June 04, 2018
The Centers for Medicare and Medicaid Services (CMS) announced that 91 percent of all clinicians eligible for the Merit-based Incentive Payment System (MIPS) participated in the first year of the Quality Payment Program (QPP). This participation rate exceeded the agency’s goal of a 90 percent participation rate for 2017.
While in this announcement CMS does not directly address the percent of participants avoiding a penalty or receiving a positive adjustment, in 2017, eligible clinicians only needed to submit one measure for one patient encounter to earn three points and avoid a 4 percent penalty in 2019, the payment year for 2017 performance. With greater participation and the submission of more data, clinicians were eligible for positive payment adjustments. In 2018, the threshold to avoid a penalty was increased to 15 points (which can be achieved through multiple pathways). It remains to be seen how many clinicians will receive a penalty in 2019.