How did allergy/immunology fare with MIPS?

The 2017 Merit-based Incentive Payment System (MIPS) performance results are in, and we now have information on the overall performance of the program, as well as data about how the allergy/immunology specialty fared.

The Centers for Medicare & Medicaid Services (CMS) released its 2017 Quality Payment Program (QPP) Experience Report with an Appendix, which provides a comprehensive overview of the clinician reporting experience during the first year of the QPP.

Allergy/immunology data

  • A total of 2,969 clinicians in the allergy/immunology specialty were required to participate in MIPS in 2017. Of those, approximately 89% participated and 11% did not.

  • The allergy/immunology participation rate of 89.2% was lower than the average participation rate for all clinicians of 94.6%.

  • ‚Äč2017 was a year that included the Pick Your Pace option, which meant eligible clinicians could report just one measure to avoid a penalty. 172 allergy/immunology clinicians chose this option to do the bare minimum and avoid a penalty.

  • 2,209 clinicians in allergy/immunology (86.3% of those participating in both MIPS and APMs) reported measures within the allergy/immunology specialty measure set.
  • See the top 10 reported Improvement Activities for allergy/immunology.
  • See top 10 Promoting Interoperability (PI) measures reported by allergy/immunology.
  • These reports don’t include any data on 2017 Advanced APM participation for allergy/immunology clinicians.

All clinicians

  • In total, 95% of all clinicians required to participate in MIPS avoided a negative payment adjustment in 2019 based on 2017 performance.
    • 93% earned a positive payment adjustment.
    • 2% avoided a penalty.
  • But bonuses were small because the program was required to be budget-neutral.
    • 22% earned bonuses of 0.2% or less.
    • 71% earned exceptional bonuses due to top performance. But those bonuses ranged from only 0.28% to 1.88%.
  • Penalties were steep: 5% of all clinicians received penalties ranging from -2.1% to -4.0%.
2019 Payment Adjustments (based on 2017 performance)*
Payment Adjustment TypePercent of TIN/NPIMin Final ScoreMax Final ScoreMinimum Payment AdjustmentMaximum Payment Adjustment
Negative Payment Adjustment5%0.001.42-2.11%-4.00%
Neutral Payment Adjustment2%3.003.000.00%0.00%
Positive Payment Adjustment22%3.0269.990.00%0.20%
Positive with additional adjustment for exceptional performance71%70.00100.000.28%1.88%
*Excludes clinicians who were Qualifying APM Participants (QPs) in an Advanced APM as well as Partial QPs who did not elect to participate in MIPS. The table reflects payment adjustment status prior to any targeted reviews.

 

  • Of all the eligible clinicians who participated in MIPS, 54 percent did so as groups, 12 percent as individuals, and 34 percent through MIPS APMs.

Steps for 2019

Penalties for not participating in 2019 will be much steeper: up to -7%. So check your participation status today and take the required steps to avoid a penalty. For more info on 2019 MIPS requirements, read the Advocacy Council’s summary of changes for 2019.

Advocacy Issue: 
MIPS