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Analysis

CMS Report: 98% of Eligible Clinicians Avoided MIPS Penalty in 2018

By Revenue Cycle Advisor  
   July 13, 2020

The number of clinicians achieving qualifying APM participant status also nearly doubled from 2017 to 2018.

A version of this article was first published July 13, 2020, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

CMS recently released its 2018 Quality Payment Program (QPP) experience report, which includes data on participation and performance in the Merit-based Incentive Payment System (MIPS) during the 2018 performance year. 

According to the report, in 2018 a total of 889,995 clinicians were eligible to participate in MIPS. Of these, 874,515 clinicians, or 98%, participated in the program.

The report also shows that:

  • 97% of eligible clinicians in rural practices earned a positive payment adjustment
  • 84% of MIPS eligible clinicians, or 749,016 eligible clinicians, earned an “exceptional performance” designation by earning 70 points or more
  • 84% of small practices earned a positive payment adjustment

In addition, the report shows an increase in MIPS Advanced Payment Model (APM) participation: 356,353 MIPS eligible clinicians participated in MIPS through an APM, which is a 15,000-clinician increase from the 2017 performance year.

The number of clinicians achieving qualifying APM participant status also nearly doubled from 99,076 in 2017 to 183,306 clinicians in 2018. 

More extensive data on MIPS participation during the 2018 performance year will be released in a separate public use file this summer.

Revenue Cycle Advisor combines all of HCPro's Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly. Learn more.


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