Quality Payment Program (QPP)
2018 Merit-based Incentive Payment System (MIPS) Reporting
The Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA) created the Quality Payment Program (QPP) which began on Jan. 1, 2017. The program is currently in its second year.
Under the QPP, eligible clinicians and groups participate in a value-based payment system under one of two tracks:
- The Merit-based Incentive Payment System (MIPS)
- Advanced Alternative Payment Models (Advanced APMS).
Visit the ACC MACRA Hub to learn more.
Using the PINNACLE Registry® and Diabetes Collaborative Registry®
The PINNACLE Registry and the Diabetes Collaborative Registry are approved by the Centers for Medicare and Medicaid Services (CMS) as one Qualified Clinical Data Registry (QCDR) for the 2018 Merit-based Incentive Payment System (MIPS) Program Year.
As a QCDR, the PINNACLE Registry and the Diabetes Collaborative Registry offer an easy solution for practices to report MIPS for the 2018 program year. Reporting MIPS data to CMS is a FREE benefit to practices currently submitting data through the registries with the benefit of interoperability with most electronic health record (EHR) systems.
Practices that are not currently enrolled can click here to join.
Practices that used the registries to submit their MIPS data in 2017 or Physician Quality Reporting System (PQRS) data in previous years are on the path for successful reporting.
Participants can use the many benefits of reporting via the QCDR including:
- Flexibility to select your six Quality measures, Advancing Care Information measures and Improvement Activities that are specific to your practice;
- Practices have the option of reporting as individual providers or at the group practice level. When a practice reports as a group, their data is scored at the practice level. Group practice reporting also means that performance data on Physician Compare is posted at the group level, not individual provider level;
- FREE participation with 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;
- Bonus points available through participation in the PINNACLE Registry and/or Diabetes Collaborative Registry.
2018 Outpatient Registry QPP Timeline:
Measures indicated as available for public reporting are required to meet certain standards set by CMS. These measures must be statistically valid, reliable, accurate, comparable across submission mechanisms and meet the minimum reliability threshold to be included in the Physician Compare Downloadable Database. The measures are posted publicly in plain language, making them easier to understand. First-year measures are not available for public reporting.
Click here to view the ACC Outpatient Registries MIPS Measures.
Click here to view the ACC Outpatient Registries QCDR Measures Specifications.
2018 MIPS Performance Year
The 2018 MIPS performance year started Jan. 1, 2018, and end on Dec. 31, 2018. Eligible clinicians are required to submit a full year of data on Quality measures and 90 days or a full year of data for Advancing Care Information and Improvement Activities. Health care providers will begin to receive payment adjustments in the form of incentives or penalties in 2020 for the 2018 MIPS program year. Not participating in MIPS in 2018 will result in an automatic payment adjustment of negative 5 percent in 2020.
In 2018, four categories will contribute to the overall MIPS Performance Score:
- The Quality component accounts for 50 percent
- Providers are responsible for reporting six measures, including one outcome measure or high-priority measure if outcome measure is not available.
- All eligible providers will be required to report a full year of data for Quality in 2018.
- Improvement Activities accounts for 15 percent
- Advancing Care Information accounts for 25 percent
- Cost category accounts for 10 percent (New in 2018)
CMS will automatically calculate the performance score for Cost based on Medicare claims data. There is no additional work required from eligible clinicians.
Click here to view the QPP Year Two Program change highlights.
2017 MIPS Status
Reporting through the PINNACLE Registry and the Diabetes Collaborative Registry for the 2017 MIPS Program year is closed.
The ACC successfully submitted MIPS performance data on behalf of nearly 2,000 clinicians for 2017, including 85 group practices. In 2017, clinicians could select from 21 quality measures, including several outcome and high-priority measures, covering four National Quality Strategy domains: Effective Clinical Care, Communication and Care-Coordination, Community and Population Health and Patient Safety. Clinicians could also select from all CMS-approved Advancing Care Information measures and Improvement Activities.
CMS will review and calculate final performance scores by July 1, 2018, to determine whether clinicians and groups satisfactorily met the 2017 MIPS requirements. The data submitted in 2017 will be used to calculate the payment adjustment applied to 2019 Medicare Part B payments.
If you opted to report through the PINNACLE and/or Diabetes Collaborative Registries, we will communicate updates through the Outpatient Registries Newsletter and other email communications. If you have any questions on your submission, please email firstname.lastname@example.org.
Create an Enterprise Identify Management (EIDM) to access your 2017 MIPS Performance Score and Quality Resource Use Report (QRUR).
Find out if your practice has a dedicated Quality Improvement team by asking your practice administrator if your practice is a part of an Alternative Payment Model (APM) or Accountable Care Organization (ACO).
For more information:
- For questions about the Outpatient Registries and MIPS participation, contact the Registry Support Team at 1-800-257-4737 or email@example.com.
- For inquiries about MIPS and related topics, such as reporting requirements, negative payment adjustments, QRUR and Individuals Authorized Access to the CMS Enterprise Identity Management system (EIDM) registration – please visit the CMS QualityNet Help Desk website, or reach out by phone at 1-866-288-8912, Monday through Friday from 7 a.m. to 7 p.m. CT, or by email at Qnetsupport@hcqis.org.
Click here to join the PINNACLE Registry and/or Diabetes Collaborative Registry.
- 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
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 firstname.lastname@example.org.
- If you have questions about the Outpatient Registries and participating in MIPS, contact the Registry Support Team at (800) 257-4737 or email@example.com.
- 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.