QPP

Clinicians

The Quality Payment Program Has Two Participation Tracks

MIPS
Merit-based Incentive
Payment System

 

In MIPS, you may earn performance-based payment adjustments for the services you provide to Medicare patients.

APM
Alternative Payment Model

 

An APM is a CMS customized payment approach designed to incentivize clinicians who are providing high-quality, high-value care. APMs can focus on specific clinical conditions, care episodes, or populations.

Eligible Professional / Eligible Clinician CQMs

Our MIPS experts and ONC-certified CQMsolution software combine to enhance your CQM experience from start to finish. Our focus is optimizing your measure performance and facilitating successful CQM submission. CQMsolution allows you to monitor measure performance, automatically run monthly reports and drill down to analyze patient data and measure logic.

 

DHIT offers expertise in data extraction, measure logic and quality program support. Our efforts are geared toward alleviating organizational burden and giving you peace of mind when deadlines loom. We can also serve as your Qualified Registry (QR) to submit MIPS CQMs, handling submission and follow-up on your behalf. Our goal is for you to spend more time with patients and less time with confusing regulatory requirements.

  • Physicians (including Doctors of medicine [KE3] [NS4], osteopathy, dental surgery, dental medicine, podiatric medicine, and optometry)

  • Osteopathic practitioners

  • Chiropractors

  • Physician assistants

  • Nurse practitioners

  • Clinical nurse specialists

  • Certified registered nurse anesthetists

  • Physical therapists

  • Occupational therapists

  • Clinical psychologists

  • Qualified speech-language pathologists

  • Qualified audiologists

  • Registered dietitians or nutrition professionals

In order to be MIPS eligible, a clinician must:

  1. Identify on Medicare Part B claims as a MIPS eligible clinician type

  2. Have enrolled in Medicare before 2020

  3. Not be a Qualifying Alternative Payment Model Participant (QP)

  4. Exceed the Performance Year low-volume threshold

Start with checking your participation status with CMS tool...

Beginning in Performance Year 2019, the low-volume threshold includes 3 aspects of covered professional services:

  1. Allowed charges

  2. Number of beneficiaries who receive services

  3. Number of services provide

Clinicians and groups fall under the low-volume threshold and are exempt from MIPS if they:

  • Bill $90,000 or less in Medicare Part B allowed charges for covered professional services payable under the Physician Fee Schedule (PFS), or

  • Provide covered professional services for 200 or more Part B-enrolled individuals, or

  • Provide 200 or more covered professional services to Part B-enrolled individuals

MIPS Strategic Partnership

CQMsolution + Registry

Supporting Programs:  MIPS, Primary Care First, CPC+, CCBHC, IQR, and The Joint Commission
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ONC certified 2015 Edition Cures Update bolt-on software for Clinical Quality Measures.

 

CQMsolution is certified for 170.315(c)(1-4) with all eCQMs and a substantial list of non eCQMs. The dashboard provides performance scores and benchmarks for each quality measure. Users can drill-down to view clinical data and see how CQM logic was applied to the patient and whether the patient is in the numerator, exclusion, or exception.

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Since we are the Quality Measure experts, we created a seamless integration between CQMsolution and our MIPS Registry platform.  EHRs have integrated CQMsolution and added an optional Registry partner for their users.  Users review their measures and when ready to submit, they just click a button. 

 

Our MIPS Registry dashboard displays your overall MIPS score and your performance for each Measure Set:

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