Understanding the Impact of the Final Rule

November 9, 2017

The Centers for Medicare & Medicaid Services (CMS) finalized modifications to the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) participation options and requirements for 2018. In the Quality Payment Program Year 2, here is how CMS adopted 2018 policies to further reduce burden and give more ways to participate successfully. CMS is keeping many transition year policies and making some minor changes including:

  • Raising the performance threshold to 15 points in Year 2 (from 3 points in the transition year)
  • Increasing the reporting period for the quality component of MIPS from 90 days to one calendar year
  • Allowing the use of 2014 Edition and/or 2015 Certified Electronic Health Record Technology (CEHRT) in year 2 and giving a bonus for using only 2015 CEHRT
  • Increasing the low-volume threshold exclusion to $90,000 in Medicare Part B allowed charges or 200 Medicare Part B patients
  • Counting the cost component as 10% of the MIPS final score
  • Offering a virtual group option for solo practitioner and small practices to aggregate their data for shared MIPS evaluation
  • Giving up to 5 bonus points on your final score for treatment of complex patients
  • Automatically weighting the Quality, Advancing Care Information, and Improvement Activities performance categories at 0% of the final score for clinicians impacted by hurricanes Irma, Harvey and Maria and other natural disasters.
  • Adding 5 bonus points to the final scores of small practices

Quality Payment Program Final Rule Fact Sheet:

Quality Payment Program Year 2 Public Webinar
Date: Tuesday, November 14, 2017
Time: 1:00 – 2:30 pm ET
Registration Link:

Virtual Groups Public Webinar
Date: Tuesday, November 21, 2017
Time: 1:00 – 2:00 pm ET
Registration Link

Please stay tuned to HQI for additional information and analysis on the rule. If you need help with MIPS in 2017 or are planning ahead to 2018, please reach out to us at or 1-844-357-0589.

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