Key Changes in 2018

The Centers for Medicare and Medicaid Services (CMS) updates the Quality Payment Program's requirements and rules annually.  Because 2017 was a transition year, some policies have been changed to increase the threshold for participation in 2018.  Many of the changes pertain to the Merit-based Incentive Payment System (MIPS) track.

  • The low-volume threshold for 2018 is caring for 200 or fewer Medicare Part B patients or submitting $90,000 or less in Medicare Part B charges.  
  • Cost performance will be measured in 2018.
  • Quality performance will contribute a smaller amount to the overall final score.
  • The performance threshold to avoid a negative payment adjustment increased from 3 points to 15 points.
  • Bonus points will be available for small practices.
  • Bonus points will be available for eligible clinicians and practices who care for complex patients.

CMS also laid the groundwork for the All-payer Combination Option in the Advanced Alternative Payment Model (APM) track.  Starting in performance year 2019, ob-gyns and other health care providers may be able to qualify for the 5% bonus in this track by participating in Medicaid and commercial APMs in addition to Medicare models.

Cost-Conscious Cases:

Physicians have a responsibility to our patients and society to “do no harm” which includes providing cost-conscious medical care.

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