decisionhealth Newsletters, Coder Pink Sheets - 2019 Issue 11 (November)
Quality payment program: For QPP 2020, fairer MIPS cost scoring emerges amid array of smaller changes
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Article Overview
This article explains proposed changes for the 2020 Medicare Quality Payment Program, focusing on how the Merit-based Incentive Payment System (MIPS) may be updated across several categories. It is relevant to clinicians, practice managers, coders, and quality reporting professionals who track QPP policy changes, especially those working with cost measurement, reporting requirements, alternative payment models, and registry-based reporting. The discussion covers broad Medicare policy updates, category scoring adjustments, measure additions and removals, and operational impacts for affected reporting entities.
Why This Topic Matters
These proposed updates can affect how clinicians and groups are measured, reported, and scored under QPP. The article helps readers understand which parts of MIPS are changing and where reporting and compliance workflows may need attention.
Article Sections
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Cost shakeup
Overview of proposed changes to the MIPS Cost category and the broader role of cost in the QPP score. Covers the main cost measures and attribution-related policy updates.
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Assessing the TPCC measure
Discussion of proposed refinements to how the TPCC measure is assessed and attributed. Focuses on patient-based timing, risk profiling, and clinician attribution concepts.
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Minding the MSPB measure
Summary of proposed changes affecting MSPB attribution and exclusions. Highlights the measure’s role in cost scoring and the distinction between different hospital episode types.
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New episode-based measures
Introduction of additional episode-based cost measures and their place in the evolving MIPS cost program. Includes reference to specialty areas affected by the new measures.
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Revisions to Improvement Activities
Proposed updates to the Improvement Activities category, including additions, removals, and reporting threshold changes for groups.
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Tweaks to Promoting Interoperability
Summary of limited changes to the Promoting Interoperability category and related scoring updates. Addresses measures being modified, removed, or made optional.
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4 new Quality measures, 55 removed
Overview of proposed updates to the Quality category, including new measure additions and a large set of removals and revisions.
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APMs and Advanced APMs
Discussion of reporting and scoring changes for clinicians participating through MIPS APMs and those in advanced APMs. Covers how quality reporting may be handled under proposed rules.
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Trouble for QCDRs
Explanation of proposed changes affecting Qualified Clinical Data Registries and their measure development expectations. Addresses vendor requirements and measure acceptance concerns.
What You Will Learn
- How proposed QPP changes may affect MIPS scoring in 2020
- Which QPP categories are receiving the most policy updates
- How cost measurement and attribution are being revised at a high level
- What types of quality, interoperability, and improvement activity changes are being proposed
- How APM and QCDR reporting rules may be affected
Who Should Read This
- Physicians and clinicians participating in QPP
- Practice administrators and compliance staff
- Medical coders and quality reporting specialists
- Registry and QCDR stakeholders
- Healthcare policy and reimbursement professionals
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