MIPS: How Hard Is Hard? CMS Wants to Know

Posted on 19 Mar, 2018 |comments_icon 0|By Elizabeth

MACRA stress is—and has been—high. Last year’s AMA/ KPMG survey reported that fewer than one of four physicians had perceived themselves as “well prepared” to meet MACRA’s Quality Payment Program (QPP) reporting requirements in 2017. Ninety percent of the physicians surveyed had considered the requirements “somewhat” or “very” burdensome.

KPMG survey analysts predicted that approximately a third of survey respondents wouldn’t meet the basic standard of one patient, one measure, no penalty. Among the challenges factored into the high fail rate, the following were noted with greatest frequency:

  • Time required to report performance
  • Understanding requirements and how MIPS performance is scored
  • Cost involved to correctly capture and report performance

The prior year, with MACRA’s programs still on the horizon, Lawrence R. Huntoon, M.D., Ph.D., neurologist and editor-in-chief of the Journal of American Physicians and Surgeons, wrote a rather tongue-in-cheek editorial entitled MACRA, Stress, Brain Atrophy, and the End of Fee-for-Service Medicine—which, yes, as the title indicates, associates MACRA stress to brain atrophy.

“Physicians who are in the Medicare system who are experiencing difficulty sleeping, weight gain, increased anxiety and worry about what will happen to their practice under MACRA, memory difficulties, increased difficulty making decisions, increased irritability, and depression over what the future will hold for them may be harming their brains by remaining in the Medicare system,” Huntoon wrote.

Again, Huntoon’s commentary was satirical, an expression of frustration resonating throughout the medical community. He sensed a MACRA migraine coming on (in keeping with his tone) and, as it turned out, the ensuing migraine proved to be a resistant variant.

Is Your Head Still Spinning?

How did your practice fare in 2017 MACRA reporting? If you’re like the overwhelming majority—or, rather, the overwhelmed majority—the word MACRA continues to bring on a cold sweat. But the good news is, you’re not alone in the struggle. In fact, CMS is aware of your difficulties and they’re inviting you to participate in their efforts to ease MACRA-related stress.

How Would You Like to Partake in CMS’s Quality Measures Study?

CMS will be studying the Burdens Associated with Reporting Quality Measures in 2018, as outlined in the Quality Payment Program Year 2 Final Rule. To participate, you must apply by March 23. In return for your successfully participation, you’ll receive full credit for the 2018 MIPS Improvement Activities performance category.

Of course, you must be a MIPS-eligible clinician participating in MIPS as an individual or as part of a group to partake in the study—although CMS plans to include a limited number of clinicians who aren’t eligible for MIPS in 2018, perhaps to round off their findings.

You can choose to participate as an individual or as part of a group. If you participate as a group, your entire group will earn credit. If you participate as individuals, only you will earn credit.

The Goal of the Study

No special knowledge or expertise is required on your part. CMS is interested in gauging your MIPS experience to potentially lessen program difficulties in the future. In the study, they will attempt to:

  • Examine clinical workflows and data collection methods using different submission systems
  • Understand the challenges you have when you collect and report quality data
  • Recommend changes to try to lower your burden, improve quality data collection and reporting, and enhance clinical care

Study Participation Will Involve:

The study runs from April 2018 to March 2019. To successfully complete the study and earn full Improvement Activity credit, you’ll need to:

  • Complete a 2017 MIPS participation survey in April/May 2018.
  • Complete a 2018 MIPS planning survey in September/October 2018.
  • If invited by the study team, join a virtual 90-minute focus group between November 2018 and February 2019.
  • Meet minimum requirements for the MIPS Quality performance category by submitting data for at least three measures in the MIPS Quality performance category, as required for 2018 MIPS participation. The data submitted must:
    1. Include one outcome measure
    2. Be submitted to CMS by the March 31, 2019 final MIPS reporting deadline
    3. Be submitted through any method accepted under MIPS for Year 2 of the Quality Payment Program (2018)

If you’re application to participate in the study is accepted, CMS will notify you via email in spring 2018.

Learn More About MACRA

In the meantime, if you can’t shake your MACRA migraine, TCI can help. Pick up a copy of the MACRA Quality Measures Guide 2018—and learn the ins and outs of successful MACRA navigation to stay on track for optimum reimbursement in 2018.



Elizabeth works on an array of projects at TCI, researching and writing about modern reimbursement challenges. Since joining TCI in 2017, she has also covered the nuts and bolts of cybersecurity, compliance with federal laws, and how to tap into the advantages of telehealth services.

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