5. The performance threshold
will increase from:
30 points to 45 points
That means in 2020, Eligible Clinicians would need to
score at least 45 points to avoid a penalty.
6. Also, you must score a minimum of
80 points
To receive the Exceptional Performance bonus money
14. They will post it as soon as it’s
available (late 2019), as soon as they
can technically get it done.
They will post your aggregate MIPS
score, but include the minimum,
maximum and final scores.
CMS will post
your 2018
performance
on Physician
Compare
25. Total Per Capita Cost (TPCC)
Medicare Spending Per Beneficiary (MSPB)
8 episode-based measures
In 2019, CMS will consider the
following for Cost:
COST
26. They are revising the TPCC & MSPB
measure specifications
And adding 10 new episode-based measures
In 2020:
COST
27. 1. Acute Kidney Injury Requiring New Inpatient Dialysis
2. Elective Primary Hip Arthroplasty
3. Femoral or Inguinal Hernia Repair
4. Hemodialysis Access Creation
5. Inpatient Chronic Obstructive Pulmonary Disease
(COPD) Exacerbation
6. Lower Gastrointestinal Hemorrhage
7. Lumbar Spine Fusion for Degenerative Disease,
1-3 Levels
8. Lumpectomy Partial Mastectomy, Simple Mastectomy
9. Non-Emergent Coronary Artery Bypass Graft (CABG)
10. Renal or Ureteral Stone Surgical Treatment
10 new episode-
based measures
COST
COST
30. At least 50%
of your group
must attest to completing
the improvement activity
for 90 days
Group
Participation
IA
IA
31. • Addition
of 2 new Improvement Activities
• Modification
of 7 existing Improvement Activities
• Removal
of 15 existing Improvement Activities
Measure
Changes
IA
IA
33. The definition of a rural area will now be based on
FORHP’s most recent list of eligible ZIP codes.
(FORHP: Federal Office of Rural Health Policy)
IA
38. In 2019, if you wanted this category
reweighted (meaning your PI category
weight would go to 0 and your Quality
category weight would increase to 70)
your group must have 100% of the
clinicians meeting the CMS definition of a
hospital-based clinician.
Category
changes
PI
PI
39. In 2020, that goes down to 75% of your
group muse meet that definition.
Category
changes
PI
PI