Home Forums Discussions MACRA/MIPS Quality Payment Program Year 2: MIPS Highlights

In the Quality Payment Program Year 2, here?s how we?ve adopted 2018 policies to further reduce your burden and give you more ways to participate successfully. We are keeping many of our transition year policies and making some minor changes including:
? Raising the performance threshold to 15 points in Year 2 (from 3 points in the transition year).
? Allowing the use of 2014 Edition and/or 2015 Certified Electronic Health Record Technology (CEHRT) in Year 2, and giving you a bonus for using only 2015 CEHRT.
? Giving up to 5 bonus points on your final score for treatment of complex patients.
? Automatically weighting the Quality, Advancing Care Information, and Improvement Activities performance categories at 0% of the final score for clinicians impacted by hurricanes Irma, Harvey and Maria and other natural disasters.
? Adding 5 bonus points to the final scores of small practices


More detail https://www.cms.gov/Medicare/Qualit...ary/QPP-Year-2-Final-Rule-Fact-Sheet.pdf [font:Georgia][/font]

Thank you Ms. Wimbley.
When I look at any document relating to MIPS/MACRA/QPP --
I just go all wobbly in the knees, and I get a sinking feeling that makes me want to crawl into a hole.

I know you are trying to help.
And I am just trying to stay sane.
I have come to the conclusion that CMS and I are on different planets.

Ditto Tom, to me it reads like a transcript of an actuary having clang associations.
I just say no.

26 pages just for the overview!

Ms. Wimbley:
I am one that played your game with the various stages of Meaningful Use. That program was an abject failure. I never heard CMS offering apologies for putting us through all that, or the massive waste of tax dollars that really did nothing "meaningful" for healthcare. Now CMS is trying to get us to play again with another complicated program. I just want to seem my patients and help them. Since you are with CMS, I have to ask: did they learn anything from the last time? If you do have any say, Please, please stop.

CMS/MeaningfulUse/MIPS nice title for the latest Greek Tragedy playing in our practices.

No matter what any of its proponents say, Medicare still pays by procedures, and by how many patients you see.
Quantity.

The "quality" part is and adjustment to the "quantity" -- not the other way around.

Not participating might cost 10 - 15% off the top (before taxes)
Participating is very expensive in terms of additional staff, inability to see patients efficiently and untold frustration.

I believe the tradeoff for small offices remains is negative either way -- and is clearly designed to destroy independent practice.

yup, my attempt is to try and add another patient or 2 a day to 'cover' the loss for not running the gauntlet

This one seems out of nowhere, and I wonder why CMS wouldn't simply send this to those who participate in Medicare.

I certainly agree with the users above. Everything that the government has done has added little benefit to physicians and added tons of paperwork and useless time. I doubt that this will improve healthcare. And, more importantly, all of the alphabet soup that the government has crammed down our throats such as CCHIT, Meaningless Use, MACRA, MIPS, etc. have costs the EMRs money and costs the users of those EMRs a much longer wait for the EMR to be upgraded. EMR companies have no choice but to upgrade and change their EMRs, at the expensve of much money and wasted time, so that their EMRs can be certified for the garbage. If they don't, they can't sell them.

The Quality Payment Program Hardship Exception Application for 2017 (covering those of us affected by the hurricanes) is now online at: https://qpp.cms.gov/mips/advancing-care-information/hardship-exception

If you want to apply for the exception for 2017, it must be filed by 12/31/2017.

now I propose they consider adding the 'Grumpy Old Fart/Not My First Rodeo' exception

Even better news in this CMS release. Physicians in MIPS who practice in the hurricane affected states (Texas, Florida, South Carolina & Georgia), the US Virgin Islands and Puerto Rico, plus areas of California affected by wildfires, are not going to receive negative payment adjustments in 2019, even if they don't submit MIPS data. If I'm reading this right, you don't even need to apply for it:


(Incredibly, they failed to include koby's exception)

As long as patients want to see an independent doctor, I will be here, with our without CMS.

If I have offended anyone by posting information related to the CMS quality reporting programs I sincerely apologize. My goals is always to be helpful.

I work with many AC providers who need and want help navigating the different programs. In a world where none of us "writes the rules" I seek only to share information that some providers may not be aware of and is helpful. I have never been rude, offensive or tried to solicit business from any forum members.

Kindest regards and Happy New Year to you All!!

Betty,
No need to apologize! There are many people here who are interested in learning about quality reporting programs, and appreciate the help. I would encourage you to continue posting.
There are also many who are very angry about the program; they sometimes direct that anger where it does not belong.
Perhaps it would be helpful for you to explain who you are and for whom you work.

I don't believe that anyone on this board is directing any anger toward Betty.
All the anger and frustration that I feel, and I suspect many others feel, is directed toward a nebulous collection of people and programs somewhere "out there" -- presumably in Washington, D.C., but who really knows?

I sincerely appreciate any "real" people -- like Betty -- who are brave enough and motivated to try to be helpful.

I believe that the American medical system is fatally flawed, and that all the fixes that have been applied over several decades have incrementally made things worse. One can not blame MIPS or MACRA or Meaningful Use -- or DRG's or any other single program. It isn't because of "Obamacare" or "Trumpcare".

We need a general housecleaning, but I can't see how it will ever happen -- there are too many vested interests competing with each other for power and dollars. Doctors and patients have essentially become irrelevant in the mad grab for "return on investment" and "market share" -- it is beyond anyone's control.

I guess the answer will be when UnitedHealthCare runs everything, powered by Amazon or Google

I don't get it. How do you say none of us writes the rules? The government writes the rules. No, you haven't tried to solicit business. How would you solicit business? It's the government who solicits the business without our agreeing to it. I think you will find that over 90% of doctors do not like CCHIT, Meaningless Use, MACRA, MIPS or any government intervention. Certainly penalizing a doctor for not meeting the criteria the government sets should be illegal.

I guess part of the issue is there was no question or anyone asking a question here. It was out of the blue. Which made it all the more frustrating.

My recommendation would be to ask for a forum just for CMS and government and how it affects healthcare. Then you can post all you want and those who wish to comment and interact there can. I already know the perfect moderator.

Let me know.

She posted in the MACRA/MIPS forum.
It is in the right place.

That wasn't the point. The point is she said she helps people who I assume have asked a question. Here it was just an informational post.

My suggestion is for her to have her own forum.

Hmm!

I am also thinking like Jon that MIPS/MACRA is the right place for such topics.


Aramiz
Houston.

Certainly of the current forums:

Amazing Charts Company Updates
ICD-10
General Discussion
Problems
Meaningful Use
MACRA/MIPS
Amazing Charts Practice Management
Coding and Billing
Clinical Corner and Cases
Wish List
Tech Talk
aCBay
Tips and Tricks
Amazing Charts User Groups (ACUG)
Third-Party Vendor Discussion
Helpful Downloads

that MACRA/MIPS would be the closest thing. If it were put anywhere else, I would move it. Again, that isn't the point. Sure, she can answer questions in MACRA/MIPS. I guess according to those interested, she would not be allowed to answer in Meaningful Use?

What I was proposing is if she is going to start topics that many are not interested in, she could have a forum entitled, CMS, Info on Government Intervention in Medicine. I suppose those posts would show up, but maybe I would let it go as those who are interested could post there.

If anyone would like, I couild open a survey, and users could vote on what forum would be most appropriate.

I, for one, appreciate any contribution from CMS or an insurance company here. My policy has been, for many years, to just suck it up and jump through any hoops presented. CMS, and the insurance industry in general, are as much our customers as are our patients. Patients spend far more time researching their insurance options than checking the credentials of their physicians, they trust the insurance companies to do that for them. Working on quality improvement always means doing something that is not direct patient care. I have 100 MIPS because of years of working with HEDIS measures with insurance companies and our own measures and practice improvement projects through MOC. We have PCMH status through the AAAHC because of years of stomping down my ego and my staff's egos with population measures showing that centering the practice around the patient works and improves care. And, yes, I am getting paid better for the efforts.

To show how silly this is, I know a dermatologist who sees someone for psoriasis, and there is always a section where the MA asks, Do you smoke, do you drink? That covers them. I mean it is good and it probably has something to do with derm, but they just do it to meet the criteria.

Our ER asks 2 year olds if they have been abused or sexually abused. Really?

I appreciate it as well. Not saying they shouldn't come on. Just saying they are SO important, they should have their own forum. Those that appreciate their contribution can use that forum and those that don't, can stay away from them.