Quality New Year Resolutions for 2018
As the ball drops, we rejoice in the arrival of 2018. Moments of reflection intermingle with optimism for a new year, a fresh beginning. Many will pledge fragile confidences to shave their holiday beards or inches off their waistlines. Professionally, consider prioritizing quality improvement this year.
You may have successfully trimmed your diet and quit smoking, but 2017 marked the first Performance Year (PY) for the Quality Payment Program (QPP) of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This past November, CMS issued the final edict for the second year of QPP reporting. The following highlights several takeaways from their statement:
- Performance Category Weighting:
Quality – 50%
Cost – 10% *New for PY 2018
Improvement Activities (IA) – 15%
Advancing Care Information (ACI) – 25%
- Performance Period:
A minimum 12-month performance period for the Quality performance category and 90-day performance period for the ACI and IA performance categories will be in effect.
The option to participate and avoid a penalty by submitting at least one measure for one patient has been removed.
- Performance Threshold:
The minimum points required to avoid a five percent penalty in 2020 for performance in 2018 is now 15, an increase from the 3-point performance threshold for PY 2017.
- Low-Volume Threshold:
MIPS-eligible clinicians or groups with less than or equal to $90,000 in Part B allowed charges or less than or equal to 200 Part B beneficiaries will be excluded from MIPS participation. This has increased from PY 2017.
- Virtual Group Participation: *New for PY 2018
The deadline to participate as a virtual group ended Dec. 31, 2017. A virtual group is a combination of two or more Taxpayer Identification Numbers (TINs), comprising:
A solo, MIPS-eligible practitioner billing under a TIN with no other National Provider Identifiers (NPIs) linked to the TIN.
A group of 10 or fewer clinicians (at least one MIPS-eligible) that joins with at least one other solo practitioner or group for a PY of a year.
- Small Practices:
CMS finalized these flexibilities for groups of 15 or fewer clinicians:
Five points will be added to the final score.
A hardship exception will be added to the ACI performance category.
A 3-point minimum (instead of 1-point) will be open for measures in the quality performance category not meeting data completeness requirements.
- Complex Patients:
Up to five points are eligible for the treatment of complex patients.
Again, radiology residents often remain insulated from the politics influencing the future of our practice. Keep your eyes and ears open to how your program and future employers are preparing for MACRA implementation. Immerse yourself with departmental projects focusing on quality to supplement your lexicon. For light reading, here is the link to the full document highlighting QPP Y2 reporting.
Happy New Year!
By Michael Chorney, MD, diagnostic radiology resident at Pennsylvania Hospital of the University of Pennsylvania Health System.