HCPro, JustCoding Outpatient - 2019 Issue 47 (November)
Healthcare News: CMS increases MIPS performance threshold, confirms transition to MVP model
November 18th, 2019
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Article Overview
This news article covers CMS updates finalized in the 2020 Medicare Physician Fee Schedule rule related to the Quality Payment Program and MIPS. It explains changes to performance thresholds, penalty and bonus levels, category weighting for 2020 and 2021, and CMS’s planned move toward the MIPS Value Pathways framework. It is relevant for healthcare organizations, clinicians, and coding or compliance professionals tracking Medicare payment policy and reporting programs.
Why This Topic Matters
The article helps readers understand how CMS policy changes may affect Medicare payment adjustments, performance requirements, and future reporting structure under MIPS. It is useful for organizations planning quality reporting and preparing for evolving CMS payment models.
Article Sections
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2020 Medicare Physician Fee Schedule final rule
Overview of the CMS final rule and the major MIPS-related updates announced for upcoming performance periods.
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Performance threshold and payment adjustment changes
Discussion of updates to MIPS performance expectations, bonus-related thresholds, and the general direction of payment adjustment changes.
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MIPS category weights and cost measures
Summary of category weighting for the MIPS score and the addition of new episode-based cost measures for the 2020 performance period.
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MIPS Value Pathways (MVP) framework
Explanation of CMS’s planned transition to a new MIPS framework and the timing of its adoption.
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Stakeholder input and program development
Notes on CMS’s ongoing invitation for stakeholder feedback as the program framework is developed further.
What You Will Learn
- How CMS updated MIPS-related performance thresholds in the 2020 final rule
- What broad payment adjustment changes were announced for eligible participants
- How MIPS category weights were addressed for the 2020 performance period
- What CMS said about the planned transition to the MIPS Value Pathways framework
- How CMS described the role of stakeholder input in future program development
Who Should Read This
- Physicians and eligible clinicians
- Hospital and health system compliance teams
- Medical coding and reimbursement professionals
- Quality reporting staff
- Practice administrators
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