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  • CMS Reports High Levels of Participation in MIPS; Will It Be Expanded to PTs in 2019?

    Things are looking good for the Merit-Based Incentive Payment System (MIPS), according to the US Centers for Medicare and Medicaid Services (CMS). According to CMS, participation in MIPS—which could be required of physical therapists (PTs) as early as next year—was just above 90% during its first year of operation.

    The 91% clinician participation rate was slightly better than the CMS goal of 90%, and included particularly strong performance from accountable care organizations and physicians in rural areas, which reported at rates of 98% and 94%, respectively, according to a blog post from CMS administrator Seema Verma. Beginning in 2019, clinicians can earn Medicare payment increases or face penalties based on quality reporting data provided through the program.

    MIPS is part of a broader effort by CMS to shift toward value-based payment systems through the Quality Payment Program (QPP). Under QPP, providers can choose 1 of 2 paths: reporting through MIPS, or participating in an Advanced Alternative Payment Model (AAPM). MIPS requires reporting in 4 performance categories—quality, promoting interoperability, clinical improvement activities, and cost. Providers earn points in each category, producing a total annual MIPS score, which in turn determines whether the providers earn a payment incentive, remain neutral in payment, or be subject to a penalty. Several of the data points must be reported electronically through certified EHR vendors or registries like APTA’s Physical Therapy Outcomes Registry.

    Although PTs are not yet required to report outcomes through MIPS, they can participate voluntarily—an option strongly encouraged by APTA, given that all indications point to PTs being required to participate in MIPS or APMs as early as 2019. CMS is expected to make its decision on the inclusion of PTs in MIPS in early July 2018.

    According to Verma, while CMS presses for broader participation in MIPS, it will remain "committed to removing more of the regulatory burdens that get in the way of doctors and other clinicians spending time with their patients" through its "Patients Over Paperwork" initiative.

    "We’re also eager to improve the clinician and patient experience through our Meaningful Measures initiative so that clinicians can spend more time providing care to their patients and improving the quality of care their patients receive," Verma writes. "Within MIPS, we are adopting measures that improve patient outcomes and promote high-quality care, instead of focusing on processes."

    Get ready for the future of PT payment: APTA offers a wide range of online resources on value-based care in general and MIPS in particular, including a readiness self-assessment quiz, a podcast series, a video, a frequently-asked question page on MIPS, and more. Additionally, APTA's Physical Therapy Outcomes Registry has earned "qualified clinical data registry" status from CMS, meaning that PTs who participate in MIPS can use the PTOR to submit their data to CMS.


    • Please do NOT push for PTs to be required to do even more paperwork! I am highly opposed. If the APTA continues to push for this, I may no longer support it. Too much paperwork already! Stop pushing for more!!

      Posted by Joanna on 6/6/2018 1:23 PM

    • I hope APTA is not talking to CMS and encouraging them to add PTs to MIPS. MIPS is PQRS on steroids and does not measure outcomes. Just more useless data and most PTs and PT practices wouldn't have to report MIPS due to low-volume threshold.

      Posted by Rick Gawenda -> =IY`?L on 6/6/2018 5:42 PM

    • Would like hear more. Specific on Acute care vs Outpatient. Outpatient in hospital vs in community outpatient clinics, etc.

      Posted by Sabrina on 6/6/2018 9:33 PM

    • Unless Medicare is willing to cover all the costs of physical therapists putting in place the infrastructure for electronic healthcare records medical records keeping - like they did for MDs a few years ago (e.g. costs for EHR system, staff and documentation time), I absolutely do not support our profession joining MIPS. I base this on my own professional experience for the last years with PQRS and preparing for MIPS. I have had to cut my patient caseload by at least a quarter to make time to keep up with all of the documentation. I see MIPS without huge financial incentives for PTs/PTAs as a push into major burnout for those participating in this tedious and time-consuming program.

      Posted by Lise McCarthy, PT, DPT, GCS on 6/7/2018 1:07 PM

    • I agree with abouve coments. CMS must pay for EHR and QPP. I already complained to inpector general How this new system killing low volum Physical therapy clinics. APTA has no idea. IS APTA working for CMS or big group of physical therapy clinic and killing low volum physical therapy clinics?

      Posted by Deepak S on 6/8/2018 9:09 AM

    • This is a HUGH mistake. Useless and worthless! for Therapist. Sorry

      Posted by Darlene R. on 6/14/2018 8:32 AM

    • "... an option strongly encouraged by the APTA"??? Yes, this is just what we need ... LIKE A HOLE IN THE HEAD!!! More paperwork, more useless data collection, more imposition upon patients, more wasted time, etc. Where does this all stop?. This stick-and-carrot approach may be fine for training animals but I personally find it dehumanizing, demeaning, insulting, wasteful, and useless. Count me out. Count me out of APTA membership as well if they support something like this. This is insanity!

      Posted by Brian Miller on 6/22/2018 11:42 PM

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