Transition and Flexibility Are the Buzzwords for QPP 2018 Proposed Rule

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Transition and Flexibility Are the Buzzwords for
QPP 2018 Proposed Rule
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CMS released the proposed 2018 Quality Payment
Program (QPP) rule on June 20. To sum up the
1,000 pages, 2018 will be something of a
transition year like 2017 was for QPP, which was
established under MACRA. If you read through
the various summaries available, youll see the
term flexibility used quite often, with
specialty groups adding the warning that they
need time to get through the complete rule before
coming to a final verdict.
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Here are Some Areas to Watch
Small provider exemption and low-volume
threshold The 2017 low-volume threshold was set
at 30,000 in Medicare Part B allowed charges, or
100 or fewer Part B patients. The idea was to
exclude practices from QPP requirements if they
were under the low-volume threshold because the
burden would be too great based on their numbers.
In 2018, the proposed low-volume threshold is
90,000 or less in Part B allowed charges, or
less than or equal to 200 Part B patients.
Virtual group reporting If youve got 10 or
fewer practitioners in your group (or if youre
solo), theres a proposed option to let you join
with others in that size-set to be scored as a
group.
Hospital-based provider reporting at facility
level A proposed MIPS reporting option would let
hospital-based clinicians use their facilitys
value-based purchasing measure results.
EHR certified to 2014 Edition OK MIPS-eligible
clinicians can continue to use EHR technology
certified to the 2014 Edition for 2018, but
youll get a bonus under advancing care
information (ACI) for using only 2015 Edition
certified EHR. One reason for this proposal is a
concern about the availability of certified
products.
MIPS scoring for cost stays at 0 The proposed
weighting is 60 quality, 25 ACI, 15
improvement activities, 0 cost. But dont ignore
cost completely. The plan is still for cost to
weigh in at 30 in 2019, so you need to be
prepared to handle cost when it finally counts.
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What Are Societies Saying?
Each specialty, setting, and industry has its own
concerns. Here are some views from just a few
groups

• AAPMR, the American Academy of Physical Medicine
  and Rehabilitation, declared a win for
  physiatry after seeing a proposed update to the
  2018 measure Closing the Referral Loop Receipt
  of Specialist Report. The update was in line with
  discussions AAPMR had with CMS about reporting
  difficulties.
• ASCO, the American Society of Clinical Oncology,
  notes it will be analyzing a provision that could
  make some Part B drug payments subject to MIPS
  adjustments.
• AHA, the American Hospital Association, posted a
  statement supporting proposals and encouraging a
  future focus on changes that provide an
  incremental approach to implementation and that
  promote alignment of hospital and clinician
  efforts.

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CMS is accepting comments until Aug. 18, 2017,
and you can get instructions on how to submit
comments on page 1 of the proposed rule.
What About You? Do you think the proposed rule
adds flexibility? Do you think it achieves the
goal of moving to a value-based approach? Source
URL- http//bit.ly/2goNQyK  
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