Physician Practice

OIG: CMS must improve technical assistance, internal IT systems for QPP

Physician Practice Insider, January 10, 2017

CMS must improve its physician outreach and beef up its IT systems to successfully implement the Quality Payment Program (QPP), according to a December 20, 2016, report from the Office of Inspector General (OIG).

The QPP’s sweeping reimbursement reforms, including the Merit-Based Incentive Payment System (MIPS) and advanced alternative payment models (advanced APM), were finalized in October 2016 and the first performance year began only two months later in January 2017. Initially, CMS planned full implementation by January 2017 but after physicians and other stakeholders expressed concerns about the short amount of time physicians would have to prepare, the agency finalized a compromise for 2017 that allows physicians to ease into the QPP’s payment models in phases. Although many physicians are still concerned that they will not be able to make the necessary changes and upgrades to meet the new requirements, the OIG’s report found that CMS also may not be prepared.

The OIG identified CMS’ key management priorities and policies for the QPP and evaluated to what extent it fulfilled them. CMS has met several of its goals for management of the QPP such as identifying payment models that qualify as advanced APMs and launching physician outreach and education programs. However, several measures vital to the successful management of the program are still incomplete. CMS has still not expanded its technical assistance to physicians, developed IT systems to support critical QPP operations, or issued subregulatory guidance as promised. The report also found that some contracts for technical assistance and education were still waiting to be awarded.

The report identified two main vulnerabilities:

  • Lack of technical assistance and guidance to physicians
  • Failure to develop IT systems to support the QPP

The OIG recommends that CMS address these vulnerabilities. CMS did not disagree with the OIG’s report and said it plans to provide support to physicians as the QPP rolls out and will continue to improve its backend IT systems support.

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