decisionhealth Newsletters, Part B News - 2023 Issue 7 (July)
In QPP, CMS raises bonus floor, floats new APM conversion factor
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Article Overview
This article explains proposed CMS changes to the Quality Payment Program for upcoming performance years. It is aimed at clinicians, practice managers, and coding or reimbursement professionals who track MIPS, Advanced APM participation, interoperability-related reporting, and third-party registry requirements. The piece covers anticipated updates to scoring, measure sets, CEHRT-related policy, payment adjustment structure, targeted review timelines, and broader program direction under CMS’s evolving quality framework.
Why This Topic Matters
The proposed changes could affect how participants report, qualify, and receive payment adjustments under QPP. It is relevant to organizations planning for MIPS participation, Advanced APM alignment, and future measure consolidation.
Article Sections
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Quality Payment Program
An overview of the article’s main policy focus and the broader QPP changes CMS is proposing for future performance periods.
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Seven more points to make
Discussion of proposed MIPS threshold changes, performance period lookback updates, and related payment adjustment context.
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MVP changes
Coverage of proposed MIPS Values Pathways updates, alignment efforts tied to CMS’s measure framework, and expansion of pathway options.
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CEHRT shift
Explanation of proposed changes affecting electronic health record technology requirements and related participation criteria in Advanced APM settings.
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From lump sum to CF?
Discussion of proposed changes to Advanced APM incentive structure, qualification thresholds, and conversion factor concepts.
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Other changes
Additional proposed revisions involving targeted review timing, third-party intermediaries, and oversight of registry-related entities.
What You Will Learn
- How CMS is proposing to revise QPP participation and reporting requirements
- What broad categories of MIPS and Advanced APM changes are under consideration
- How CMS is updating quality measure alignment and pathway structure
- What administrative process changes are being proposed for reviews and intermediaries
Who Should Read This
- Clinicians participating in QPP
- Practice administrators
- Medical billing and reimbursement professionals
- Health care compliance staff
- Quality reporting teams
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