American Society of Plastic Surgeons
For Consumers
 

2020 MIPS - Year 4

Set your goal for 2020

Every year, weights are assigned to each of the four components of MIPS and are added together to give you a MIPS final score. CMS will use the final score to determine whether to give a positive, neutral, or negative payment adjustment in 2021.

2019 Final scores and 2021 Payment Adjustments

How to Avoid the 9% Penalty

In 2020, a clinician will need to earn 45 points to avoid the penalty (receive a neutral adjustment).

For a small practice (15 or fewer clinicians):

  • Apply for the hardship exemption to have PI reweighted to Quality, making Quality worth 70% of your overall score
  • Earn 15 points by fully participating in the IA component
    • Attest to 2 medium weight OR 1 high weight activity
  • Earn an additional 30 points through Quality measure reporting or Claims reporting
    • Submit at least 2 measures earning 5 points each (must meet data completeness with 70% of cases across all payers AND have a minimum of 20 cases)
    • Submit at least 4 additional measures earning 3 points each (meeting data completeness STRONGLY recommended)

For a larger practice (>15 clinicians):

  • Earn 15 points by fully participating in the IA component
    • Attest to 4 medium weight OR 2 high weight activities
  • Earn an additional 30 points through Quality measure reporting
    • For Quality, submit 6 measures with data for a full year (70% of your patients for whom the measure applies, minimum 20 patients per measure, and 1 measure must be an outcome or high priority measure)

How to Earn a Positive Payment Adjustment and an Exceptional Performance Bonus

  • Decide whether to apply for the hardship exemption to have PI reweighted to Quality, making Quality worth 70% of your overall score
  • Earn 15 points by fully participating in the IA component
  • Earn up to an additional 55 points through Quality measure reporting
    • Submit 6+ measures with data for a full year (70% of your patients for whom the measure applies, minimum 20 patients per measure, and 1 measure must be an outcome or high priority measure)
  • PI Reporting – Earn 25 points by using 2015 CEHRT to report the PI component

Learn about changes to each of the four program components effective in 2019:

  • Quality
    (45% of MIPS Score)
    • Report 60% of cases for whom the measure applies
    • 20 case minimum for each measure (does not have to be the same 20 patients for each measure, but there can be overlap)
    • Measures are worth 1-10 points depending on performance compared to the benchmark and practice size
  • Promoting Interoperability (PI)
    (25% of MIPS Score)
    • Must report the base/core measures- all or nothing- must successfully report all or forfeit category
    • Earn bonus points for reporting additional measures
    • Hospital-based clinicians (those with 75% or more of their billing from their hospital), PAs, and NPs are exempt from PI and will have this category automatically re-weighted to Quality (making Quality 75% of the score)
    • Small practices can apply for a hardship exemption to reweight PI to Quality- visit qpp.cms.gov
  • Improvement Activities (IA)
    (15% of MIPS Score)
    • Simple attestation to various quality improvement activities
    • Must have documentation somewhere in practice in case of CMS random audit
  • Cost
    (15% of MIPS Score)
    • No reporting, this is done via claims
    • Read more about how cost measures are structured here

Ready to Report?

ASPS has developed a Qualified Clinical Data Registry (QCDR) to assist with all your MIPS reporting needs.

  • 23 MIPS measures and 17 QCDR (non-MIPS) plastic surgery specific quality measures
    • Plastic surgery measures for reconstruction after skin cancer resection, breast reconstruction, and rhinoplasty
  • Can report all 3 components (Cost component determined by claims)
  • Accepts manual data entry, or integrate your EMR

New to MIPS reporting? Contact Caryn Davidson, Quality Projects Manager at quality@plasticsurgery.org or (847) 228-3349 to set up a FREE consultation for your MIPS reporting needs. Please contact Caryn as soon as possible - do not wait until 2020!