Quality Payment Program (QPP)

2017 MIPS Reporting

The Medicare Access and Children's Health Insurance Program Reauthorization ACT(MACRA) is new legislation that began on January 1, 2017. The goal of MACRA is to allow health care providers to focus on quality and cost instead of volume. Healthcare providers will begin to receive payment adjustments in the form of incentives or penalties in 2019.

The Quality Payment Program (QPP) is a new federal reporting program under MACRA. The goal of the QPP is to focus on care quality by making patients healthier. The QPP will reform Medicare Part B payments and improve care across the entire health care delivery system. The QPP offers eligible providers two tracks to choose from based on the practice size, specialty, location and patient population

  • The Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMS)
  • Advanced Alternative Payment Models (APMS)

Please visit ACC.org/MACRA for additional information on APMS.

The PINNACLE Registry® and the Diabetes Collaborative Registry® have jointly self-nominated as a Qualified Clinical Data Registry for the 2017 Merit-based Incentive Payment System (MIPS) Program Year.

As a Qualified Clinical Data Registry (QCDR), the PINNACLE Registry and the Diabetes Collaborative Registry offer an easy solution to practices to report MIPS for the 2017 program year. Reporting to the Centers for Medicare and Medicaid Services (CMS) will remain a free benefit to practices currently submitting data via the registries with the benefit of interoperability from most electronic health record (EHR) systems. Practices also have the option of reporting as individual providers or at the group level (GPRO).

For the 2017 reporting year, MIPS will replace the old PQRS program. MIPS will streamline and simply the process of reporting quality data by combining three existing programs into one program with the addition of one new component. Under MIPS, there are four performance categories:

qpp

The Quality component accounts for 60 percent of your final score in 2017. Providers are responsible for reporting six measures, including one outcome measure or high priority measure if outcome measure is not available. For practices who have used the registries to submit their PQRS data in the past you on the path to successfully reporting. Starting this year, providers now have the flexibility of selecting which measures to report!

MIPS Measures

  • Click here to view ACC Outpatient Registry MIPS Measures
  • Click here to view ACC Outpatient Registry Non-MIPS Measures Specifications


Practices that are not currently enrolled can join the registry by clicking here for our online enrollment! 

2017 MIPS measures will be the same measures offered in the 2016 PQRS reporting year in addition to several new measures.
For additional information on Improvement Activities, Advancing Care Information and Cost please click here to visit our MACRA Homepage.

The MIPS performance year started January 1, 2017 and will continue through December 31, 2017.  Practices have the option to report a full year of data or 90 days. Not participating in the QPP for the 2017 transition year will result in an automatic negative four percent payment adjustment in 2019. Your Final Score is an aggregate of the weighted score in each category.

Current and potential registry participant are strongly encouraged to report a full year in order to maximize the incentive your providers can receive. Reporting of the minimum requirements (One measure for 90 days) will be determined on a case by case basis only and may incur a cost.

Participants are able to use the many benefits of reporting via the Qualified Clinical Data Registry (QCDR) including:

  • Potential Bonus Points for your 2017 Final Score for practices who are reporting in an QCDR
  • Flexibility  to select your six quality measures
  • Option to report as an Individual Reporting or Group Practice Reporting Option
  • Ability to participate in MIPS and focus on quality improvement
  • Frequent feedback and monitoring: Participants receive access to QI tools and clinical support as well as monthly benchmarking reports that include national benchmarks for comparison purposes

How to Prepare for MACRA

  • Visit the MACRA Information Hub
  • Visit the CMS QPP site
  • Sign up for the ACC Advocate Newsletter. Opt in or out of ACC newsletters by logging into ACC.org and selecting My Communications Preferences under the My ACC tab.
  • Review your 2015-2016 reports on PQRS, Value Modifier and EHR Incentive (Meaningful Use)
  • If you're avoiding penalties in these programs, you should be prepared for MIPS
  • Find out if you are part of an Alternative Payment Model (APM)
  • Click here to download a 2017 MIPS Checklist

2016 PQRS Status

The ability to report through the PINNACLE Registry and the Diabetes Collaborative Registry for the 2016 year for PQRS is closed.

ACC successfully submitted PQRS performance data on behalf of nearly 2,200 providers this year including 26 GPRO practices.  In 2016 providers had the option to report up to 16 measures, including three outcomes measures, covering four National Quality Strategy domains: Effective Clinical Care, Communication and Care-Coordination, Community and Population Health and Patient Safety. Over the next few months CMS will review the submitted data and make determinations as to whether providers satisfactorily met the PQRS requirements. PQRS data submitted in 2016 will also be used to calculate the 2018 value-based payment modifier for all solo practitioners and group practices of two or more eligible providers.

If you opted to report through one of these registries, we will communicate any updates via the newsletter and supplemental email communications. If you have any questions on your submission, please email ncdr@acc.org.

For more information:

  • If you have questions about the Outpatient Registries and participating in MIPS, contact the Registry Support Team at (800) 257-4737 or ncdr@acc.org.
  • For more information about MIPS and how to get started please visit CMS.gov.
  • If you have an inquiry regarding the Physician Quality Reporting System (PQRS) and related topics, including, but not limited to, reporting requirements, negative payment adjustments, feedback reports, and Individuals Authorized Access to the CMS Enterprise Identity Management system (EIDM) registration, please call the QualityNet HelpDesk. Available Monday - Friday 7:00 a.m. - 7:00 p.m. Central Time (CT) by phone 1-866-288-8912, or email at Qnetsupport@hcqis.org.
  • You can also access our frequently asked questions for the outpatient registries and 2016 PQRS Reporting.