CMS revises MIPS through final rule — 5 insights

CMS' reworked the Merit-based Incentive Payment System, to simplify reporting requirements for providers in its 2020 Physician Fee Schedule Quality Payment Program Final Rule.

What you should know:

1. The reworked MIPS is one of several changes in the rule, which goes into effect, Jan. 1, 2021. In the reworked system, providers will be able to pick which clinical and specialty-related measurement sets are relevant to their practice and report stats towards that.

CMS said the reworked framework will allow patients to compare physician performance based on a combination of the measures, a set of claims-based population measures and a set of interoperability measures. "In this way, [physicians] will be held accountable for fewer but more meaningful measures," CMS wrote in the rule.

2. The rule also aimed to redefine Medicare and improve physician reimbursement. Through the rule CMS will update the evaluation and management service documentation and coding framework physicians use to bill Medicare. CMS said the updates will allow physicians to spend more time with patients and less time documenting visits.

3. As part of those updates, CMS is increasing the reimbursement rate for office-based and outpatient E/M visits. CMS will also increase payments for "certain types of visits." CMS Administrator Seema Verma said the updates will combat growing physician burnout.

4. CMS additionally revised its rules related to physician assistants, deferring to state law and scope of practice requirements. While CMS will no longer require PAs to practice under the guidance of a physician, state laws could still mandate the requirement.

5. Finally, CMS created a new reimbursement system, Principal Care Management, that aims to help patients with chronic conditions. CMS will increase payment to physicians who deal with transitional care as chronic patients move from the hospital to follow-up care. CMS will also reimburse physicians who spend time providing care management services.

Read the full rule here.

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