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News & Press: Industry News

Congress Authorizes Changes to MIPS

Monday, February 26, 2018   (0 Comments)
Posted by: Lynn Scheps, SRS-Health
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Update to “MIPS 2018: Just Another Transition Year, Right?” (posted 2/15)


Between the time I wrote the MIPS 2018 article and the date it was posted, Congress enacted the Bipartisan Budget Act of 2018. This act pushes out the full implementation—and therefore some of the consequences I described in the post—from 2019 to 2022, effectively making 2019, 2020, and 2021 three more transition years.        

The act removes two of the requirements that the MACRA legislation had previously imposed:

  • CMS is not obligated to set the MIPS threshold at the mean (or median) of prior performance until 2022. Instead, the threshold will be gradually increased to that level over the intervening years. Since budget neutrality remains a requirement, there will still be winners and losers; the good news being that it will not be as challenging to avoid a downward adjustment for a few more years. The consequence of this, however, is that the amount of money available to winners will continue to be less than the maximum provided for in the law, (i.e., 5% based on the 2018 performance year, 7% for 2019, and 9% from then on.)
  • The Cost category does not jump to 30% of the MIPS score in 2019. CMS can hold off on the increase until as late as 2022, with the flexibility to set the rate at between 10% and 30% each year until then and to make it 30% only when the Secretary is confident that the resource use, (i.e., cost), measures are ready for adoption.  

Through these changes, Congress has relieved some of the immediate pressure for providers. However, this does not change the fact that it will become progressively harder to score well as providers gain experience and benchmarks increase, making MIPS increasingly competitive in the coming years. So, as I suggested in the original post, take advantage of the (now additional) transition years to secure your future success.

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