The QPP program promised bonuses of “up to 4%” in 2019 for clinicians’ reporting achievements in the first year of MIPS performance. But in reality, eligible clinicians are finding that their bonuses are more in the neighborhood of 2% of their Medicare Allowable payments.
That’s because of the QPP program’s budget neutrality policy, which requires that the money the program pays out should equal the amount it takes in. Unfortunately, there were many more MIPS high-achievers than there were MIPS failures. That means a higher number of clinicians qualified to receive the bonus than those who are destined to pay for it with a penalty to their Medicare allowable fees.
According to CMS, 71% of MIPS participants not only earned a positive adjustment, they also qualified for an adjustment for exceptional performance – that is, they earned 70 points or higher for their MIPS reporting in 2017. An additional 22% of clinicians qualified for a bonus by scoring between 3.01 and 69.99 points in the program -- to a maximum of 0.2% -- while 2% avoided the penalty by earning three points.
About 5% of participants managed to earn 0 points, meaning that Medicare will be exacting a 4% penalty from their Medicare fees in 2019.
In total, that’s 93% of participants who qualified for a bonus and 5% who will be paying for it – which adds up to a smaller increase for everybody.
CMS plans to continue to raise the bar for successful MIPS participation, so participants should not take this as a cue to slack off. Instead, adopt a realistic perspective about the potential size of your bonus and remember, CMS did say it would be “up to” 4%.
Take a look at the 2017 QPP Performance Data Infographic for yourself
here.