Last July the Centers for Medicare and Medicaid Services (CMS) published the 2022 Medicare Physician Fee Schedule proposed rule recommending a number of changes to the Quality Payment Program (QPP), including the traditional Merit-based Incentive Payment System (MIPS) program.
This is the second article in a multi-part series that provides a summary of CMS’s proposed changes to the QPP and how they may affect you. This article focuses on key proposals concerning the cost performance category.
For the 2022 performance year (2024 payment year), CMS is required to increase the weight of the cost performance category to 30% (a 10% increase from performance year 2021). This means MIPS cost measures will play a greater role. Beginning with the 2022 performance year, CMS proposes to add a new chronic condition cost measure –Asthma/Chronic Obstructive Pulmonary Disease (COPD). This cost measure represents the cost to Medicare for items and services rendered for management and treatment of asthma or COPD during an episode of care. View the proposed list of relevant codes for the Asthma/COPD episode group and cost measure.
It is unclear how this cost measure will impact allergists. Prior to the publication of the proposed rule, the Measure Applications Partnership (MAP), a National Quality Forum-convened partnership that provides input to CMS on the selection of performance measures for federal programs, evaluated the candidate measure and ultimately did not recommend the measure for rulemaking “with potential for mitigation.” The Advocacy Council also reviewed and submitted comments regarding the proposed Asthma/COPD Cost Measure and recommended use of the measure be delayed to allow for further testing. Our comments influenced the MAP’s decision to not recommend the Asthma/COPD cost measure for inclusion in MIPS. Notwithstanding the MAP’s determination, CMS has proposed to move forward with the cost measure. The Advocacy Council will continue to urge CMS to postpone moving forward with this cost measure to give allergists more time to become familiar with it.
Read more on the 2022 QPP proposed rule. Find additional information on the Asthma/COPD cost measure in the methodology appendices.
Traditional MIPS comprises four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities. A provider’s score for each of these categories determines one’s total MIPS score and corresponding payment adjustment.
Read the first article on key performance categories, weights and final scoring proposals for the traditional MIPS program. The Advocacy Council – we have you covered.
