2021 Quality Payment Program Experience Report and Infographic Now Available; Policy Update: Excluded MIPS Cost Measure for 2022 Performance Period

2021 Quality Payment Program Experience Report and Infographic Now Available Policy Update: Excluded MIPS Cost Measure for 2022 Performance Period 2021 Quality Payment Program Experience Report and Infographic Now Available The Centers for Medicare & Medicaid Services (CMS) released the 2021 Quality Payment Program (QPP) Experience Report, infographic and Public Use File (PUF) to provide insights into QPP participation for the 2021 performance year. The report and infographic include data regarding participation and performance in the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs) tracks of QPP during the 2021 performance year. They provide information about 2021 eligibility and participation, Advanced APM participation, MIPS reporting options and performance categories, and MIPS final scores and payment adjustments. The PUF provides detailed information for individual clinicians that received a 2021 MIPS final score. Key 2021 findings include: 93.85% of MIPS eligible clinicians engaged (submitted data for one or more performance categories) in QPP. 86.12% of MIPS eligible clinicians received a positive payment adjustment in 2021 despite the minimum score for a positive payment adjustment increasing from 45 to 60 points. 96.69% of MIPS eligible clinicians avoided a negative payment adjustment. MIPS eligible clinicians receiving a final score from their APM Entity continued to earn the highest mean final score (97.48 points) in 2021, followed by groups (88.32 points), virtual groups (86.89 points), and individuals (71.61 points). The mean final score for MIPS eligible clinicians participating as individuals rose from 64.66 in 2020 to 71.61 in 2021. The number of Qualifying Advanced Payment Model Participants (QPs) rose from 235,225 clinicians in 2020 to 271,231 in 2021. The average final score for small practices has increased substantially from the first year of the program, from 43.16 in 2017 to 73.71 in 2021, while the average final score for rural clinicians went from 63.08 in 2017 to 88.44 in 2021. CMS compiled data in the 2021 QPP Experience Report to highlight elements named as important for understanding the Quality Payment Program. Please view the 2021 Experience Report Public Use File to find more extensive data. Policy Update: Excluded MIPS Cost Measure for 2022 Performance Period CMS identified that the Simple Pneumonia with Hospitalization measure warrants exclusion from our calculation of MIPS eligible clinicians' scores under the cost performance category. Therefore, this measure won't be included in CMS's calculation of MIPS eligible clinicians' scores under the cost performance category for the 2022 performance period/2024 MIPS payment year. Our analysis of the 2022 performance period showed that the other 24 cost measures in the cost performance category haven't been significantly impacted by the COVID-19 Public Health Emergency to the extent that it would be appropriate for CMS to reweight the cost performance category. As a result, MIPS eligible clinicians can be scored on these measures and the cost performance category will be weighted at 30%. The Simple Pneumonia with Hospitalization episode-based cost measure was impacted by the introduction of a new diagnosis code for pneumonia due to COVID-19 and additional guidance to report these instances as secondary to COVID-19. Empirical testing showed that these coding changes impacted the scope of pneumonia cases captured by this measure, greatly affecting the number of MIPS eligible clinicians that could meet the case minimum requirements for the measure and indicating that the measure isn't assessing clinicians as intended. For more information about the exclusion of the Simple Pneumonia with Hospitalization measure, please see the 2022 Performance Period / 2024 Payment Year Merit-based Incentive Payment System (MIPS) Cost Measure Exclusion Fact Sheet (PDF, 231KB) Additional Resources – 2022 MIPS performance period/2024 MIPS payment year Additional information about the 24 cost measures that will be calculated and reported under the cost performance category, as well as the Simple Pneumonia with Hospitalization measure, is available here: 2022 Cost Measure Information Forms (ZIP, 10.4 MB) 2022 Cost Measure Codes Lists (ZIP, 10.6 MB) You're getting this message because you subscribed to get email updates from the Centers for Medicare & Medicaid Services (CMS). Update your subscriptions, modify your password or email address, or stop subscriptions at any time on your Subscriber Preferences Page. You will need to use your email address to log in. If you have questions or problems with the subscription service, please contact subscriberhelp.govdelivery.com. This service is provided to you at no charge by Centers for Medicare & Medicaid Services (CMS). This email was sent to edwardlorilla1986.paxforex@blogger.com using GovDelivery Communications Cloud 7500 Security Boulevard · Baltimore MD 21244