The Centers for Medicare & Medicaid Services (CMS) and its contractor, Acumen, LLC, will be conducting field testing for eight episode-based cost measures before consideration of their potential use in the Cost Performance Category of the Merit-based Incentive Payment System (MIPS) of the Quality Payment Program (QPP). The Cost Performance Category was not implemented in 2017 and in the 2018 QPP Proposed Rule CMS once again proposed not to implement it. CMS indicated that more time was needed to develop measures.
Eight measures which have been developed through the clinical work group process will be field tested.
- Elective Outpatient Percutaneous Coronary Intervention (PCI)
- Knee Arthroplasty
- Routine Cataract Removal with Intraocular Lens (IOL) Implantation
- Revascularization for Lower Extremity Chronic Critical Limb Ischemia
- Screening/Surveillance Colonoscopy
- Intracranial Hemorrhage or Cerebral Infarction
- Simple Pneumonia with Hospitalization
- ST-elevation myocardial infarction (STEMI) with PCI
Field testing is an opportunity for affected clinicians and other stakeholders to provide feedback on the measures. Feedback is sought on: draft measure specifications, field test reports and supplemental documentation. Field testing will take place from October 16through November 15, 2017. There are two ways to provide feedback.
- During this time, clinicians (TIN-NPIs) and clinician groups (TINs) who are attributed at least 10 episodes for one or more measures will have the opportunity to view a confidential report with information about their cost measure performance. Clinicians can provide feedback on their individual reports.
- Feedback is also sought from stakeholders through an on-line survey which will also be open from October 16 through November 15, 2017. The online survey is available here. A mock report and supplemental documentation on the measures that will be publicly posted on the CMS website.
Acumen anticipates releasing additional episode-based cost measures for field testing in the near future.
Resources for More Information
In conjunction with field testing activities, CMS National Provider Calls will be held on the dates below. The same content will be covered for both calls. Please click on the links below to register:
More information on Acumen’s work in this area is available here.
For more information on the CMS Quality Payment Program, visit the McDermottPlus MACRA Resource Center or contact Sheila MAdhani at (202) 204-1459 or email@example.com.