MIPS 2024: Crucial Changes Physicians and Practice Managers Must Understand
The CMS (Centers for Medicare & Medicaid Services) MIPS program undergoes continual revision to ensure the delivery of high-quality healthcare for Medicare beneficiaries. The just-released rule for 2024 brings noteworthy adjustments that are vital for physicians and practice managers to understand.
Key Highlights:
Rule Intent for 2024:
The primary goal is to progress the Quality Payment Program (QPP).
There's a push for enhanced measurement efforts and refined clinician participation.
The overarching aim remains: continuous improvement in healthcare quality for Medicare beneficiaries.
CMS states their intent to drive enhanced healthcare quality through payment policy.
Eligibility:
The eligibility criteria remain unchanged. It includes physicians, osteopathic practitioners, nurse practitioners, and many other health professionals.
Notably, if you're new to Medicare in 2023 or are a Qualifying APM Participant (QP) or Partial QP, you're not part of MIPS.
Score Thresholds & Payment Adjustments:
The threshold for the CY 2024 performance period/2026 MIPS payment year is set at 75 points.
The score makeup is divided as:
Promoting Interoperability: 25%
Cost: 30%
Improvement Activities: 15%
Quality: 30%
CMS proposes updates to scoring policies, including a transition to a category-level cost improvement scoring method.
Quality:
The data completeness criteria threshold is maintained at 75% for 2024-2026.
Measure changes include the addition and removal of several MIPS quality measures. It's imperative to review the full fact sheet for a comprehensive list of these changes.
Promoting Interoperability:
The performance period has been extended from 90 days to 180 days.
CMS has made alterations to the reweighting criteria for specific clinician types.
Improvement Activities:
Five new activities have been added. Most focus on Behavioral and Mental Health (BMH) and CMS Health Equity. Three existing activities have been removed.
Cost:
Five new episode-based measures are being added while one is being removed. There are also updates to scoring policies.
MVPs:
Five new MVPs are introduced, focusing on areas such as Women’s Health and Mental Health. Old MVPs have been consolidated for better clarity.
Targeted Reviews:
The review submission period has been revised, and the time frame to provide targeted review documentation has been shortened from 30 days to 15 days.
Estimated Payment Adjustments:
The maximum penalty is set at -9% but incentives can be as high as 8.82%. The case to excel in performance is now stronger than ever!
Other Policy Updates:
CMS has proposed further procedure grouping flexibility and public reporting changes, among others.
Upcoming Deadlines:
2024 MVP Registration Deadline: November 30th
2024 Virtual Group Election Deadline: December 31st
End of 2023 Performance Year: December 31st
For more detailed insights and clarifications, refer to the resources like the QPP 2024 Final Rule Resources - Full Fact Sheet and FAQ, and the 2024 MVP Final Rule Resource Guide.
To ensure you're updated and aligned with these changes, take proactive steps now. Visit chirpybirdinc.com or contact us today!
