For QPP 2020, fairer MIPS cost scoring emerges amid array of smaller changes

Why This Topic Matters

The proposed updates could affect how clinicians and groups are scored under MIPS, how cost measures are attributed, which measures remain available, and how alternative payment model participants and registries report performance. Understanding the scope of the proposal helps organizations prepare for reporting, compliance, and operational changes tied to Medicare payment adjustments.

Article Sections

1. Cost shakeup

   Overview of proposed changes to the MIPS Cost category and why the category is receiving major attention in the 2020 rulemaking cycle. Includes broad discussion of how cost scoring is being revised for future performance years.

2. Assessing the TPCC measure

   Discussion of proposed updates to total per capita cost attribution and risk window methodology. Covers broader concerns about how patient and clinician relationships are reflected in cost scoring.

3. Minding the MSPB measure

   Summary of proposed refinements to Medicare spending per beneficiary attribution. Describes the general approach CMS is taking to separate types of inpatient episodes and reduce costs that may not reflect clinician influence.

4. New episode-based measures

   Introduces newly proposed episode-based cost measures and explains their role in the expanding Cost category. Also notes the presence of attribution metrics and the addition of new measure groups.

5. Revisions to Improvement Activities

   Covers proposed additions, removals, and threshold changes within the Improvement Activities category. Also discusses group reporting and participation credit changes.

6. Tweaks to Promoting Interoperability

   Summarizes limited 2020 changes to the Promoting Interoperability category, including measure status changes and burden-related adjustments. Also addresses clinician type exclusions and weighting updates.

7. Four new Quality measures, 55 removed

   Describes proposed updates to the Quality category, including additions, removals, and modifications to the measure set. Also mentions specialty measure set changes and potential survey-related proposals.

8. APMs and Advanced APMs

   Explains proposed changes affecting MIPS APMs and Advanced APM participation and scoring. Includes general discussion of reporting flexibility, partial QP treatment, and new model concepts.

9. Trouble for QCDRs

   Covers proposed changes to Qualified Clinical Data Registry standards and vendor requirements. Notes the likely impact on registry participation and measure development expectations.