The Quality Payment Program (QPP) announced that they are reweighting the cost performance category under the Merit-based Incentive Payment System (MIPS) from 15% to 0% for the 2020 performance period. This change follows the analysis of the 2020 performance year data, which showed that QPP could not reliably calculate scores for the cost measures that would adequately capture and reflect the performance of MIPS eligible clinicians.

Under normal circumstances, there are four categories used to evaluate performance under MIPS: quality, promoting interoperability, improvement activities, and cost. The 15% cost performance category weight will now be redistributed to another performance category or categories.

There are no actions needed from clinicians as a result of this update. This change will apply to all MIPS eligible clinicians, whether participating as an individual, group or virtual group. Clinicians who aren’t covered by the automatic extreme and uncontrollable circumstances policy or who didn’t apply to request reweighting will still have their cost performance category weighted to 0%.

MIPS is one way to participate in the QPP, a program authorized by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Traditional MIPS is the original framework available to MIPS eligible clinicians for collecting and reporting data to MIPS, of which cost is an important component. Although clinicians don’t personally determine the price of individual services provided to Medicare patients, they can affect the amount and types of services provided.

 

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This change MIPS cost component will impact your payments in 2021. How can you report MIPS measure effectively and efficiently to avoid penalties and maximize income? Get in touch with our experts to learn how to complete MIPS reporting with minimum efforts.