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The Medicare Merit-Based Incentive Payment System (MIPS) is complex and requires physicians and practices to consider many options. This guest blog post from the American Society for Radiation Oncology (ASTRO) describes resources to help demystify MIPS for radiation oncology practices.
As part of the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP), the Merit-based Incentive Payment System (MIPS) was created to reform Medicare payments while improving care and reducing costs across the entire healthcare delivery system. Started in 2017, MIPS consolidated Medicare legacy programs—including the Physicians Quality Reporting System, Value-based Modifier, and Meaningful Use—while adding a new Improvement Activities (IA) category, rolling these into one comprehensive program. CMS is implementing the transition to payment through MIPS in phases.
For 2018, MIPS-participating eligible clinicians' performance in four categories will impact their 2020 Medicare Part B reimbursement—from a negative 5 percent to a positive payment adjustment. Note that the overall payment adjustment for eligible clinicians participating in MIPS is determined by a Composite Performance Score (CPS), ranging from 0 to 100.
So not only is MIPS complex, but the program is evolving. For 2019, CMS introduced some significant MIPS updates, including:
Scaling the Learning Curve
For radiation oncology clinicians and practices participating in MIPS, the American Society for Radiation Oncology (ASTRO) has robust educational resources to help stay up-to-date on MIPS, whether your goal is to avoid the penalty (negative payment adjustment) or to aim for a large positive adjustment. Visit the ASTRO website for comprehensive information and tools to determine eligibility, reporting options, and more, including a MIPS for Radiation Oncology 2019 video. You’ll also find the following ASTRO tools for success in MIPS:
Moving Beyond MIPS: What Lies Ahead?
With the transition to value-based care picking up speed, radiation oncology practices and programs need to explore strategic approaches that support innovation and viability. On March 20, the Association of Community Cancer Centers is offering a one-day Radiation Oncology Pre-Conference to the ACCC 45th Annual Meeting and Cancer Center Business Summit, in Washington, D.C., where ASTRO Director of Health Policy Anne Hubbard, MBA, will be discussing new payment models, mandated bundles, and policy and regulatory shifts likely to impact radiation oncology; plus participants will hear clinical and economic perspectives on breakthrough treatments, practical strategies for streamlining pre-authorization processes, and much more. View the Radiation Oncology Pre-Conference Agenda. Attend and prepare for what lies beyond MIPS.
Guest blogger Randi Kudner is Senior Quality Improvement Manager with the American Society for Radiation Oncology (ASTRO).