What 2021 changes to Medicare's Quality Payment Program mean for anesthesiologists


The next iteration of Medicare's Quality Payment Program will become harder for anesthesiologists to comply with, according to a blog post by Tony Mira, founder of Anesthesia Business Consultants, a MiraMed company.


1. In 2021, the Quality Payment Program updated requirements for participants to include 70 percent of all eligible patients within the program.

2. CMS increased the number of Merit-based Incentive Payment System points needed to avoid penalties from 45 in 2020 to 60 in 2021.

3. The quality category for the Merit-based Incentive Payment System is worth 40 percent of the score, while cost is 20 percent, promoting interoperability is 25 percent, and improving activities is 15 percent. Anesthesiologists are typically exempt from the interoperability measures, so the quality score becomes 65 percent of their total score.

4. CMS increased the penalty for not meeting requirements in 2021. Physicians who don't meet the requirements this year will have their 2023 Medicare Part B payments lowered by 9 percent.

5. Next year, CMS plans to implement the MIPS Value Pathways initiative, which allows providers to submit metrics from different categories as a bundle. "This could potentially lessen the reporting and submission burden for anesthesia, given that most practices are already compliant with all the quality measures available and report several improvement activities," wrote Mr. Mira.

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