decisionhealth Newsletters, Part B News - 2017 Issue 7 (July)
CMS intends to lower the bar for the final year of PQRS participation
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Article Overview
This article explains CMS’s proposed changes for the final year of PQRS and how they relate to the shift toward MIPS. It outlines the affected provider groups, the reporting framework being used, and the broader changes to value-based modifier adjustments and potential bonuses. The piece is relevant for clinicians, group practices, solo practitioners, and coding or compliance professionals tracking Medicare quality-reporting policy.
Why This Topic Matters
The proposal affects how 2016 PQRS reporting may influence 2018 Medicare payment adjustments. Understanding these changes helps practices assess reporting status, anticipate quality-related payment impacts, and compare the final PQRS year with the MIPS framework.
Article Sections
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PQRS transition and reporting threshold changes
Summarizes CMS’s proposed alignment of the final PQRS year with the newer quality payment framework. Covers the general reporting approach and the kinds of professionals affected.
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Value-based modifier adjustments dialed back
Describes proposed changes to payment adjustment treatment for practices that met or did not meet the revised PQRS standards. Discusses which provider groups are included in the adjustment framework.
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Proposal reduces bonuses
Outlines proposed changes to potential bonus treatment for larger physician practices under the revised approach. Notes how the proposal affects different practice sizes at a high level.
What You Will Learn
- How CMS proposed to ease the final year of PQRS reporting
- Which provider categories were affected by the proposed quality-reporting changes
- How the proposal relates PQRS to the broader transition toward MIPS
- What types of payment adjustments were being revised under the proposal
- How bonus treatment differed by practice size under the proposed approach
Who Should Read This
- Physicians
- Solo practitioners
- Group practices
- Non-physician practitioners
- Coding and compliance professionals
- Medical practice administrators
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