Quality Improvement for Institutions

Quality Payment Program

The Quality Payment Program (QPP), created under the Medicare Access and CHIP Reauthorization Act of 2015, establishes new ways to reimburse clinicians who treat Medicare patients, based on value rather than volume. Hospitals and affiliated cardiovascular professionals participating in ACC’s NCDR registries can take advantage of several tools and offerings to help meet QPP requirements. 

(Learn more about QPP.)

Don’t MIPS Out!

  • The ACC’s Patient Navigator Program: Focus MI, Reduce the Risk: PCI Bleed and Clinical Quality Coach App count as Improvement Activities under the Merit-Based Incentive Payment System (MIPS) – one of two ways clinicians can participate in the QPP. You can claim a Quality Campaign Participation Certificate by taking ACC’s MIPS survey. Learn more.
  • The PINNACLE Registry® and Diabetes Collaborative Registry® have been approved as a Qualified Clinical Data Registry (QCDR) for the 2019 MIPS Program Year, offering participating practices a free and easy solution to report MIPS data in 2019. Practices currently submitting data via the PINNACLE Registry and/or the Diabetes Collaborative Registry can choose to have the ACC submit MIPS data to CMS on their behalf for free.

2019 MIPS Performance Year

The 2019 MIPS performance year started Jan. 1, 2019, and ends on Dec. 31, 2019. Eligible clinicians are required to submit a full year of data on Quality measures and at minimum 90 continuous days of data for Promoting Interoperability and Improvement Activities. Health care providers will begin to receive payment adjustments in the form of incentives or penalties in 2021 for the 2019 MIPS program year. Not participating in MIPS in 2019 will result in an automatic payment adjustment of negative 7 percent in 2021.

In 2019, four categories will contribute to the overall MIPS Performance Score:

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  • The Quality component accounts for 45 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 2019.
  • Improvement Activities accounts for 15 percent
  • Promoting Interoperability accounts for 25 percent
  • Cost category accounts for 15 percent

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 Three Program change highlights.

How to Prepare for MACRA

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