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CMS Releases 2018 Quality Payment Program Performance Data; 98% Avoid MIPS Penalty

This week, the Centers for Medicare and Medicaid Services (CMS) released the final 2018 performance data for the Quality Payment Program. For the 2018 performance year 98% of eligible clinicians participating in MIPS will receive a positive payment adjustment in 2020. Of those eligible clinicians, 84% will receive an additional adjustment for exceptional performance and 13% will receive a positive payment adjustment. Participants who scored 100 MIPS points in 2018, will receive a 1.68% positive payment adjustment in 2020.

Positive payment adjustments remain modest in 2020 due to the budget neutrality in the MACRA law and the low performance threshold in 2018. Funds available for positive payment adjustments are limited to the estimated decrease in payments resulting from the negative payment adjustments. But because the performance thresholds have been lower, many providers have qualified to receive a positive payment adjustment. It’s also important to note that Congress provided $500 million for the first six years of the law to fund additional adjustments for exceptional performance. These adjustments are not budget neutral, allowing exceptional performers to achieve higher positive adjustments. As the requirements in the MIPS program become more difficult, CMS expects the bonus levels to increase.

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