Quality Payment Program final rule: In surprise move, CMS introduces cost into 2018 MIPS performance year

Why This Topic Matters

The rule affects how clinicians are scored under Medicare’s quality program and what practices need to monitor for payment impact. It also signals which reporting areas and cost measures are becoming more important for future performance years.

Article Sections

1. QPP replaced the SGR

   Explains the program’s place in Medicare quality reporting and how it relates to earlier reporting programs. Also introduces the broader categories that make up the current framework.

2. MIPS ramps up the challenges

   Summarizes the main performance-year changes affecting participation, scoring, thresholds, payment adjustments, and reporting periods. This section provides a high-level view of the updated MIPS structure.

3. EHR reporting category gets easier

   Covers updates related to electronic health record technology and the advancing care information category. It also notes how the rule affects technology options and related scoring opportunities.

4. Look for 3 new musculoskeletal quality measures

   Describes additions and changes in the quality category, with attention to musculoskeletal reporting and measure maintenance. It also notes measures that are losing prominence under the program.

5. See if you are exempt

   Summarizes participation exceptions and the revised low-volume threshold. This section focuses on who may be excluded from the reporting requirements.

6. Pay attention to cost

   Reviews the return of the cost category and its broader significance within MIPS scoring. It also explains why practices are being advised to monitor cost data more closely.

7. 2 cost measures on the docket

   Introduces the cost measures identified in the rule and discusses attribution and data review at a general level. It also mentions future potential expansion of cost measurement.

8. MIPS performance scores

   Presents a summary chart comparing category weights across performance years. The table highlights how the MIPS score distribution changes over time.