Medicare released the final scores for the 2017 MIPS reporting year in early July 2018.

Scores are accessible through the Quality Payment Program Portal (https://qpp.cms.gov/login). Medicare has not announced plans to distribute the results in any other way.

To access the QPP Portal, you must have an Enterprise Identity Management (EIDM) account with CMS. If you have dodged the EIDM sign-up so far, you will need it to access your 2017 scores. Instructions for getting your EIDM credentials and accessing the portal are available on the CMS website here.

It was an unexpected pleasure to see the final scores out so early this year. They have been a mixed bag so far:

• The feedback reports are simple, reasonably thorough, and easy to read.
• The scoring appears to be generally accurate, although we have observed some errors. You should review your scores as soon as possible, since there are only 60 days from the release of the data to file an appeal if you disagree with the results.

Here are some common questions:

Q: What is the maximum incentive possible for the 2017 MIPS reporting year?

1.88% is the maximum possible MIPS incentive for the 2017 MIPS reporting year. If you earned a final 2017 MIPS score of 100, the positive incentive will be 1.88% added to each Medicare payment for 2019 services.

Q: Isn’t 1.88% an awfully small reward for all the work we did? I thought it was 4% or even higher?

The first few years of the program are “transition years” which make it easy to avoid the penalty and the rewards are less as a result. The adjustments are budget neutral, except for the exceptional performance bonus. The adjustments for those who receive a penalty for fewer than three points are redistributed to those earning three points and above.

CMS reports that 91% of the providers required to report for MIPS were successful in avoiding the penalty, so there wasn’t very much money to redistribute to those earning more than three points. Those who earn 70 points and above, participate in the exceptional performance bonus of $500,000 and that is distributed to all practices earning over 70 points.

5.88% is arguably a better measure of your true reward. You would have lost 4% if you had made no effort at all for 2017. By achieving a perfect score, you avoided the 4% loss AND earned an additional 1.88% (4% loss avoided + 1.88% incentive gained = 5.88% improvement compared a negative adjustment.)

Q: How is the exceptional performance bonus accounted for?

The calculated adjustment includes both the performance bonus and the additive exceptional performance bonus.

• Exceptional Performance payments are distributed from a $500 million bonus pool. Payments begin at the Exceptional Performance threshold score of 70 with an adjustment of approximately 0.5% and rise on a graduated scale for maximum payments for scores of 100 for an adjustment of approximately 1.5%.
• Exceptional Performance calculations include a “scaling factor” to assure that full distribution of the $500 million pool.
• Payments for the 2018 Reporting Year It will be paid as part of the calculated adjustment added to each CMS payment against charges for 2019 services.

Q: What do I do if your Final Score is wrong, or if you disagree with your final score?

There are several known issues in the CMS QPP Portal User Interface that may make your score appear to be incorrect when it is, in fact, correct, and vice-versa. Please review the information carefully. If you wish to appeal your score, CMS has released a new process called Targeted Review allowing practices and providers to make the case that their score is incorrect. The deadline is currently October 15, 2018 (an extension from the previous date of October 1, 2018). Learn more with this CMS Targeted Review Fact Sheet and User Guide.

Mingle Health Customers: your Consultant is standing by to assist you in reviewing your score. Read our FAQ about 2017 Final Scores and Targeted Review here (you’ll be asked to log in to your Mingle account).

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