Physician Practice

Small practices benefit under proposed QPP rule

Physician Practice Insider, June 26, 2017

More small practices can quality for exclusions from the Quality Payment Program (QPP), claim hardship exceptions from electronic health record (EHR) requirements or earn automatic bonus points if the proposed QPP rule released June 20 is finalized.

CMS proposed increasing two low-volume thresholds that would grant additional exclusions in 2018: Practices that bill less than $90,000 in Part B charges or see fewer than 200 Medicare patients would be exempt from QPP requirements in 2018. Those figures are up from $30,000 in Part B charges and 100 Medicare patients in 2017.

Small practices also could add five points to their total performance scores in the merit-based incentive payment system (MIPS) “as long as the eligible clinician or group submits data on at least one performance category in the applicable performance period.” That’ll get you closer to the proposed 15-point performance threshold.

However, eligible providers who don’t fit in those categories would have to meet these QPP requirements to avoid a 5% cut – or potentially earn a 5% bonus – in 2020, according to the proposed rule:

  • Quality reporting – no change. Eligible providers will need to report six quality measures for at least 50% of encounters that meets a measure’s specifications.
  • Improvement activities (IAs) – no change. Most providers will need to report four activities. Providers who are in rural areas, geographic health professional shortage areas or meet the definition of non-patient facing must report two activities to receive a full score. CMS also will add more improvement activities that show the use of certified electronic health record technology (CEHRT).
  • Advancing care information (ACI) – some change. Providers will be able to use the 2014 or 2015 edition certified EHR technology (CEHRT) next year to participate in ACI. That’s a reversal from the agency’s stated plan in last year’s final rule. Providers must report a numerator of at least one or a “yes” response for the yes/no measures in five of 15 ACI measures if they're using 2015 CEHRT and four of 11 ACI measures if they're using 2014 CEHRT to earn the 50 percentage points in the base score. 

For more on the QPP proposed rule, check out the free post on the Part B News blog.

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