8 Ways to Know if You Should Participate in the Quality Payment Program
May 8, 2017
You may have heard the Centers for Medicare & Medicaid Services (CMS) is reviewing claims and letting practices know which clinicians should take part in the Merit-based Incentive Payment System (MIPS). MIPS is an important part of the new Quality Payment Program.
The Quality Payment Program works to make Medicare better by keeping patients at the center of health care while paying clinicians based on their performance. It replaces the Sustainable Growth Rate formula, which threatened clinicians participating in Medicare with potential payment cuts for 13 years. This program combines and streamlines many existing Medicare quality programs. It also gives new ways to improve care delivery by supporting and rewarding clinicians who
- find new ways to engage patients, families and caregivers;
- improve care coordination and population health management.
During this first year as we move to the Quality Payment Program, CMS is committed to working hard with clinicians to make the reporting and participation process easier. It is a CMS priority to further reduce burdensome requirements so clinicians can deliver the best possible care to patients.
Here are eight ways to know whether you are included in the Quality Payment Program:
- Visit qpp.cms.gov, click on the MIPS Participation Look-up Tool and use your National Provider Identifier (NPI) to check your status. Also, you may have recently gotten a letter from your Medicare Administrative Contractor (MAC) that tells if you are included in MIPS. Your practice should have received a letter that includes the MIPS participation status of each clinician associated with the practice’s Taxpayer Identification Number (TIN).
- You are included if you are a:
- Physician (includes doctors of medicine, doctors of osteopathy (including osteopathic practitioners), doctors of dental surgery, doctors of dental medicine, doctors of podiatric medicine, doctors of optometry, and chiropractors)
- Physician assistant
- Nurse practitioner
- Clinical nurse specialist
- Certified registered nurse anesthetist
- A group including such clinicians
The Quality Payment Program has free resources to help.
You can also contact Mountain-Pacific Quality Health’s help desk for one-on-one, direct assistance by emailing QualityPaymentHelp@mpqhf.org. Mountain-Pacific has MIPS experts on staff to help you develop your 2017 action plan and find answers for your tough questions.
Leave a reply, ask a question or share information using the “Leave a Reply” section below, or email Sharon Phelps directly with your questions or comments.