Accessing your Quality Payment Program feedback reports

Abstract

The Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA) established the Quality Payment Program (QPP), which shifts Medicare from a fee-for-service to a pay-for-performance program. The QPP requires that most Medicare providers participate in the Merit-based Incentive Payment System (MIPS) or an Advanced Alternative Payment Model (APM). As there are no approved vascular APMs, most vascular surgeons will participate in MIPS. Providers who do not meet 2018 minimum participation requirements will receive a 5% penalty in 2020 reimbursements. The first performance year was 2017, and feedback reports for participating providers are available through the Centers for Medicare and Medicaid Services (CMS) website: https://qpp.cms.gov. QPP participants are required to obtain Enterprise Identity Management (EIDM) credentials to obtain their feedback reports. The EIDM credentials are used to submit and to review data for MIPS reporting. Clinicians submitting data as an individual already have EIDM credentials, whereas someone within small group submissions will also have EIDM credentials or know who in their practice does. Partcipation in QPP as part of a large health care organization or academic institution may present challenges in finding the proper department to help you provide access to your data/feedback reports. Institutions participating as an MIPS APM1White P.W. Sales C.M. Johnson B. Rathbun J. Woo K. What is an MIPS APM?.J Vasc Surg. 2018; 67: 353Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar (distinct from an Advanced APM) are responsible for distributing feedback data to clinicians; CMS will not directly provide feedback data to individuals.2Merit-based Incentive Payment System (MIPS) 2017 Performance Feedback Guide.https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2017-Performance-feedback-user-guide.pdfDate accessed: August 23, 2018Google Scholar If you do not have EIDM credentials, the first step in obtaining your QPP performance report is to create an account within the CMS Enterprise portal (https://portal.cms.gov). Select “PV: Physician Quality and Value Programs” from the application drop-down menu. Enter your demographic information, select a user name, and answer three challenge questions that can later be used to verify your identity. Submit the form, and you should receive an e-mail acknowledging successful account creation with your EIDM user ID. If you are in a large group and need to find out if your practice or organization is already registered in the EIDM, contact the Quality Payment Program by phone (1-866-288-8292/TTY 877-715-6222) or by e-mail ([email protected]). You will need to provide the group's Tax Identifier Number and the name of the group. Again, if your practice has submitted data to QPP, then someone in your group has EIDM credentials and should be able to provide your feedback report to you. With your EIDM credentials, you will be able to log into the CMS Quality Payment Program website, https://qpp.cms.gov. Select the “View Performance Feedback” button to obtain your report and to review all of the practice sites to which data were submitted under your National Provider Identifier and Tax Identifier Number. Based on your EIDM credentials, you may be able to review performance feedback for your entire group or be restricted to individual data. Detailed instructions on accessing performance feedback reports are available in the MIPS 2017 Performance Feedback Guide2Merit-based Incentive Payment System (MIPS) 2017 Performance Feedback Guide.https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2017-Performance-feedback-user-guide.pdfDate accessed: August 23, 2018Google Scholar with examples of reports and interpretations. According to CMS, 91% of MIPS-eligible clinicians successfully submitted data in 2017. High performers will receive up to a 4% bonus in their 2019 reimbursements. A final score of 70 or greater qualifies a provider for an additional bonus adjustment for exceptional performance from a $500 million incentive pool.