheets - 2018 Issue 9 (September)
2019 Quality Payment Program: CMS proposes more patient, outcome focus; episode-based cost measures
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Article Overview
This article explains proposed updates to Medicare’s Quality Payment Program for the 2019 performance year. It covers broad changes to MIPS scoring, the shift toward outcome and patient-reported quality measures, additions and removals in the quality measure set, changes to Promoting Interoperability, new episode-based cost measures, and proposed expansion of MIPS eligibility to additional provider types. The article is relevant to practices and billing/coding professionals tracking reporting requirements, performance categories, and measure-set changes.
Why This Topic Matters
The proposed changes affect how clinicians and practices are measured and scored under Medicare payment reform, including what must be reported, how points are weighted, and which specialties may newly participate. Understanding the update helps organizations prepare for quality reporting and cost-performance evaluation.
Article Sections
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Quality measure updates for 2019
Summarizes the proposed changes to the quality measure set, including the general shift in measure emphasis and the types of measures being added or removed.
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More cost, less quality in MIPS score
Explains the proposed changes to MIPS category weighting and performance thresholds, along with general reporting and scoring expectations.
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Promoting interoperability changes
Describes proposed revisions to the Promoting Interoperability category, including reporting structure and certified EHR technology requirements.
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Welcome, newly MIPS-eligible providers
Covers proposed expansion of MIPS participation to additional provider types and the related approach to category weighting for new reporters.
What You Will Learn
- How the proposed 2019 Quality Payment Program updates change the focus of quality reporting
- What broad types of measures are being added, removed, or emphasized
- How proposed MIPS category weights and thresholds would shift
- What changes are proposed for Promoting Interoperability reporting
- Which provider groups may become newly MIPS-eligible
Who Should Read This
- Physician practices
- Orthopedic practices
- Quality reporting staff
- Medical coders
- Billing and reimbursement professionals
- Practice administrators
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