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MGMA Washington Connection

07/09/2020 7:41 AM | Rebekah Francis (Administrator)

New CMS report details 2018 MIPS, APM performance results

The Centers for Medicare & Medicaid Services (CMS) released its 2018 performance results from the Quality Payment Program's Merit-based Incentive Payment System (MIPS) and alternative payment models (APMs). 2018 was the second year of the program and informs 2020 payment adjustments. Highlights include:

  1. 98% of MIPS eligible clinicians avoided a negative payment adjustment by scoring at least 15 points. 84% received an exceptional performance bonus by scoring 70 points or higher. The maximum positive payment adjustment, inclusive of the bonus, was just 1.68% due to the small pool of payment penalty money.
  2. The average MIPS score was 86 points. MIPS APM participants had the highest average score at 98 points, followed by groups at 82 points, and individuals at 52 points.
  3. Individual reporting is down to just 6% overall. 
  4. More clinicians are participating in Advanced APMs. The number of qualifying participants nearly doubled in 2018 (183,306) from 2017 (99,076).

The report contains more information including the most commonly reported measures, average scores, and more.

Congress advances HHS spending bill

On July 7, a House Appropriations subcommittee approved the FY 2021 Labor-Health and Human Services (HHS)-Education funding bill, which would raise the HHS annual budget to $96.4 billion. The proposal includes billions of dollars in emergency supplemental funding in addition to regular, discretionary funding. The bill also includes a handful of Democratic priorities, such as money directed towards ACA outreach and enrollment as well as gun violence research. The subcommittee voted along party lines to advance the proposal to the full Appropriations committee for debate next Monday the 13th. Any package must be approved by the full House and Senate before going to the President’s desk for signature and becoming law.


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