Passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) resulted in implementation of the质量付款方案, a Medicare payment system designed to reward physicians for delivering high-quality, cost-effective care. The program is comprised of the following two participation tracks:
- Advanced Alternative Payment Models (APMs)
If you decide to participate in an Advanced APM through Medicare Part B, you may earn a 9% incentive payment for engaging in an innovative payment model and will not need to participate in MIPS. Since sleep clinicians can only participate in an Advanced APM if they are affiliated with a large academic institution or healthcare center, most will select the MIPS track. If you choose to participate in MIPS, you will earn a performance-based payment adjustment based on submission of evidence-based and specialty-specific quality data.
Providers participating in MIPS will earn a performance-based adjustment by reporting patient care data, as well as reporting how their practice used technology during the year. An eligible provider can report as an individual, group, or virtual group. Your MIPS score is calculated using four weighted performance categories: Quality (45%), Improvement Activities (15%), Promoting Interoperability (25%) and Cost (15%). Each performance category has a maximum point value assigned to it, as well as a length of time over which data must be collected. Please note that Cost data does not have to be submitted, as Medicare Part A and B claims data are used to calculate cost measure performance.
Providers are eligible for the MIPS track if all of the following criteria are met:
- You bill more than $90,000 per year in Medicare Part B allowed charges
- You provide more than 200 Medicare professional services
- You are one of the following:
- Clinical psychologist
- Occupational therapist
- Qualified speech-language pathologist
- Qualified audiologist
对于2021年的性能年，CMS再次实施了极端和无法控制的情况政策。该政策允许符合条件的临床医生，组和虚拟组提交申请，要求重新加入基于优质的激励支付系统（MIPS）绩效类别，由于Covid-19。The 2021 extreme and uncontrollable circumstances application is open through December 31, 2021, 8 pm ET。Extreme and Uncontrollable Circumstances applications will be reviewed on a case-by-case basis, and if approved, the performance categories included in the application are weighted at 0% and will not contribute to the participant’s final score unless MIPS data are submitted for the 2021 performance period. In some instances the Extreme and Uncontrollable Circumstances exception will be automatically applied. Learn more aboutCovid-19灵活性。
The AASM has several quality measures included in the Quality Payment Program for 2022.
MIPS.Clinical Quality Measures (CQMs):
- Sleep Apnea: Severity Assessment at Initial Diagnosis
- Sleep Apnea: Assessment of Adherence to Positive Airway Pressure Therapy
- Pediatric OSA: Objective Assessment of Positive Airway Pressure Therapy Adherence