decisionhealth Newsletters, Coder Pink Sheets - 2017 Issue 12 (December)
Quality reporting: MIPS 2018 picks up the pace for eligible doctors and non-physician practitioners
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Article Overview
This article explains how CMS is changing the Merit-based Incentive Payment System (MIPS) for 2018 under the Quality Payment Program. It is aimed at clinicians, practice managers, and coding/reimbursement professionals who need a high-level view of performance scoring, reporting timeframes, eligible clinician types, participation exemptions, and patient-facing status. The discussion focuses on the general structure of the program and the operational changes that affect reporting and payment adjustments.
Why This Topic Matters
2018 MIPS requirements affect whether eligible clinicians face payment adjustments and how they must prepare their quality reporting workflows. Understanding the updated thresholds, reporting periods, and low-volume rules helps practices assess participation obligations and planning needs.
Article Sections
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2018 MIPS program overview
Introduces the overall direction of CMS policy for the 2018 performance year and contrasts it with the prior year’s transition period. Summarizes the major program areas that changed or remained in place.
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Key aspects of the 2018 MIPS program
Covers the main program parameters described for 2018, including scoring structure, performance threshold, payment adjustment, reporting periods, and quality completeness expectations.
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Clinician participation and low-volume threshold
Describes which clinician types are affected and summarizes the updated low-volume exemption criteria that may remove some clinicians from participation requirements.
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Submission methods and patient-facing definition
Explains the reporting-method framework for performance categories and the related patient-facing classification discussed by CMS.
What You Will Learn
- How CMS framed the 2018 MIPS performance year
- Which broad program areas were changing for 2018
- What the article says about participation and exemption criteria
- How reporting methods and patient-facing status are addressed in the discussion
Who Should Read This
- Physicians and other eligible clinicians
- Practice administrators
- Medical coders and billing staff
- Quality reporting and compliance teams
- Health care reimbursement professionals
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