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Get your MIPS motor running: CMS releases specs for individual reporting

Clinicians who have have been anxious to start the next round of merit-based incentive payment system (MIPS) participation will be delighted to learn that the bulk of measures specifications information is now available for this year. All other clinicians who need to participate to protect their payments also should review the updated information and get a start on MIPS year 2.
Clinicians who intend to participate in MIPS as a group or in the Quality Payment Program through an advanced alternative payment model should keep checking the page; the 2018 Resources website has slots for that information but nothing was live when this blog post was written.
Quality measure specification documents. Start with this .zip file. It contains a lot of important information including the release notes for claims-based and registry measures. Clinicians who intend to report the same measures they reported in 2017 should check these documents first. PBN analysis of the release notes found that nearly half of the measures that were carried over from last year contain changes that will impact the way clinicians perform and report measures in 2018.
Other documents in the file include the 2018 measures list. This Excel sheet is a good place for a clinician who is selecting new measures to start. The filters make it easier to manage the list of more than 270 measures. The filters will be especially helpful if CMS doesn’t create a measure search tool this year. For example, the data-submission filters will let you quickly reduce the list to the measures that can be reported through a specific method, such as claims. Filtering on a specialty will pare the list down to the measures CMS has identified as potentially being appropriate for a clinician of that specialty.
You’ll find the single source masters for claims and registry measures in the file. And something new this year: a measures tag file. The file provides at-a-glance information about codes, such as how often the clinician needs to report the measure, reporting methods and additional analytic logic or guidance.
Quality measure specifications, which include nine files for individual claims and registry measures and documents for web interface – formerly known as GPRO – measures.
If you want to see the eight new measures, skip straight to the file labeled Claims Registry Measures 401-467 and look for measures 459-467.
Quality benchmarks have been updated. The file includes more information about how benchmarks – including the topped measures – will be scored in 2018.
Cost measures. That’s right, cost is back this year and will account for 10% of the overall MIPS score. The file contains detailed documents about the two measures: Medicare spending per beneficiary (MSPB) and total per capita costs for all attributed beneficiaries (TPCC).
Improvement activities. Check this file for a list of the 113 improvement activities that are available for 2018. There’s a PDF version of the file which may be easier for clinicians to review. The Excel sheet allows the user to filter on subjects like the activity weight.
Advancing care information (ACI) measure specifications. Last but not least are the two files that contain the 15 measure specifications and the 11 transition measure specifications. The clinician should review each one to make sure she selects and performs measures that are appropriate to her practice. The HHS Office of Inspector General and the Department of Justice are already on the hunt for people and practices that falsely claim they earned a bonus under the meaningful use program, which ACI replaced. The latest example is a national oncology practice that paid $26 million to settle allegations that it had falsely attested to its meaningful use participation and violated Stark law.
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